Description
Business Process Consultant - Pasadena
Job Summary
This 12 month contract opportunity is for a Business Process Consultant role for a major health care provider. The individual in this role will support large group HMO full adjudication through external claims processing system. This individual will be responsible for a range of process improvement and process management activities. Activities include planning, performing, documenting, and implementing process improvement initiatives, in addition to ownership of operational processes. These initiatives may represent one portion of a larger project, or may represent a stand-alone initiative or function within a work group or department. Process management functions may include data gathering and analysis, best practice research, process mapping, developing and recommending alternatives for improvement, developing performance metrics, obtaining leadership or stakeholder agreement, implementing improvements, and monitoring post-process improvement initiative performance to updated standards. Activities are undertaken and executed in support of organizational goals and are accountable for providing business process solutions to meet internal and external customer expectations. May utilize Lean/Six Sigma processes and concepts to lead process improvement initiatives. Partners with management, project champions, and process owners to execute the project and deliver results.
Duties:
Data Analysis:
Prepares data analyses. Defines requirements for data and sets standards of data collection. Analyzing accounts is EPIC and Claims system to identify and report on root cause. Assist in requirements gathering and IT work order creation based on root cause issues and concerns
Research:
Conducts best practice research. Makes recommendations on appropriate solutions based on research; selects from alternatives presented.
Process Architecture:
Designs processes. Document workflows and process flows. Ensures process mapping is complete; Interviews stakeholders and process owners to define processes. Defines standards and methods.
Process Recommendations:
Reviews business requirements and related impact analyses for highly complex processes. Negotiates final requirements and mediates impacts across all stakeholders. May apply Lean/Six Sigma concepts and techniques to process improvement initiatives, including completing Lean/Six Sigma analyses and tasks. Shares accountability for realization of results with process owners and will present recommendations to stakeholders and process owners.
Performance Management & Control:
Defines, develops and evaluates performance metrics to establish process success, including working with multiple stakeholders, often with competing/conflicting objectives, to ensure cohesive and reachable measures of success Reviews data post- implementation to measure success; defines standards of improvement success.
Change Management:
Leads or partners in change management activities associated with process improvement. Engages leadership and stakeholders to obtain support and buy in for changes. Champions process improvement efforts and a continual process improvement culture. Partners with management, Labor partners, project champions, and process owners to align process improvement initiatives with business objectives.
Works on significant and unique assignments of diverse and complex scope, developing solutions which require a high degree of ingenuity and innovation, using independent judgment to accomplish objectives. Involves a high degree of interpretation and analysis of obscure or inconclusive data with a high level of judgment and risk taking to make appropriate decisions for diverse, sophisticated, and undefined issues and without considerable direction. Work is evaluated upon completion to ensure objectives and performance requirements have been met. Serves as a technical/professional coach to team members.
Educational requirements:
Bachelor's Degree or higher OR five (5) years of experience in a directly related field.
Minimum five (5) years of process and/or project management, consulting, or related business experience with knowledge of process management/improvement methodologies.
Additional Requirements:
Expertise in healthcare provider or integrated healthcare system revenue cycle operational processes and systems.
Must be able to work in a Labor/Management Partnership environment.
Required Certification:
Green Belt OR Black Belt Certification required.
Skills:
They need excellent skills with Process Flows, Visio, Excel, Powerpoint
Preferred: Epic system knowledge preferred