Operating Effectiveness Lead Analyst

Job description

Your role will include:

• Transformation & Value Delivery Lead cross‑functional LSS projects end‑to‑end (charter → control), converting VOC into CTQs and measurable outcomes (DPMO↓, FTR↑, NPS↑, AHT↓, rework↓). Drive Lean/Kaizen interventions—waste elimination, standard work, mistake‑proofing, visual management—embedded into run‑ops and IHDS delivery. Quantify and track benefits with IHDS portfolio governance and financial partners.
• International Health Domain & Compliance Improve quality across global claims adjudication, enrolment, billing, provider/network & medical review workflows supporting International Health lines of business. Ensure rigorous compliance with HIPAA, GDPR, and Cigna privacy/security standards for cross‑border PHI/PII; support internal/client audits and enterprise security reviews.
• Quality Systems & Controls Design/optimize QMS for International Health ops: risk‑based sampling, QA scorecards, calibration routines, and auto‑scoring opportunities. Establish SPC dashboards & early‑warning indicators; run FMEA on top failure modes; maintain rock‑solid control plans with ≥95% adherence.
• Analytics & Insights Apply advanced analysis (root cause, hypothesis testing, regression/segmentation, DoE where warranted) to pinpoint drivers of denials, rework, leakage, and CX friction. Partner with BI (Power BI/Tableau) to build role‑based views tracking SLA, quality, cost, and IHDS portfolio health.
• People Leadership & Change Coach/certify Green Belts, upskill QA/ops teams on LSS and data literacy; facilitate Kaizens/rapid improvement bursts. Lead change management (ADKAR/PROSCI), aligning with IHDS cadence (e.g., intake, prioritization, PI) to sustain adoption.

Your Abilities

The ideal candidate blends deep healthcare domain understanding (HIPAA/PHI handling, payer/provider processes) with hands-on expertise in process excellence, change management, and stakeholder engagement across global, high-volume operations. The role drives defect reduction, cost/outcome improvements, regulatory compliance, and client satisfaction using structured methods (DMAIC/DMADV), analytics, and robust control systems.

Required Skills and Qualifications

• Bachelor’s degree in Engineering, Healthcare Administration, Statistics, or related field; Master’s preferred.
• Certified Lean Six Sigma Black Belt (ASQ/IASSC or equivalent); COPC/ISO knowledge a plus.
• 8–12 years total experience with 5+ years in healthcare BPO/RCM/payer/provider processes.
• Proven track record delivering multiple high-impact projects with quantified benefits in a high-volume operations environment.
• Strong knowledge of HIPAA, PHI handling protocols; exposure to payer policies and US healthcare revenue cycle preferred.
• Proficiency with statistical tools (Minitab/R/Python—analysis), BI (Power BI/Tableau), and Excel at advanced level

About The Cigna Group Cigna Healthcare, a division of The Cigna Group, is an advocate for better health through every stage of life. We guide our customers through the health care system, empowering them with the information and insight they need to make the best choices for improving their health and vitality. Join us in driving growth and improving lives.