Senior Process Improvement Professional

Accountabilities: Analyze LTSS operational workflows to identify opportunities to improve efficiency, quality, regulatory compliance, member outcomes, and contract performance.

Partner with Care Management, Utilization Management, Quality, Reporting, Provider, Compliance, and other teams to redesign and implement effective operational processes.

Develop standardized workflows, policies, procedures, audit tools, process documentation, and operational resources supporting LTSS programs.

Monitor contract and regulatory requirements and coordinate operational changes needed to maintain compliance.

Conduct root cause analyses of operational issues, performance gaps, audit findings, grievances, appeals, and quality concerns.

Analyze reporting and performance data to identify trends, develop actionable recommendations, and measure the effectiveness of process improvements.

Facilitate process mapping, workflow redesign, training, and change management initiatives across multiple business functions.

Support state-directed initiatives, regulatory changes, EVV-related processes, assessment requirements, and other LTSS program enhancements.

Develop KPIs, monitoring tools, and performance measures to evaluate operational effectiveness and process outcomes.

Research industry best practices and emerging trends across Medicaid, HCBS, LTSS, care coordination, and healthcare quality improvement.

Prepare presentations, reports, and executive summaries that communicate findings, recommendations, project progress, and performance metrics to leadership and key stakeholders.

Serve as a subject matter resource for continuous improvement methodologies and operational excellence initiatives.

Requirements

Bachelor’s degree required.

At least 3 years of experience in process improvement, healthcare operations, quality improvement, project management, or a related discipline.

Professional experience within healthcare, managed care, Medicaid, LTSS, HCBS, or population health environments.

Demonstrated ability to interpret operational and performance data and translate insights into effective business decisions.

Proven experience analyzing business processes, identifying root causes, and implementing improvements that enhance performance, efficiency, and quality.

Advanced proficiency with Microsoft Office applications, particularly Excel and PowerPoint.

Excellent written and verbal communication skills, including the ability to present process improvement opportunities, project updates, and performance results to leadership.

Strong project management, analytical, organizational, and problem-solving capabilities.

Ability to collaborate effectively with cross-functional stakeholders and manage multiple initiatives simultaneously.

Must reside in Michigan or within a 40-mile radius of the Michigan border in Ohio or Indiana.

A master’s degree in healthcare administration, business administration, public health, or a related field is preferred.

Lean, Six Sigma, PMP, or another relevant process improvement certification is preferred.

Experience with Michigan Medicaid and LTSS programs is preferred.

Knowledge of Michigan HCBS waiver requirements and applicable regulatory standards is preferred.

Experience supporting state contract compliance, audits, or quality improvement initiatives is a plus.

Benefits

Annual salary range of $78,400–$107,800 , with individual compensation varying based on location, experience, education, certifications, skills, and other job-related factors.

Eligibility for a performance-based bonus incentive plan.

Remote work arrangement with occasional business travel.

Up to 10% travel, including periodic visits to a Michigan office for team engagement, collaboration, training, and meetings.

Monday–Friday schedule, generally 8:00 AM–5:00 PM Eastern Time .

Medical, dental, and vision insurance benefits.

401(k) retirement savings plan.

Paid time off, company holidays, and personal holidays.

Paid parental and caregiver leave.

Short-term and long-term disability coverage.

Life insurance.

Additional benefits and resources designed to support whole-person wellbeing.

Remote-work support requiring a dedicated workspace and reliable internet connection suitable for secure handling of protected health information.

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