There is still a lack of coherent theoretical explanations for why and how IT Business alignment (ITBA) influences process outcomes. This study draws on the knowledge-based theory to develop and test a process-level model that links different types of alignment and IS usage to process outcomes. While prior research has mostly focused on strategic alignment, we posit that the implementation of strategies into an operational process also is important to achieve beneficial outcomes. Therefore, we investigate the impact of ITBA on performance at a process-level of analysis. Additionally, we propose that business-internal alignment is an important construct contributing to the explanation of performance. Furthermore, we include IS usage and business skills to encompass further essential resources of the business process. Testing the model using data from 136 banks shows that ITBA and business-internal alignment have direct and positive effects on performance at the process level. Furthermore, IS usage and business skills proved to have significant effects on process performance. Overall, the result contribute to the IT value creation debate by empirically showing the effect of alignment and IS usage on a process level and by revealing the role of businessinternal alignment.