We are seeking a highly skilled and experienced Six Sigma Business Optimization Specialist with an interest in artificial intelligence (AI) initiatives. The ideal candidate will have a strong background in Six Sigma methodologies and a passion for artificial intelligence to drive process optimization.  

This role will be expected to support the HealthRules Payer Consulting Services team in the realization of continual optimization of operational effectiveness.  

• Process Improvement:  

• Utilize Six Sigma methodologies to identify process gaps, issues, pain points. 

• Provide recommendations for people, process, technology and data improvements 

• Drive and deliver process optimization projects 

• AI Integration: Lead the integration of AI technologies into business processes to enhance efficiency and decision-making as well as recommending AI enabled process automation 

• Change Management: Develop and manage optimization changes to consulting processes to improve efficiency, quality, service, and profitability 

• Data Analysis: Analyze data to identify trends, inefficiencies, and opportunities for improvement. 

• Stakeholder Communication: Communicate effectively with stakeholders at all levels of the organization. 

What you will do: 

Business Process Optimization 

• Support the development and operationalizing of departmental processes and initiatives by working with Consulting leaders and PMO to help define requirement of playbooks and other process documentation for such initiatives 

• Analyses / Recommendations for Process Optimization 

• Analyze gaps, pain points, current challenges faced and automated solutions to facilitate efficient support of the audit with emphasis on process and software development best practices, quality, and timely delivery. 

• Analyze, assess and develop best practices to solve complex business problems related to people, process, technology and data 

• Analyze and assess how automated systems be implemented to solve complex business problems. 

• Partner with Business and Engineering teams and summarize risks, insights and recommendations 

• Recommend changes to address deficiencies and/or further improve and streamline processes based on analytical findings. 

• Identify / create best practices for different processes, especially those owned by Consulting team in a cross-functional scenario. 

• Act as a liaison with other cross-functional groups to promote cohesion and efficiency across the organization. 

• Evaluate current processes to identify how to leverage AI within the day-to-day operations of the Consulting Services team. 

• Support commercialization of new products by facilitating repeatable processes and managing acceptance criteria for Consulting Services’ ability to support the new offering. 

What you bring (Education, Experience and Abilities): 

• Bachelor's degree in Business, Engineering, Computer Science, or related field. 

• Certified Six Sigma Black Belt. 

• Mandatory experience – In US Healthcare (Payer Industry preferred) 

• Knowledge of Healthcare Payer operations from Enrollment through Claims Payment and other ancillary functions.  

• Deep knowledge of healthcare payer business functional areas, business management issues and implementation methodologies. 

• Proven experience in business process improvement using Six Sigma methodologies. 

• Expert knowledge around latest automation technologies (RPA etc.).  

• Experience with AI technologies and their application in business processes. 

• Strong project management skills. 

• 3+ years of experience in Business Process Re-Engineering, process excellence & process improvement. 

• Develop process maps and function steps with the knowledge gained during process study 

• Experience handling Non-IT processes. 

• Excellent documentation skills. Expertise in Visio, PowerPoint, Word and Excel 

•  Communicates With Impact: Presents information and ideas in a thoughtful and compelling manner. Is clear and concise in verbal and written communications. Shares information freely and speaks openly and honestly. Seeks to understand the perspectives of others. 

• Experience in group facilitation & interviewing 

• Drives and Delivers Results: Sets clear priorities, takes action, stays focused, and overcomes barriers to deliver expected results. 

• Flexible in adapting to changing priorities. 

• Self-motivated, proactive, and able to work well under pressure in a fast-paced, results-oriented environment. 

• Solves Problems and Makes Good Decisions: Evaluates critical information needed to understand problems, determine probable causes, and develop workable solutions. Accurately assesses the costs, benefits, and risks associated with alternative courses of action and makes high quality and timely decisions. 

• Leads Change: Sees emerging patterns and opportunities. Adapts quickly and easily to new information, changing conditions or unexpected events. Facilitates and communicates change across the team or organization to drive adoption. 

• Information Security and Compliance: Demonstrates understanding of HealthEdge’s policies, procedures, and external regulatory requirements, and performs duties in accordance with such regulatory requirements. Assures confidentiality and security of all data. Demonstrates the skills, knowledge, and ability to ensure that our environment is a safe one, complying with industry standards.