Role Summary
The Black Belt – Manager will lead end-to-end process excellence, quality transformation, and productivity programs across Healthcare Claims operations (Commercial, Medicare, Medicaid, Specialty). The role is responsible for driving measurable business outcomes through Lean Six Sigma, RCA-driven improvements, automation enablement, and cross-functional governance while partnering closely with Operations, Quality, Training, WFM, and Client stakeholders.
1. Transformation & Continuous Improvement
- Lead Lean Six Sigma Black Belt projects across Claims (Intake, Adjudication, Adjustments, Appeals, EDI, Correspondence).
- Drive defect reduction, rework elimination, and cycle time improvement using DMAIC / Lean methodologies.
- Identify and execute high-impact transformation opportunities aligned to business priorities and client KPIs.
- Own end-to-end project lifecycle from problem definition to benefit realization and sustainment.
2. Quality & RCA Leadership
- Conduct deep-dive RCA using People | Process | System | Technology frameworks.
- Lead Pareto analysis, FMEA,
trend analysis, and defect heatmaps for escalations, audits, and quality failures.
- Partner with Quality teams to improve OAR, financial accuracy, compliance scores, and audit outcomes.
3. Claims Domain & Client Value Creation
- Apply robust US Healthcare Claims knowledge across Commercial, Medicare, Medicaid, and Specialty lines.
- Work closely with UHG stakeholders to align process improvements with payer policies and regulatory requirements.
- Support client governance, business reviews, client visits, and escalations with data-backed insights.
- Translate operational improvements into quantified benefits (QNI, BVM, FTE productivity, cost savings).
4. Automation & Digital Enablement
- Identify opportunities for RPA, AI, analytics, and system-led automation across claims processes.
- Collaborate with Automation / IT teams on solution design, deployment, and benefit tracking.
- Drive man
📌 Process Excellence Manager (Kolkata)
🏢 Wipro
📍 Kolkata