Process Management/Network Oversite and Process Manager

Overview

Remote
Accepts corp to corp applications
Contract - W2
Contract - Independent
Contract - long term

Skills

MOS
Performance Analysis
Relationship Management
Decision-making
Collaboration
Business Operations
Optimization
Performance Metrics
Pharmacy
Network Operations
Service Level
Network
Process Reengineering
Process Automation
Reengineering
Research
Process Modeling
Process Management
Innovation
Continuous Improvement
Policies and Procedures
Management
Process Improvement
Training
Business Management
Electronic Commerce
Business Process Management
Business Process
Organizational Skills
Microsoft Office
Documentation
Communication
Health Care
Customer Service
Business Analysis
PMBOK
Six Sigma
EXT
IMG

Job Details

Process Management/Network Oversite and Process Manager

Remote- DC/MD/VA/WV/DE/NC/PA/FL/NY/NJ/TX

18mos CTH

No H1b

ls: Top 5 Mandatory Skills:

1. Network performance analysis Monitoring access, disruptions, trends, and service quality.
2. Provider relationship management Engaging with pharmacy networks and resolving escalations.
3. Data-driven decision making Using performance data to guide contracting, retention, and outreach.
4. Operational optimization Driving improvements in network access, satisfaction, and cost efficiency.
5. Cross-functional collaboration Coordinating with stakeholders across business, operations, and regulatory tea

This role supports the oversight and optimization of pharmacy network operations. Responsibilities include:

- Monitor key performance metrics such as claims volume, turnaround times, network adequacy, and member satisfaction.
- Support credentialing, re-contracting, and termination processes across all network pharmacy providers.
- Ensure alignment of network operations with contractual, regulatory, and service-level standards.
- Coordinate with internal stakeholders to address network performance concerns and ensure resolution.


PURPOSE:
This position will play a key role in delivering on all aspects of enterprise wide, cross functional process management initiatives including developing process architecture and hierarchy, process transformation, process automation and reengineering. The incumbent will function as a champion of process improvement methodologies and implementation throughout the organization. This individual will help drive the measurement of business effectiveness, research business processes and practices and analyze process data to develop and implement sustainable, repeatable and quantifiable operational and strategic process improvement. This individual will be part of the BPM center of excellence team that will drive process improvement initiatives and bring efficiency, effectiveness and a culture of continuous improvement to the organization.

ESSENTIAL FUNCTIONS:
40% Develop industry standard best practices for process management, innovation and continuous improvement across the enterprise

25% Develop framework to align process architecture with strategic business capabilities and govern linkages. Ensures that policies and procedures align with corporate vision

20% Develop core program framework, governance structure, tools and templates for delivering cross functional process improvement initiatives

15% Manage resources (change agents and champions) within a matrix environment to lead process improvement initiatives across the enterprise. Engage in training activities with change agents and champions to develop this capability and skill set across the enterprise.

Qualifications
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable
accommodations may be made to enable individuals with disabilities to perform the essential functions.

Education Level: Bachelor's Degree

Education Details: Business Management or related field

Experience: 10 years relevant business process specialization (i.e. business process management, consulting or other applicable business process transformation experience).

In Lieu of Education
In lieu of a Bachelor's degree, an additional 4 years of relevant work experience is required in addition to the required work experience.

Preferred Qualifications
Knowledge, Skills and Abilities (KSAs)
Skill in analyzing and organizing technical data, Expert
Proficient in Microsoft Office programs., Advanced
Knowledge of web based applications and documentation tools., Expert
Excellent communication skills both written and verbal., Expert

The incumbent is required to immediately disclose any debarment, exclusion, or other event that makes them ineligible to perform work directly or indirectly on Federal health care programs. Must be able to effectively work in a fast-paced environment with frequently changing priorities, deadlines, and workloads that can be variable for long periods of time. Must be able to meet established deadlines and handle multiple customer service demands from internal and external customers, within set expectations for service excellence. Must be able to effectively communicate and provide positive customer service to every internal and external customer, including customers who may be demanding or otherwise challenging.

Licenses/Certifications
Certified in Business Analysis -PMI Upon Hire Pref
CSSBB - Six Sigma Black Belt BPMI Certification Pref

Ayush Sharma Sr. US Technical Recruiter

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Employers have access to artificial intelligence language tools (“AI”) that help generate and enhance job descriptions and AI may have been used to create this description. The position description has been reviewed for accuracy and Dice believes it to correctly reflect the job opportunity.