Transformation Lead

Role Summary

The Transformation Lead will own the functional transformation and Model Office, translating Centene’s objectives into future-state processes, operating models, global design decisions, local-market variations and ultimately implementable requirements.

This individual should bring a consulting-style combination of structured problem solving, process design, facilitation and implementation orientation.

We want someone who can enter an ambiguous environment, rapidly understand current-state workflows, identify unnecessary variation and process debt, design the future state, facilitate difficult decisions and then work side-by-side with technology/FDE teams to make the design executable.

Key Responsibilities

• Lead Model Office and Global Design activities.
• Define future-state business and clinical workflows.
• Document current-state processes and identify process debt, variation and automation opportunities.
• Define the standard/global process model and determine where legitimate local variations are required.
• Facilitate design workshops with clinical, operational, technology and market stakeholders.
• Establish decision frameworks and drive stakeholders toward closure.
• Translate operating-model and process decisions into business requirements and configuration requirements.
• Partner closely with Clinical, FDE, AI and Product teams.
• Support local-market design and rollout following completion of global design.
• Define roles, handoffs, controls, KPIs and business-readiness requirements.
• Ensure transformation decisions produce measurable operational improvements rather than simply recreating existing processes on new technology.

Ideal Background

Must Have

• 10+ years of consulting, transformation or operating-model experience.
• Strong business-process redesign and future-state operating-model skills.
• Experience leading complex workshops with senior stakeholders.
• Excellent structured problem-solving capability.
• Experience translating process design into technology-enabled transformation.
• Hands-on orientation and ability to create the actual deliverables.

Strongly Preferred

• Big 4 / strategy or transformation consulting background.
• Healthcare payer experience.
• UM/CM, clinical operations or prior authorization experience.
• Model Office / Global Design / process standardization experience.
• Experience implementing enterprise platforms after designing the future-state process.