Overview

This senior level individual contributor will be primarily responsible for expert consultation across project teams within the provider data management, contract administration and network management arenas, including influencing direction across operations and technical solutions, and providing program oversight to teams engaged in efforts for provider data management related systems and capabilities. Additional expectations for this role include program/project consultation for critical regional and national projects involving business process redesign, system implementations or system modifications within Provider Contracting, Provider Network Management, Utilization Management, and Data Analytics.

This position is responsible for the overall management of the NW specific business requirements and relevant project implementations for or involving provider data management capabilities. Consultation duties for these projects include the identification of the business needs, communication with business customers, prioritization of needs, partnering with IT for solution identification, oversight of user acceptance testing, participation in relevant interregional project teams, and the tracking of timelines to deliver on business needs.

This role will be expected to practice self-leadership and promote learning in others by soliciting and acting on performance feedback; building collaborative, cross-functional relationships; and communicating information and providing advice to drive projects forward. Additionally, this individual will be expected to drive the execution of multiple work streams by identifying customer and operational needs; developing and updating new procedures and policies; gaining cross-functional support for objectives and priorities; translating business strategy into actionable business requirements; obtaining and distributing resources; setting standards and measuring progress; removing obstacles that impact performance; guiding performance and developing contingency plans accordingly; solving highly complex issues; and influencing the completion of project tasks by others.

Join Our Medical Group

Northwest Permanente is a self-governed, physician-led, multi-specialty group of 1,500 physicians, surgeons, and clinicians, caring for 630,000 members in Oregon and Southwest Washington. Kaiser Permanente is one of the nation's preeminent health care systems, a benchmark for comprehensive, integrated, value-based, and high-quality care.

Responsibilities

Major Responsibilities / Essential Functions

Technology and Business Process Optimization

• Provide direction for provider data management, contract administration, and network management system capabilities, implementation strategy and multi-year roadmap
• Foster strong relationships with IT teams and key stakeholder groups to approve network management requirements, processes and/or system solutions to meet strategic objectives
• Lead or participate in the development of financial investment requests for system infrastructure and resources to support maturation of network management and modeling capabilities
• Provide insight and influence on approaches to integrate requirements with current and/or new systems and business processes to support business outcomes
• Provide direction to network service analysts and/or associated operation and technical teams that support network management process improvement efforts to achieve strategic and operational goals of the business

Change Management

• Ensure stakeholder operational and technical adoption requirements are understood, documented and factored into overall plan for deployment of new or modified technical capabilities for NW region and in relation to broader enterprise efforts (as applicable)
• Lead planning and execution of operational and technical adoption activities for NW region in support of programs/projects within Provider Data Management, Contract Management or Network Management arena

Qualifications

Minimum Education

• Bachelor's degree in Information Technology, Engineering, Business Administration, Insurance or related field, or equivalent education and experience

Minimum Work Experience

• Minimum Eight (8) years experience in IT consulting, management consulting, business analysis or related field, with specific experience in business process improvement techniques, reengineering, strategic business and IT planning

Additional Requirements

• Considerable knowledge of IT systems and management, application development methods and techniques
• Knowledge of IT industry standard project management techniques
• Knowledge of systems planning and strategic planning
• Proficient facilitation skills for senior level committees, teams, or groups of key stakeholders from all levels and segments of the organization, while developing and building teams
• Excellent influence and engagement skills in building alignment and accountability without formal ownership or authority over resources
• Ability to work cooperatively and strategically in a team environment with all levels of professional, technical, and administrative staff and to integrate resources on a timely and organized basis
• Strategic thinker with end-to-end view who has an eye for detail, is organized, and can manage multiple priorities simultaneously
• Ability to deal with highly confidential information and act as a liaison between executive leaders and other constituencies, both internal and external
• Ability to identify politically charged situations and manage the political challenges
• Strong proficiency in the use of current software, including spreadsheets, process mapping tools, project work plan tools, charts, and graphs, etc.
• Determine the key business issues, create patient-centric solutions, and develop appropriate action plans to solve complex problems
• Demonstrated ability to conduct and interpret quantitative/qualitative analysis and lead a multi-disciplinary team through the problem-solving process

Preferred Education

• Master's degree in Information Technology, Engineering, Business Administration, Insurance or related field
• Certified Business Analyst Professional (CBAP) or other comparable business analyst or IT consulting certification
• Five (5) years experience working in IT for a health care organization
• Four (4) years leadership experience working on projects or programs requiring the integration of cross-functional technology and/or business solutions
• Five (5) years experience in workflow analysis, and business case development analysis, including the use of modeling software (e.g., Visio)
• Four (4) years experience managing vendor relationships
• Four (4) years of work experience in a role requiring interaction with executive leadership (e.g., Vice President level and above)

Preferred Work Experience and Qualifications

• Strong knowledge of regulatory guidelines affecting the healthcare industry
• Experience leading complex programs or projects requiring the integration of cross-functional business and technical teams to deliver business solutions
• Strong understanding and experience in business case development, workflow analysis, including the use of modeling software (e.g., Visio)
• Strong understanding of systems that enable provider data management, network design, reimbursement models and episode analytic platforms
• Familiarity with CMS 5 Star, HEDIS, Risk Adjustment, and other Pay-for-Performance Programs desirable
• Working familiarity with various managed healthcare provider compensation methodologies, including but not limited to fee-for-service, capitation, and various forms of risk, ASO, etc.

Equal Opportunity Employer

At Northwest Permanente, we are committed to providing an environment of mutual respect where equal employment opportunities are available to all applicants without regard to race, color, religion, sex, pregnancy (including childbirth, lactation, and related medical conditions), national origin, age, physical and mental disability, marital status, sexual orientation, gender identity, gender expression, genetic information (including characteristics and testing), military and veteran status, and any other characteristic protected by applicable law. Northwest Permanente believes that equity, inclusion, and diversity among our employees are critical to our success, and we seek to recruit, develop, and retain the most talented people from a diverse candidate pool.