Job Description
Job Summary
Leads and manages team responsible for process improvement initiatives that result in operational efficiencies and/or increase customer satisfaction. Assists in development of enterprise process improvement methodologies and the implementation of business process improvement capabilities.
Job Duties
• Oversees program development, implementations and process improvement initiatives.
• Assesses business and operational needs for opportunities to improve efficiency, productivity, effectiveness, and accuracy.
• Collaborates with senior leadership to develop and deploy an organizational strategies to optimize workflows.
• Uses Lean and Six-Sigma methodologies to create and maintain a culture of continuous improvement.
• Develops and conducts process improvement trainings.
• Conducts meetings and disseminates communications related to process improvement activities.
• Hires, trains, develops and manages team demonstrates accountability for team performance and achievement of quality/department-specific goals.
Job Qualifications
REQUIRED QUALIFICATIONS:
• At least 7 years of health care operations, process improvement and/or lean management experience, or equivalent combination of relevant education and experience.
• At least 1 year of management/leadership experience.
• Understanding of all areas of health plan operations including: claims processing, customer service/call center, provider contracting, benefit design and configuration, product development, membership accounting and enrollment, operational systems, provider contracting, authorizations/referrals, and utilization management.
• Experience with Medicare, Medicaid, and Marketplace plans.• Understands key revenue levers and cost drivers of business processes.
• Understanding of critical success factors for the industry.
• Experience designing and delivering solutions related to operational improvement functions.
• Ability to work cross-collaboratively across a highly matrixed organization and establish and maintain effective relationships with internal and external stakeholders.
• Strong organizational and time-management skills ability to manage simultaneous projects and tasks to meet internal deadlines.
• Strong verbal and written communication skills.
• Microsoft Office suite (including Excel), and applicable software programs proficiency.
- Lead end‑to‑end process improvement initiatives, from problem identification through implementation and measurement
- Analyze current‑state workflows and system behavior to identify inefficiencies, risks, and improvement opportunities
- Define future‑state processes supported by data, clear metrics, and operational outcomes
- Establish KPIs and success measures to track adoption and performance improvements
- Serve as a subject‑matter expert across core operational platforms, with a strong understanding of how system design and data impact business processes
- Understand upstream and downstream data flows and how system changes affect operational performance and reporting
- Partner closely with IT, Product, and Operations teams to support system enhancements, process changes, and analytics continuity
- Translate system and operational data into actionable insights that inform process decisions
- Ensure accuracy, consistency, and usability of reporting tied to operational workflows
- Partner with analytics and reporting teams to ensure dashboards and metrics accurately reflect operational workflows
- Act as a trusted partner to Sales, Agent Operations, and Member/Provider teams
- Communicate complex process and system insights clearly to both technical and non‑technical stakeholders, including leadership
- Manage timelines, dependencies, and delivery commitments across multiple concurrent initiatives
- 4+ years of experience in process improvement, operational excellence, business intelligence, or analytics roles
- Required hands‑on experience supporting operational processes and data management for the following platforms:
- Salesforce (CRM)
- Genesys (Telecom)
- Member, Provider and Broker
- Proven ability to translate complex, multi‑system data into process improvements and operational insights
- Experience operating in integrated, enterprise system environments
- Strong communication, organization, and problem‑solving skills
- Salesforce Administrator Certification
PREFERRED QUALIFICATIONS:
• Lean certification and/or Lean Six Sigma black belt.
• Health care related process improvement experience with demonstrable successes in application of Lean/Six Sigma.
To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
Skills Required
- 7+ years healthcare operations, process improvement, or lean management experience
- 1+ year management or leadership experience
- Understanding of health plan operations (claims, customer service, provider contracting, benefit design, enrollment, utilization management)
- Experience with Medicare, Medicaid, and Marketplace plans
- Hands-on experience supporting operational processes and data management for Salesforce (CRM)
- Hands-on experience supporting operational processes and data management for Genesys (Telecom)
- Proven ability to translate multi-system data into process improvements and operational insights
- Experience operating in integrated, enterprise system environments
- Strong verbal and written communication, organization, and problem-solving skills
- Proficiency with Microsoft Office suite (including Excel) and applicable software
- 4+ years in process improvement, operational excellence, business intelligence, or analytics roles
- Salesforce Administrator Certification
- Lean certification or Lean Six Sigma Black Belt
What We Do
Molina Healthcare Inc. is dedicated to delivering effective, reliable, and affordable health care to those who need it most. The company focuses on improving the health and well-being of its members and positively impacting the communities it serves. Recognized as a leader in the health insurance category, it provides essential healthcare services to ensure accessible and quality care for its members.

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