Process Architect

Role Overview

• Responsible for designing, standardizing, and governing end-to-end business processes across the organization.
• Ensures processes are efficient, compliant, scalable, and aligned to enterprise optimization goals.
• Translates optimization strategy into clear, executable, and measurable process designs.
• Establishes standards that support consistent execution across teams and platforms.
• Designs and documents end-to-end processes across claims, enrollment, customer service, utilization management, operations, and finance.
• Develops current-state and target-state process models using standard methodologies (e.g., BPMN).
• Defines process boundaries, handoffs, roles, controls, and decision points.
• Establishes enterprise process standards, modeling conventions, and documentation requirements.
• Maintains a centralized process repository and architecture artifacts.
• Ensures processes align with regulatory, contractual, and audit requirements.
• Partners with Business Optimization Architects to translate optimization initiatives into process designs.
• Supports operational teams during implementation by clarifying process intent and design.
• Provides guidance on process adoption, change impacts, and risk mitigation.
• Identifies process inefficiencies, bottlenecks, and control gaps.
• Supports process measurement by defining operational metrics and controls.
• Incorporates feedback and performance results into ongoing process refinements.
• Works closely with IT, data, compliance, and operations teams to ensure process designs are feasible and enforceable.
• Supports technology enablement efforts by defining business process requirements.

Requirements

• Bachelor’s degree in Business, Healthcare Administration, Industrial Engineering, or related field.
• 5–8+ years of experience in process design, process architecture, or operational excellence.
• Experience working within healthcare, insurance, or TPA operations.
• Proficiency with process modeling tools and methodologies (e.g., BPMN).
• Strong documentation and facilitation skills.
• Lean, Six Sigma, or process improvement certification (preferred).
• Experience supporting system implementations or automation initiatives (preferred).
• Familiarity with healthcare compliance and audit requirements (preferred).

Benefits

• health and wellness benefits
• 401(k) savings plan
• pension plan
• paid time off
• paid parental leave
• disability insurance
• supplemental life insurance
• employee assistance program
• paid holidays
• tuition reimbursement
• other incentives