Northwest Permanente, P.C., is a self-governed, physician-led, multispecialty group of over 1,500 physicians, surgeons, and clinicians, caring for over 600,000 members in Oregon and Southwest Washington. Kaiser Permanente is one of the nation's preeminent health care systems, a benchmark for comprehensive, integrated, and high-quality care.
The Business Analyst (BA) Contract Management collaborates with other business SME's, systems and IT teams to deliver high impact business solutions that address the current and future business needs of the Provider Contracting department, and related downstream functions (claims and reimbursement, provider directories, credentialing). BA will have accountability for the following.
administering Change HealthCare's (CHC) Contract Manager (CM) system solely used by Provider Contracting Department, working with vendor, department leadership and cross functional SME's to optimize use of CM system, define business requirements, evaluate and test new functionality, and implement system upgrades.
cross-departmental initiatives to improve and optimize legacy processes and systems, identify system and process inefficiencies and minimal and optimal business requirements in recommending, designing, advocating for and implementing improvements for new system solutions.
develop and maintain provider contracting web-based tools and business processes with the objective of continuous process improvement. The position is accountable to continually evaluate and enhance systems and workflows to leverage automation, wherever possible, implement and improve best practices for contracted provider data management, interfaces with Credentialing, Finance and Claims functions, provider contract intake process, portfolio management and reporting capabilities of contracting and related work functions for purposes of keeping key stakeholders apprised of status of work.
BA develops training materials and delivers system and process training and support to department users.
Major Responsibilities / Essential Functions
In consultation with leadership and users, the position will define business requirements and translate these requirements to partners responsible for the implementation of technologies and management of vendor software releases. Collaborate with cross functional system teams to advocate and represent provider contracting business, legal, regulatory and compliance needs and ensure implementation of upgrades are complete, documented, and consistent with business requirements and that impact analysis have been performed and communicated. Participates in testing cycles for new system upgrades or enhancements.
Administer Change HealthCare's Contract Management system in Provider Contracting dept. Act as lead business user and have primary accountability for developing requirements and contract/ template design in Provider Contracting CM contract management system. Performs technical testing and validation of new contract templates in the CM testing environment prior to the release in CM production.
Consults with stakeholders to understand business problems, translates functional and non-functional requirements, designs solutions into the optimal end to end experience and deliver results.
Evaluate internal needs and business processes, assess appropriate tools and systems to improve processes, develop business requirements, make recommendations and drive the implementation of solutions that are sustainable and repeatable.
Deconstruct technical concepts to facilitate process development and process improvement.
Develop process maps and workflows; write and update relevant documentation. Review and assess processes, and on-going monitoring and analysis against requirements. Develop and deliver training solutions to users.
Regularly collaborate with cross functional team members to turn highly complex, previously unsolved problems into actionable recommendations for change.
Leading project teams of functional team members, coordinating team efforts and deliverables, serving as 'chief problem solver', communicating effectively with team, systems groups, project sponsors and stakeholders. Projects may range from full company impacting to individual department process enhancements.
Serves as Team Lead in creating and maintaining overall status of projects, process improvement and associated tasks. Requires management reporting as well as coordination with and direction to other team members as necessary.
Provides complex analytics and prepares analytical and statistical reports for Provider Contracting department leadership and staff, along with senior leaders, regulatory, and compliance requests. Develop specifications, identify data sources, design queries, and create reports to transform data into meaningful information that will be used to inform leaders in the assessment and management of Provider Contracting team workloads, contract and related project deliverables and to ensure compliance.
Bachelor's degree or equivalent experience
Minimum Work Experience
Minimum five (5) years of experience as a business analyst, project manager or process engineer
Minimum five (5) years of expert level knowledge and proficiency in the use of MS Office applications (Word, Excel, Outlook, Project, PowerPoint, Visio, SharePoint), in depth knowledge and experience with web-based technologies and relational database design concepts.
Minimum two (2) years of experience as a systems administrator performing system and user acceptance testing, system implementation and process improvement.
Prior experience with requirements gathering, documentation and process mapping. Demonstrated ability to quickly develop understanding of and translate business needs onto a web-based solution and administer the back end of applications to update functionality, understanding systems and how they operate, develop processes to optimize workflow including use cases.
Applied use of analytical skills including data analysis.
Provides communication to internal team, business and clinical partners and other key stakeholders. Communication should be specific and explain data/technical concepts in a way that is understood by non-technical business and clinical partners.
Strong problem solving, project management, business analysis, presentation and analytical skills.
High level of intellectual curiosity to understand current state, identify issues and provide solutions, while advising on positive and negative implications of decisions
Ability to communicate with external and internal stakeholders at all levels of the organization, including a strong ability to present, persuade and influence decision makers in order to meet business and regulatory needs.
Ability to meet deadlines in a fast paced, changing environment
Excellent written and verbal communication with a strong customer orientation. Ability to synthesize a variety of data to produce a cohesive and well-documented process.
Self-motivated and able to apply judgment in the prioritization and coordination of multiple assignments and projects. Ability to adapt within a dynamic environment with competing priorities.
Analytical, extremely detail oriented with ability to work effectively in both independent and team environments.
Organized and efficient in their approach to the work and is able to work both independently and as a team member in achieving objectives.
Flexibility in meeting the demands and strategic priorities of the department and organization.
Master's degree or equivalent experience
Preferred Work Experience and Qualifications
Lean Six Sigma Green Belt Certification and/or Project Management Professional Certification or equivalent certification.
Understanding of relevant corporate data systems including Change HealthCare Contract Manager system, Onyx and/or its replacement, Credentialing software, Claims/Tapestry application, among others
Seven (7) years of experience process development, policy and procedure documentation.
Seven (7) years of expert level knowledge in the use of MS Office applications and relational database design concepts.
Five (5) years of experience in managed care contracting.
Five (5) years of experience as a systems administrator and performing system and user acceptance testing.
Five (5) years of experience in project management, facilitation, and team building skills. Ability to plan, prioritize and deliver within constrained timelines.
Five (5) years of experience in managed care contracting, physician relations or practice management, legal administration, health plan administration. Strong familiarity with and ability to understand all aspects of a contract document.
Knowledge of health care delivery systems and operations, specific knowledge of Kaiser Permanente medical care delivery operations and systems highly desired.
At Northwest Permanente, P.C., 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, P.C. believes that diversity, inclusion, and equity among our employees is critical to our success and we seek to recruit, develop and retain the most talented people from a diverse candidate pool.
Physician Opportunities in Oregon & Southwest Washington. For more information please visit https://nwpermanente.com/jobs/About Us - Northwest Permanente is the Northwest’s largest physician-led, self-governed multispecialty group. We have opportunities available across the region in Portland, Salem, Oregon, and Longview, Washington. Northwest Permanente physicians practice medicine with a purpose that provides unparalleled opportunities for a meaningful and rewarding career in medicine.