Kaiser Permanente Business Consultant/Analyst Specialist Revenue Cycle Compliance and Risk Management in Oakland, California
The Business Consulting Specialist - Revenue Cycle Compliance and Risk Management role is responsible for the analysis and evaluation of business and system processes, controls and functional requirements, remediation of control deficiencies and on-going monitoring of compliance and other defined control standards for Revenue Cycle processes both at a regional and national level. This position assists and provides consultation to key partners, including operational leadership, regarding recommended modifications to established practices and procedures, education to business owners on both risks and internal controls as well expert consultation on financial control issues and solutions to assess and mitigate various organizational risks. The role will also assess and advise leadership on operational impact due to adoption of and compliance with new regulations and statutes both at a federal, state and local level by closely partnering with various compliance functions within the organization.
The role may also handle a full range of complex assignments, projects, and system functionality; therefore, the understanding of process dependencies is key to effective performance. Also, critical to success of the role is, the ability to think in creative and innovative ways, adapt to changes in environment, strong communication, project management and facilitation skills, and the ability to create effective relationships with partners across a highly matrixed organization to influence outcomes.
Broad application of principles, theories, and concepts in applicable discipline, plus working knowledge of other related fields.
Uses professional concepts in accordance with company objectives to solve complex problems in creative and effective ways.
This job is the fully-qualified, career-oriented, journey-level position.
Demonstrates functional area business processes and assigned and thoroughly understands cross-functional areas.
Directs the analysis of enterprise-wide or very complex client needs in project areas such as new/existing business operating models, innovative approaches to solutions support, market research of emerging or available product functionality and operational readiness assessment.
Directs the development of comprehensive and strategic business cases with cost/benefit dimensions of proposed projects that are used at management and executive levels for funding and scope decisions.
Accountable for tracking and/or monitor and report for senior mgmt the results of actualization of benefits.
Directs/conducts the analysis of current business processes and functional requirements.
Prepares appropriate documentation to communicate and validate the information.
May develop project plans.
Identifies and coordinates within other project managers and implements schedule deadlines as appropriate.
Manages common resource demands.
Provides on-going project management and status reporting at all levels.
Provides advice and input into the project plan.
Minimum ten (10) years of experience, to include a minimum three (3) years in a consulting role.
Minimum five (5) years of experience in a relevant environment such as a healthcare environment.
Bachelor's degree in business/health care administration or related discipline OR four (4) years additional relevant experience.
High School Diploma or General Education Development (GED) required.
License, Certification, Registration
Certification or advanced qualification by third party association that matches the function or field applicable to the business discipline (such as AHIP or HIAA) preferred.
Certification by professional society or industry group such as AHIP or HIAA preferred
A Master's degree in Business Administration, Public Health, Health Administration, Finance, Accounting or other related field preferred.
Certified Public Accountant, Certified Internal Auditor, Certified Healthcare Compliance professional or other related certification preferred.
Health plan management/Revenue Cycle knowledge preferred.
Healthcare compliance experience preferred.
Understanding of risk management and compliance principles strongly preferred.
Demonstrated ability or experience to do the following:
Provide subject matter expertise to cross-divisional, common business areas.
Make recommendations regarding business strategy and policy development.
Make recommendations for improvements to KP standards/methodologies.
Establish relationships with supervisors, peers and project member to obtain necessary resources and gain support in project delivery.
Make timely decisions based on knowledge and understanding of key business opportunities.
Ensure that all actions and decisions made (by self and staff and/or team) support established strategies and improved performance.
Make decisions which reflect insight into key market and health care trends/issues, customer information and relevant internal data.
Evaluate and proposes alternative operational efficiencies.
Develop solutions to problems of unusual complexity, which require a high degree of ingenuity and innovation.
Gain cooperation and acceptance/approval in resolving problems, and/or negotiating with other parties to arrive at an agreement
TITLE: Business Consultant/Analyst Specialist Revenue Cycle Compliance and Risk Management
LOCATION: Oakland, California
External hires must pass a background check/drug screen. Qualified applicants with arrest and/or conviction records will be considered for employment in a manner consistent with Federal, state and local laws, including but not limited to the San Francisco Fair Chance Ordinance. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, protected veteran, or disability status.