Job Summary: The Membership Administration (MA) shared services organization at Kaiser Permanente (KP) is a customer-facing group that provides critical information to support care delivery, revenue management, and health plan operations. Within KP, the MA function oversees over 100 million transactions (e.g., enrollment, premium billing, reconciliation) per year to support $70+ billion of annual premiums for 12+ million members and 90K+ employer groups. MA is currently implementing a new administration platform (KP MembershipConnect) that will enhance transaction processing automation and facilitate business process standardization across multiple MA lines of business (Commercial, individual & Family, Medicare, and Medicaid) across all KP markets. KP MembershipConnect (KPMC) is a multi-year system implementation and process optimization program that will roll out industry leading capabilities for premium billing, enrollment/eligibility updates, group/contract setup, and self-service transaction processing.The Solution Implementation Business Consultant III reports to the role of Manager, Managerial Consulting and is assigned to the KPMC program. The role will work closely with MA operational leaders, IT leaders, and vendor partners across one or more components of the KPMC platform. This key role will operate as a business consultant who analyzes application configuration against approved requirements, provides critical insights through root cause analysis and solution recommendations to testing defects, and documents business process flows to validate integration with upstream/downstream KPMC components.Essential Responsibilities:
Pursues effective relationships with others by proactively providing resources, information, advice, and expertise with coworkers and members. Listens to, seeks, and addresses performance feedback; provides mentoring to team members. Pursues self-development; creates plans and takes action to capitalize on strengths and develop weaknesses; influences others through technical explanations and examples. Adapts to and learns from change, challenges, and feedback; demonstrates flexibility in approaches to work; helps others adapt to new tasks and processes. Supports and responds to the needs of others to support a business outcome.
Completes work assignments autonomously by applying up-to-date expertise in subject area to generate creative solutions; ensures all procedures and policies are followed; leverages an understanding of data and resources to support projects or initiatives. Collaborates cross-functionally to solve business problems; escalates issues or risks as appropriate; communicates progress and information. Supports, identifies, and monitors priorities, deadlines, and expectations. Identifies, speaks up, and implements ways to address improvement opportunities for team.
Serves as part of a consultant team to ensure the alignment, buy-in, and coordination of diverse stakeholders to drive the implementation of successful business initiatives and projects within a functional track or workstream by identifying and ensuring representation and inclusion of appropriate stakeholders; building rapport and partnerships with stakeholder teams, third party vendors, and senior management; working with stakeholders to develop goals and set the prioritization of deliverables; identifying and escalating tough stakeholder issues while maintaining an independent perspective; preparing presentations and reports; and leading or facilitating team meetings.
Develops requirements for business, process, or system solutions within assigned business domain(s) by interfacing stakeholders and cross-functional teams as appropriate; leveraging multiple business requirements gathering methodologies to identify business, functional, and non-functional requirements; and developing and documenting comprehensive business cases to assess the costs, benefits, and ROI of proposed solutions.
Provides insight and supports the development and implementation of business initiatives, systems, and/or processes to a desired future state by maintaining a working understanding of how current processes impact business operations; mapping current state against future state processes; identifying the operational impact of requirements on upstream and downstream solution components; providing options and recommendations to management and business stakeholders on how to integrate solutions and deliverables with current systems and business processes; and identifying and validating value gaps and opportunities for process enhancements or efficiencies.
Supports strategic planning and organizational alignment and prioritization of business initiatives by defining, developing, and evaluating performance metrics, standards, and methods to establish business success; collaborating with multiple stakeholders, often with competing/conflicting objectives, to ensure cohesive and reachable metrics; and managing assigned initiatives to ensure delivery of measurable results and alignment with strategic objectives.
Serves as a advocate of continuous learning and professional development by keeping abreast of industry practices, standards, and benchmarks; attending and participating in roadshows, conferences, and speaking events; contributing to the ongoing enhancement and innovation of consulting practices, standards, and methods across KP; and serving as an advocate to ensure continuous learning and improvement is championed as a people strategy.
Manages moderately complex projects or project components by coordinating stakeholder contacts; recommending or assigning team resources based on project needs and team member strengths; consulting in the development, analysis, and management of project plans; coordinating project schedules and resource forecasts; proactively monitoring and identifying project or business initiative risks, issues, and trigger events; developing mitigation plans and strategies; and resolving or escalating risks or issues as appropriate.
Participates in change management activities associated with business initiatives by engaging stakeholders to obtain support and buy in for changes; collaborating with management, project champions, and business owners to communicate and align improvement initiatives with business objectives; using appropriate change management methods and approaches; and ensuring stakeholders embrace a change management mindset, and understand initiative intent and purpose.
Performs data analyses to support business initiatives by using appropriate data analysis tools and approach to assess business performance; deploying suitable data gathering and analysis methods (e.g., process observation, hard data, etc.); defining data requirements and obtaining customer agreements, including customer requirements as appropriate; conducting analyses and performing experimental tests to evaluate the effectiveness of business solutions; and identifying and alleviating risks through data-driven analysis.
Supports vendor management as required by assisting with reviews of vendor performance levels; ensuring service level agreements are met; and partnering with Procurement and/or Legal to assist in the development of service level and/or scope of work agreements as appropriate.
Monitors compliance of work activities by ensuring business plans and team members adhere to KP, departmental, and/or business line policies and procedures.
Minimum Qualifications:
Bachelors degree from an accredited college or university and Minimum three (3) years experience in consulting, project management, data analytics, operations or a directly related field OR Masters degree in Business, Public Health, or a directly related field and Minimum one (1) years experience in consulting, project management, data analytics, operations or a directly related field OR Minimum six (6) years experience in consulting, project management, data analytics, operations or a directly related field.
Additional Requirements:
Knowledge, Skills, and Abilities (KSAs): Negotiation; Creativity; Applied Data Analysis; Conflict Resolution; Risk Assessment; Service Focus; Requirements Elicitation & Analysis; Business Acumen; Managing Diverse Relationships
COMPANY: KAISERTITLE: KP Membership Connect Solution Implementation Business Consultant IIILOCATION: San Diego, CaliforniaREQNUMBER: 1265271External hires must pass a background check/drug screen. Qualified applicants with arrest and/or conviction records will be considered for employment in a manner consistent with Federal, state and local laws, including but not limited to the San Francisco Fair Chance Ordinance. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, protected veteran, or disability status.
