Job Summary

Business Process Consultant job in Pasadena (97463)

  • Location:
    Pasadena , California
  • Category:
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Are you interested in working for the #1 Healthcare company in America?
Are you authorized to work in the U.S. without sponsorship?  (We are unable to work C2C all employees must work W2).
Job Summary
Responsible for a range of process improvement and process management activities. Activities include planning, performing, 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 standalone 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.
Major Responsibilities/Essential Functions:

  • Data Analysis: Reviews data analyses prepared by less senior analysts/ consultants. Defines requirements for data and sets standards of data collection. Support staff in resolving issues that prevent customer agreement.
  • Research: Reviews best practice research prepared by less senior analysts/consultants. Makes recommendations on appropriate solutions based on research; selects from alternatives presented.
  • Process Architecture: Designs more complex processes and reviews the work of less senior analysts/consultants. Ensures process mapping is complete; provides feedback and guidance to less senior analysts/consultants. 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. Leads the development of recommendations by less senior analysts/consultants. 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, project champions, and process owners to align process improvement initiatives with business objectives.
  • May have formal supervisory responsibility.
  • 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.
  • May have formal supervisory responsibility, and provides ongoing coaching, enabling team members to improve skills and capabilities that support the effectiveness of the department and/or function. Serves as a technical/professional coach to team members.

Minimum Education
Bachelor's degree required
Minimum Work Experience and Qualifications
1. 5+ years of process improvement, management consulting, change management, or related business experience with advanced knowledge of process improvement methodologies.
2. Expertise in healthcare provider or integrated healthcare system revenue cycle operational processes and systems.
3. Ability to demonstrate knowledge of the local, state, and/or federal, Commercial laws and regulations; billing requirements, to include, but not limited to: ICD-9, CPT, and DRG codes, and fee schedule allowances and reductions; medical terminology and calculations necessary for account management.
4. Ability to demonstrate knowledge of line of business specific billing and collection rules, regulations and other pertinent payer specific requirements.
5. Good understanding of denial management
6. Good understanding of both hospital billing as well as Professional billing
7. Proficiency with MS Office suite
Preferred Work Experience and Qualifications
Graduate degree preferred. Healthcare or insurance experience preferred. Detailed knowledge of HealthConnect and the use of and proficiency with EPIC in context of revenue cycle operations.
If you feel that you are a great match for this opportunity, please apply directly or feel free to contact Bryan at 303-474-2071.
"In compliance with federal law, all persons hired will be required to verify identity and eligibility to work in the United States and to complete the required employment eligibility verification document form upon hire.

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