Process Excellence Manager

Role Summary The Black Belt – Manager will lead end-to-end process excellence, quality transformation, and productivity programs across Healthcare Claims operations (Commercial, Medicare, Medicaid, Specialty). The role is responsible for driving measurable business outcomes through Lean Six Sigma, RCA-driven improvements, automation enablement, and cross-functional governance while partnering closely with Operations, Quality, Training, WFM, and Client stakeholders. 1. Transformation & Continuous Improvement Lead Lean Six Sigma Black Belt projects across Claims (Intake, Adjudication, Adjustments, Appeals, EDI, Correspondence).Drive defect reduction, rework elimination, and cycle time improvement using DMAIC / Lean methodologies.Identify and execute high-impact transformation opportunities aligned to business priorities and client KPIs.Own end-to-end project lifecycle from problem definition to benefit realization and sustainment. 2. Quality & RCA Leadership Conduct deep-dive RCA using People | Process | System | Technology frameworks.Lead Pareto analysis, FMEA, trend analysis, and defect heatmaps for escalations, audits, and quality failures.Partner with Quality teams to improve OAR, financial accuracy, compliance scores, and audit outcomes. 3. Claims Domain & Client Value Creation Apply strong US Healthcare Claims knowledge across Commercial, Medicare, Medicaid, and Specialty lines.Work closely with UHG stakeholders to align process improvements with payer policies and regulatory requirements.Support client governance, business reviews, client visits, and escalations with data-backed insights.Translate operational improvements into quantified benefits (QNI, BVM, FTE productivity, cost savings). 4. Automation & Digital Enablement Identify opportunities for RPA, AI, analytics, and system-led automation across claims processes.Collaborate with Automation / IT teams on solution design, deployment, and benefit tracking.Drive manual exception reduction and touchless processing improvements. Required Qualifications & Experience Education Bachelor’s degree (Engineering / Healthcare / Business preferred)Certifications Lean Six Sigma Green Belt (Certified – Mandatory)PMP / Agile certification – good to haveAny programming / Coding would be an advantageExperience 10–15+ years total experience, with 5+ years in US Healthcare ClaimsProven experience leading Black Belt–level transformation programsStrong hands-on knowledge of:Claims adjudication & processing workflowsUS healthcare regulations & payer guidelinesRCA tools, statistical analysis, and storytelling for leadership/client forums Skill Set Core Skills Lean Six Sigma (DMAIC, SPC, Hypothesis Testing)RCA / FMEA / Pareto / Control PlanningClaims domain expertise (Commercial / Medicare / Medicaid)Data analytics & insight storytellingStakeholder & client managementBehavioural Competencies Outcome-driven mindsetStructured problem solvingExecutive communication & influenceStrong ownership and accountabilityCoaching & people development