The resource based view of firms is used to explore how information system (IS) competencies affect process innovation in an organization. Data was collected through a case study of two process innovations at a healthcare firm in the United States. The findings illustrate how six IS competencies – Knowledge Management, Collaboration, Project Management, Ambidexterity, IT/Innovation Governance, Business-IS Linkages – can differentially affect the conception, development and implementation of process innovations. Implications for researchers and practitioners are drawn from these conclusions and suggestions for further research are proposed.