Process Improvement Specialist

2 Months ago • 2-5 Years

Job Summary

Job Description

The Process Improvement Specialist is responsible for analyzing, optimizing, documenting, and standardizing processes within the Payment Optimization team at Zelis. This role involves identifying inefficiencies, standardizing workflows, and developing operating procedures to improve operational effectiveness. The specialist collaborates with frontline teams, leadership, and cross-functional stakeholders in India and the United States. This involves analyzing existing processes, identifying improvement opportunities, implementing process changes, documenting and tracking process performance. They also develop and maintain Standard Operating Procedures (SOPs) to ensure compliance and consistency. Furthermore, the specialist partners with various teams to ensure smooth process implementation and acts as a bridge between employees and leadership to translate challenges into structured improvements.
Must have:
  • Lead process change and improvement initiatives.
  • 2+ years of experience in operational support role
  • Develop SOPs, workflow documentation, and process mapping.
  • Proficiency in Excel and process mapping tools.
  • Analyze data and make data-driven recommendations.
  • Strong written and verbal communication skills.
Good to have:
  • Knowledge of contact center operations.
  • Experience in healthcare finance.
  • Experience working with CRM/ticketing systems.
  • Understanding of workforce management in a contact center.
  • Ability to manage multiple priorities in a fast-paced environment.
  • Well versed with ISO methodologies (PMS and QMS).

Job Details

About Us 

Zelis is modernizing the healthcare financial experience in the United States (U.S.) by providing a connected platform that bridges the gaps and aligns interests across payers, providers, and healthcare consumers. This platform serves more than 750 payers, including the top 5 health plans, BCBS insurers, regional health plans, TPAs and self-insured employers, and millions of healthcare providers and consumers in the U.S. Zelis sees across the system to identify, optimize, and solve problems holistically with technology built by healthcare experts—driving real, measurable results for clients.  

Why We Do What We Do 

In the U.S., consumers, payers, and providers face significant challenges throughout the healthcare financial journey. Zelis helps streamline the process by offering solutions that improve transparency, efficiency, and communication among all parties involved. By addressing the obstacles that patients face in accessing care, navigating the intricacies of insurance claims, and the logistical challenges healthcare providers encounter with processing payments, Zelis aims to create a more seamless and effective healthcare financial system.

Zelis India plays a crucial role in this mission by supporting various initiatives that enhance the healthcare financial experience. The local team contributes to the development and implementation of innovative solutions, ensuring that technology and processes are optimized for efficiency and effectiveness. Beyond operational expertise, Zelis India cultivates a collaborative work culture, leadership development, and global exposure, creating a dynamic environment for professional growth. With hybrid work flexibility, comprehensive healthcare benefits, financial wellness programs, and cultural celebrations, we foster a holistic workplace experience. Additionally, the team plays a vital role in maintaining high standards of service delivery and contributes to Zelis’ award-winning culture. 

Position Overview

The Specialist, Process Improvement is responsible for analyzing, optimizing, documenting and standardizing processes within the Payment Optimization team at Zelis. This role focuses on identifying inefficiencies, standardizing workflows, and developing operating procedures to improve operational effectiveness. The specialist collaborates with frontline teams, leadership, and cross-functional stakeholders in India and the United States to ensure consistent, scalable, and compliant processes that align with industry best practices. 

Process Improvement & Workflow Optimization 

  • Analyze existing processes, data and workflows to identify inefficiencies and improvement opportunities.  

  • Work with frontline teams, supervisors, and leadership to assess pain points and implement sustainable process changes.  

  • Utilize Lean Six Sigma principles to streamline processes and enhance operational effectiveness.  

  • Document and track process performance, productivity metrics, and key operational insights.  

Standard Operating Procedure (SOP) Development 

  • Partner with QA team to ensure clear, detailed, and standardized SOPs for Payment Operations support functions are created and maintained.  

  • Ensure SOPs are consistent, scalable, and aligned with compliance requirements (e.g., HIPAA, PCI-DSS).  

Collaboration & Stakeholder Engagement 

  • Partner with operations teams, quality assurance, technical teams, compliance, and training to ensure smooth process implementation and sustainability.  

  • Act as a bridge between frontline employees and leadership, helping translate operational challenges into structured improvements.  

  • Work closely with project managers and process owners to align SOPs with broader business goals.  

Required Skills and Competencies 

  • Demonstrated ability to lead process change and improvement initiatives and manage projects with cross-functional teams.  

  • 2+ years of experience in a contact center or operational support role with a focus on sustainable process improvement.  

  • Strong background in developing SOPs, workflow documentation, and process mapping.  

  • Proficiency in Excel, process mapping tools (e.g., Visio, Lucidchart) 

  • Ability to analyze data, identify trends, and make data-driven recommendations.  

  • Strong written and verbal communication skills with attention to detail.  

  • 2+ years experience coaching and mentoring individuals and teams leading improvement projects (lean six sigma, change management) 

Preferred Skills 

  • Knowledge of contact center operations, back-office processing, and payment workflows.  

  • Experience in healthcare finance, payment processing, or a similarly regulated industry is strongly preferred (HIPAA, PCI-DSS compliance).  

  • Experience working with CRM / ticketing systems.  

  • Understanding of workforce management, reporting, or quality assurance within a contact center.  

  • Ability to manage multiple priorities in a fast-paced and evolving environment.  

  • Well versed with ISO methodologies (PMS and QMS) 

Qualifications 

  • Bachelor’s degree in Business Administration, Operations Management, or a related field.  

  • Certifications in Lean Six Sigma (Green Belt or higher) and / or Project Management (PMP, CAPM).  

  • Certification in change management methodology such as Prosci preferred. 

  • At least 5 years of experience leading continuous improvement or a similar role.  

Life at Zelis begins with a promise. A promise to MAKE AN IMPACT.  

We make this promise to our clients, our communities, and to each other. It's reflected in our purpose - modernizing the healthcare financial experience for all - and how we make it happen by leveraging our incredible technology built by healthcare experts, partnerships that evolve with our clients, and visibility that unlocks value.  

Through our connected platform, we price over 100 billion dollars in healthcare claims each year with our claims intelligence solutions. We pay over 200 billion dollars in healthcare claims annually using the Zelis Advanced Payments Platform to maximize electronic delivery of both dollars and data together, and we empower more than 100 million healthcare consumers with advanced communications and digital engagement solutions.   

Our promise is felt in how we care for ourselves and our families - through comprehensive benefits and competitive compensation to wellness initiatives, flexible workplaces, career growth opportunities, and more. It’s how we drive innovation and embrace a growth mindset. It’s how we put people first and act with agility. It’s how we champion collaboration. And most importantly, build trust. Join us and MAKE AN IMPACT! 

 

 

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About The Company

Zelis is modernizing the healthcare financial experience by providing a connected platform that bridges the gaps and aligns interests across payers, providers, and healthcare consumers. This platform serves more than 750 payers, including the top 5 national health plans, BCBS insurers, regional health plans, TPAs and self-insured employers, and millions of healthcare providers and consumers. Zelis sees across the system to identify, optimize, and solve problems holistically with technology built by healthcare experts – driving real, measurable results for clients.

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