Company :Highmark Inc.Job Description :
GENERAL OVERVIEW:
***CANDIDATE MUST BE US Citizen (due to contractual/access requirements)***
This is a hybrid position requiring EST work hours. Office attendance is mandatory three days a week for those living within 50 miles of Highmark's footprint. Candidates living outside the 50-mile radius should anticipate 25% travel for client and stakeholder meetings.
The Highmark Provider Technology & Operations team aims to improve the healthcare ecosystem by equipping our provider partners with cutting-edge technology and seamless operations to enable them to deliver high-quality care and achieve optimal health outcomes for all.
This position is responsible for providing expert data analysis or consultation regarding complex data processes, business processes and interfaces to support the areas to allow project teams to make decisions on the integration of enterprise-wide applications. The position will leverage current and emerging technologies to develop business solutions, and perform functional decomposition techniques to reengineer processes for continuous improvement. Responsible for communicating effectively with all levels of the organization, including steering committees and project sponsors. Provides consulting as an application or cross-functional expert on complex and/or highly visible projects using project management and business expertise. Provides coaching, consulting and mentoring team members on multi-faceted, highly complex business/systems processes.
ESSENTIAL RESPONSIBILITIES:
- Communicating effectively with all levels of the organization.
- Identify and articulate problems to steering committees and/or project sponsors.
- Provide consultation on the development of business solutions to satisfy complex project goals and objectives.
- Resolve problems and make decisions regarding complex issues and projects.
- Establish and maintain customer touch points
- Providing expert data analysis or consultation regarding complex data processes, business processes and interfaces to support the areas. Provides expert advice to allow project teams to:
- Make decisions based on how individual applications integrate with other enterprise-wide applications using expert knowledge.
- Collaborate with systems architects utilizing analytical, testing or project management tools to facilitate project deliverables.
- Perform functional decomposition techniques to reengineer processes for continuous improvement.
- Consulting as an application or cross-functional expert on complex and/or highly visible projects using project management and business expertise to produce project deliverables.
- Coaching, consulting and mentoring team members on multi-faceted, highly complex business/systems processes.
- Other duties as assigned or requested.
EDUCATION
Required
- High School Diploma or GED
Substitutions
- None
Preferred
- Bachelor’s degree
EXPERIENCE
Required
- 7 years analyzing business processes to include one or more of the following: Interpreting system documentation, Data modeling and/or business process modeling, Dataflow / context diagramming, etc.
- 7 years in Project Management, including: Project Lifecycle methodology for gathering requirements, developing test scenarios and cases, risk management, issue management planning and coordination, etc.
- 7 years utilizing PC with standard applications, report writers and/or query tools
- 7 years of presenting to large groups, developing training documentation and/or providing training and creating process/technical documentation
OR
- 3 years of relevant work experience with a Bachelor’s Degree
OR
- 1 year of relevant work experience with a Master’s Degree
Preferred
- Experience in Health Insurance or Provider operations and technology.
- Experience in the domains of revenue cycle, health plan operations, interoperability, hospital operations, value-based reimbursement, healthcare technology, healthcare data and analytics, or similar functions.
LICENSES or CERTIFICATIONS
Required
- None
Preferred
- Project Management Professional (PMP)
SKILLS
- Ability to analyze business processes to include one or more of the following:
- Interpreting system documentation, Data modeling and/or business process modeling, Dataflow / context diagramming, etc.
- Ability to manage projects including activities such as:
- Project Lifecycle methodology for gathering requirements, developing test scenarios and cases, risk management, issue management planning and coordination, etc.
- Ability to utilize PC with standard applications, report writers and/or query tools
- Ability to present to large groups, developing training documentation and/or providing training and creating process/technical documentation
Language (Other than English):
None
Travel Requirement:
0% - 25%
PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS
Position Type
Office-based
Teaches / trains others regularly
Occasionally
Travel regularly from the office to various work sites or from site-to-site
Rarely
Works primarily out-of-the office selling products/services (sales employees)
Never
Physical work site required
Yes
Lifting: up to 10 pounds
Constantly
Lifting: 10 to 25 pounds
Occasionally
Lifting: 25 to 50 pounds
Rarely
Disclaimer: The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job.
Compliance Requirement: This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies.
As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company’s Handbook of Privacy Policies and Practices and Information Security Policy.
Furthermore, it is every employee’s responsibility to comply with the company’s Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements.
Pay Range Minimum:
$67,500.00
Pay Range Maximum:
$126,000.00
Base pay is determined by a variety of factors including a candidate’s qualifications, experience, and expected contributions, as well as internal peer equity, market, and business considerations. The displayed salary range does not reflect any geographic differential Highmark may apply for certain locations based upon comparative markets.
Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities and prohibit discrimination against all individuals based on any category protected by applicable federal, state, or local law.
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