AVP, Process and Perf. Optimization

Operations At EmblemHealth

Drive organizational efficiency and effectiveness by optimizing business processes. Lead teams, develop strategies, and implement changes to improve workflows, reduce costs, and enhance overall performance.

Provide oversight for identifying, quantifying, and minimizing inefficiencies; streamlining workflows; and developing and implementing strategies / technologies / processes to improve productivity and reduce costs.

Utilize a holistic understanding of business processes to determine how changes in one system may impact other parts of the business.

Assess internal organizational structures; rearrange hierarchies and workflows to improve efficiency. Work alongside department heads and team members to communicate the importance of efficient processes and lead change initiatives effectively. Research new equipment, techniques, and technologies to incorporate into the business.

Gather and analyze data to understand current performance and identify root causes of issues; map workflows and analyze existing business processes to identify bottlenecks, inefficiencies, and areas where improvements can be made; determine how processes impact production, quality, and customer satisfaction, and identify root causes of problems.

Collect information about current procedures, outputs and metrics to develop a baseline of how the company works.

Compare internal processes to industry standards or competitor performance to identify gaps and set goals. Use historical business data to assess the cost and benefit of each business system and process.

Collaborate with departments to design improvement strategies that align with the organization's goals. Work with cross-functional teams to gather input, implement changes, and ensure buy-in. Develop implementation plans and develop step-by-step procedures and timelines for each modification.

Create process maps to visualize workflows and document current processes. Use theoretical modeling to predict the results of system and process changes.

Assemble, motivate and guide selected small teams through process improvement initiatives, fostering a culture of continuous improvement. Lead projects to implement solutions, which may involve adopting new technologies, revising workflows, or improving employee training.

Provide training and support to employees on new processes and procedures. Monitor the performance of implemented changes; make adjustments as needed to ensure sustainable results. Establish metrics to monitor the success of process improvements; track key performance indicators (KPIs) and make adjustments as needed to maintain optimal performance.

Communicate process improvement initiatives, recommendations, and findings / results to all stakeholders. Prepare reports for management that detail improvements, outcomes, and recommendations for further process enhancements.

Ensure process improvements comply with relevant regulations, policies, and industry standards.

Develop strategy in concert with key business stakeholders across the EmblemHealth enterprise. Translate strategy into defined tactics, program priorities, and timelines, and ensure alignment and attainment of business unit strategic plans to turn strategy into reality.

Build and leverage relationships to provide innovative solutions to complex business problems.

Serve as the subject matter expert in Project and Portfolio Management methodology and best practices.

Manage a variety of viewpoints to build consensus and create positive outcomes for all parties involved.

Serve as primary liaison to Executive Sponsors / Senior leaders in support of attaining desired project outcomes.

Support department executive in executing business strategy, enhance organizational culture, team development and process improvement. Contribute to the development, coordination and administration of strategic initiatives in support of enterprise objectives and goals. Assist in annual Project Portfolio planning, scoping and prioritization.

Utilize financial modeling and forecasting to support project prioritization and resource allocation. Partner with Finance to validate business cases, monitor budget adherence, and assess financial impact of strategic initiatives.

Oversee centralized services such as project definition, planning, scheduling, pricing, risk assessment and tracking to effectively monitor the committed time, scope and budget of the projects.

Actively lead in project status meetings; may lead on project Steering Committees of mission critical projects.

Track and report on risks and opportunities and how they may impact the financial results and projections by developing close ties to key financial and operational leadership.

Uphold the enterprise's code of ethics and business conduct.

Lead a strategically oriented project portfolio and / or program (a group of projects), while monitoring internal and / or external dependencies. Ensure projects are properly funded and staffed, have / maintain executive sponsorship, and key stakeholders are continuously engaged and aware of projects status and critical issues.

Oversee and support multiple, complex projects based on the overall enterprise strategy and resource capabilities.

Partner with the Executive Sponsors, business owners, and when necessary, the IT organization.

Provide guidance and oversight on mission-critical projects to meet business deadlines; develop mitigation strategies as warranted; and work with business on monitoring financial performance of funded projects.

Establish and implement strategic project management documentation and methodologies including policies, standards, procedures, and necessary technologies.

Provide active consultation and mentoring to the project management community throughout the project lifecycle and monitor adherence to PM standards and methodology. Identify, provide direction, and / or remediate, when possible, any major project management risks.

Drive decision making regarding utilization of project resources.

Develop and maintain financial dashboards and KPIs to track project performance and value realization.

Identify critical resource needs and negotiate with functional resource managers to secure allocation to the project and to ensure projects progress in accordance with agreed upon deliverables.

Reprioritize work as business and strategy needs dictate and facilitate discussions at all levels of the organization.

Partner with IT as needed for technical workstream as part of overall project.

Provide oversight of the relationships between the entire project team including external vendors and suppliers that are engaged with the project.

Conduct Financial impact assessments and scenario planning to support strategic decision-making.

Track and manage all project action items to timely resolution.

Utilize finance metrics to determine degree of success for projects; report on results to senior management.

Manage project completion postmortem to ensure gathering of Lessons Learned and call outs for future projects.

Bachelor's degree, in a relevant field such as engineering, business, statistics or equivalent; master's preferred.

Lean Six Sigma certifications (e.g., Black Belt, Master Black Belt) or equivalent / related preferred.

Coursework or certification in corporate finance, financial planning, actuarial science, or data analytics is preferred

10 15+ years' professional business experience, preferably in the Healthcare Payer business.

10+ years' experience managing large and highly complex Healthcare Payer projects.

7+ years of progressively responsible experience in a leadership role, with a focus on process improvement or quality management.

3+ years' experience in Management Consulting or Investment Banking.

Proven ability to oversee multiple improvement projects; strong organizational, prioritizing and time management skills.

Strong understanding of project related business case development and cost benefit analysis.

Demonstrated ability to translate strategic plans into financial outcomes and performance metrics.

Strong knowledge of process improvement methodologies, data analysis, and performance measurement tools.

Strong problem-solving and analytical skills; ability to dissect complex processes, identify inefficiencies, and design effective solutions. Ability to adapt strategies to fit different contexts.

Ability to form, lead and motivate teams, influence stakeholders, drive change, and to work effectively with cross-functional teams across the entire organization.

Strong financial acumen with experience in budgeting, forecasting, and financial analysis.

Experience working with finance teams to develop and monitor project budgets and ROI.

Ability to quickly identify and address operational blocks and impediments to efficiency and effectiveness.

Strong attention to detail and ability to see how small inefficiencies can have a significant impact on overall performance.

Ability to assess and develop risk mitigation strategy recommendations and to capitalize on opportunities.

Ability to build and maintain relationships with staff up to and including leadership.

Excellent communication skills (verbal, written, presentation, interpersonal) with all types / levels of audiences, including stakeholders; ability to explain technical concepts clearly and build support for change.

Expert knowledge of Microsoft Office tools, (Excel, Word, PowerPoint, Teams, Outlook).