Quality Transformation Manager

Role Summary:

• We are seeking a seasoned Process Excellence leader to drive enterprise-grade quality transformation across US
• Healthcare provider operations (Revenue Cycle Management, Patient Access, Coding, Billing, AR Follow-up,
• Clinical Documentation, etc.). The Senior Manager will architect, implement, and sustain a robust process
• excellence framework leveraging Six Sigma/Lean methodologies, operational analytics, and advanced quality
• practices to deliver measurable improvements in accuracy, compliance, turn-around-time (TAT), productivity,
• patient/provider satisfaction, and financial outcomes.

Key Responsibilities:

• Design and deploy end-to-end Process Excellence roadmap across provider processes;
  standardize SOPs,
• KPIs, and control plans.
• Lead cross-functional Kaizen, DMAIC, and Lean initiatives to reduce defects, rework, and cycle time;
  deliver sustained productivity gains.
• Own quality governance: define QMS, audits, sampling methodologies, and quality scorecards.
• Ensure adherence to US Healthcare regulations and guidelines (e.G., HIPAA privacy/security standards, provider requirements, documentation integrity).
• Perform root cause analysis (RCA) and implement corrective and preventive actions (CAPA) for recurring issues.
• Build dashboards and performance frameworks for SLAs/OLAs—accuracy, first-pass resolution (FPR), denial rates, TAT, and CSAT/NPS.
• Partner with client leadership and internal operations to identify improvement opportunities;
  lead governance reviewsand QBRs.
• Implement controls to mitigate operational risk, audit findings, and compliance breaches.
• Collaborate with Technology/RPA teams to evaluate automation opportunities (RPA, macros, workflow tools, analytics).
• Coach and develop a high-performing team of quality analysts, Black Belts/Green Belts, and project managers.

Required Qualifications:

• 10–20 years in US Healthcare provider processes with at least 5+ years in Process Excellence/Quality leadership.
• Six Sigma Certification: Mandatory (Green Belt required;
  Black Belt preferred).
• Proven delivery of large-scale improvement programs with quantified outcomes.
• Strong knowledge of provider-side workflows: Patient Access, Eligibility/Authorization, Coding (ICD/CPT), Charge Entry, Billing, AR & Denial Management, Payment Posting, Clinical Documentation.
• Hands-on experience setting up QMS, audits, sampling plans, and control charts;
  adept at RCA & CAPA.
• Advanced proficiency in Excel/BI tools (Power BI/Tableau), statistical analysis, and dashboarding.
• Excellent communication, stakeholder management, and client-facing governance experience.

Preferred Qualifications:

• Six Sigma Black Belt or formal Lean certification.
• Exposure to RPA/Automation programs and analytics-led transformation.
• Experience with EHR/EMR systems (Epic, Cerner) and payer guidelines.
• Prior experience managing large teams across multiple provider processes and geographies.

Core Competencies:

• Strategic problem-solving & quantitative analysis
• Execution rigor and result orientation
• Client partnership & executive communication
• Change management & stakeholder influence
• Team coaching & talent development