The Process Improvement Consultant IV collaborates closely with the director to develop, manage, and oversee regulatory and compliance functions for the utilization and case management programs under Permanente Advantage. Experience with policies (writing and revising) based on regulatory requirements that drive processes for UM. This includes ensuring compliance with state insurance laws and URAC accreditation standards, conducting compliance monitoring and audits, and addressing areas of non-compliance. A significant portion of the work involves mental health parity non-quantitative treatment limitations (NQTLs) comparative analyses at both Federal and State levels. Independently understand and prepare work for review with the director, and a clinical background would be beneficial as the clinical aspects of mental health parity, as well as the utilization and case management components.

Delivers, executes, and sustains process improvement (PI) engagements including kaizen. Serves as a consultant to stakeholders and process owners to drive process improvements. Contributes to strategic planning and supports organizational alignment and prioritization of process improvement initiatives. Serves as an advocate for continuous improvement by keeping abreast of industry practices, standards, and benchmarks. Participates in and may lead change management activities associated with process improvement and performs data analyses to support process improvement initiatives.

• Promotes learning in others by proactively providing and/or developing information, resources, advice, and expertise with coworkers and members; builds relationships with cross-functional/external stakeholders and customers. Listens to, seeks, and addresses performance feedback; proactively provides actionable feedback to others and to managers. Pursues self-development; creates and executes plans to capitalize on strengths and develop weaknesses; leads by influencing others through technical explanations and examples and provides options and recommendations. Adopts new responsibilities; adapts to and learns from change, challenges, and feedback; demonstrates flexibility in approaches to work; champions change and helps others adapt to new tasks and processes. Facilitates team collaboration to support a business outcome.


• Completes work assignments autonomously and supports business-specific projects by applying expertise in subject area and business knowledge to generate creative solutions; encourages team members to adapt to and follow all procedures and policies. Collaborates cross-functionally and/or externally to achieve effective business decisions; provides recommendations and solves complex problems; escalates high-priority issues or risks, as appropriate; monitors progress and results. Supports the development of work plans to meet business priorities and deadlines; identifies resources to accomplish priorities and deadlines. Identifies, speaks up, and capitalizes on improvement opportunities across teams; uses influence to guide others and engages stakeholders to achieve appropriate solutions.


• Delivers, executes, and sustains process improvement (PI) engagements including kaizen by leveraging the appropriate methods and tools to ensure the development of stakeholder capabilities for process change and improvement; applying data-driven PI principles, tools, and problem-solving methods including Lean/Six Sigma concepts and techniques; building high performance team capabilities to harness collective intelligence and take quick action to test ideas and achieve real time business results; developing and designing process architecture and recommendation documents, including presentations, process maps, supporting metrics, business requirements and related impact analyses; sharing accountability for realization of results with process owners; and presenting results and recommendations as appropriate.


• Serves as a consultant to stakeholders and process owners by providing consultation and trusted partnership to stakeholders and teams to drive process improvements; developing management systems to sustain process changes; developing stakeholder process improvement leadership competencies; providing training and guidance to stakeholders; and providing ongoing coaching to build a continuous improvement mindset, and build capabilities that drive results.


• Contributes to strategic planning and supports organizational alignment and prioritization of process improvement initiatives by defining, developing, and evaluating performance metrics, standards, and methods to establish process success; collaborating with multiple stakeholders, often with competing/conflicting objectives, to ensure cohesive and reachable metrics; refining strategic plans and performance metrics as appropriate; and managing assigned initiatives or portfolio to ensure delivery of measurable results and alignment with strategic objectives.


• Serves as an advocate for continuous improvement by keeping abreast of industry practices, standards, and benchmarks; attending and participating in roadshows, conferences, and speaking events; contributing to the ongoing enhancement of process improvement practices, standards, and methods across KP; and serving as an advocate to ensure continuous learning and improvement is championed as a people strategy.


• Participates in and may lead change management activities associated with process improvement by engaging stakeholders to obtain support and buy in for changes; partnering with management, project champions, and process owners to align process improvement initiatives with business objectives; identifying appropriate change management method and approach; and ensuring stakeholders embrace a change management mindset, understand intent and purpose, and foster a culture of change.


• Performs data analyses to support process improvement initiatives by identifying appropriate data analysis tools and approach to assess system or process performance; determining suitable data gathering and analysis methods (e.g., process observation, hard data, etc.); defining data requirements and obtaining customer agreements, including customer requirements as appropriate; conducting analyses and performing experimental tests; and identifying and alleviating risks through data-driven analysis.

• Minimum one (1) years experience in a leadership role with or without direct reports.


• Bachelors degree in Business Administration, Finance, Engineering, Health Care/Public Health Administration, Behavioral/Social/Computer Science, Liberal Arts, Mathematics, or related field and Minimum five (5) years experience in process improvement or a directly related field OR Minimum eight (8) years experience in process improvement or a directly related field.

• Knowledge, Skills, and Abilities (KSAs): Business Acumen; Business Process Improvement; Written Communication; Applied Data Analysis; Managing Diverse Relationships; Service Focus; Negotiation; Project Management