Highmark Health Associate Principal Consultant - relocate or reside Mountain West (CO, ND, WY, MN) area in Bismarck, North Dakota

Description

**PLEASE READ ENTIRE JOB DESCRIPTION - SPECIFIC DETAILS RELATING TO EACH OF THE 2 OPENINGS ARE LISTED BELOW

JOB SUMMARY

The consulting workforce leverages combined people, process, and technology competencies to support large-scale, complex customer engagements; collaborates with Product, Infrastructure, and Security teams to configure solutions and deliver value to customers; acts as subject matter expert and trusted advisor in both practice and customer spaces; and works closely with engagement and practice leadership team to define strategic and tactical direction.

The Senior Consultant delivers value to customers through client-facing advisory and delivery service in support of the HM Health Solutions product offerings. Accountabilities include, but are not limited to, owning deliverable artifacts, leading workstreams, engaging key customer stakeholders, building and sharing institutional knowledge, and developing junior professionals.

ESSENTIAL RESPONSIBILITIES

  • Contribute to the delivery and execution of complex, large scale, multi-year (high cost, high complexity and/or high risk) client enterprise transformation programs by: gathering required data through direct observation and/or inquiry and synthesizing data into meaningful observation; analyzing, identifying and problem solving from information sets (issues could be business or systems issues) drawing conclusions from information sets based on analysis, creating hypotheses and presenting recommendations to team; developing client specific requirements, standard operating procedures, functional roles & responsibilities, process flow and user-guides.

  • Must also have some/any experience with or knowledge of: ( i) how to provide Healthcare Domain Consulting in one of the functional areas like marketing, sales, claims, authorization, provider, benefits, contracts, billing, commissions, enrollment, portals and data warehousing; (ii) how to develop and implement SaaS based Products and Solutions for healthcare payer/provider organizations; (iii) how to use process flows and work flows for business process re-engineering; (iv) how to analyze problems to present pro/cons for solutions and recommended approaches; and (v) how to serve as liaison between customer communities (internal/external).

  • Build, share, and maintain expertise in both practice area and client environment, regularly interface with Product, Infrastructure, and Security teams to deliver on customer commitments.

  • Contribute to operational readiness, organizational change management, solution capability, packaging, and estimating, planning and delivery management.

  • Design and own deliverable artifacts to deliver client value and meet contractual obligations.

  • Lead engagement workstreams to meet milestones on time, and to deliver with high quality and within agreed to budgets.

  • Provide coaching, mentorship, and professional development for junior resources.

  • Other duties as assigned or requested.

Specific Experience Preferred for Associate Principal - Middle Office

  • In the Middle Office & Vendor integration (care management, utilization management, pharmacy, dental, vision) role. The candidate must have exceptional communication, program/project portfolio management, and consulting skills as described in the job description. The role will be accountable for operating performance and client satisfaction within the Middle Office domain. The candidate also must have background with health care provider activities such as Care Management, Audit/Finance, Utilization Management, Pharmacy Account, Spending account, Vendor integration-Dental, Vision. The position will be actively engaged in leading IT development projects and steady state support as well as development of solutions in the middle office space.

  • Help manage production operations within the Middle office domain by coordinating the identification and resolution of production issues for those defined applications and processes

  • Oversee multi-tiered development initiatives in the Middle Office and Vendor management space, ensuring the project team is in alignment with approved project plans and key deliverables (requirements, test scenarios, risks, etc.) are being properly and timely managed.

Specific Experience Preferred for Associate Principal - Back Office

  • In the Back Office (provider, membership, claims) role the candidate must have exceptional communication, program/project portfolio management, and consulting skills as described in the job description. The role will be accountable for operating performance and client satisfaction within the Back Office domain. The candidate also must have background with health care provider activities such as provider, claims, enrollment, appeals, billing, credentialing, pricing and reimbursement. The position will be actively engaged in leading IT development projects and steady state support as well as development of solutions in the back office space.

  • Help manage production operations within the Back office domain by coordinating the identification and resolution of production issues for those defined applications and processes

  • Oversee multi-tiered development initiatives in the Back Office and Vendor management space, ensuring the project team is in alignment with approved project plans and key deliverables (requirements, test scenarios, risks, etc.) are being properly and timely managed

EDUCATION

Required

  • Bachelor's Degree in Business Administration, Management Information Science, Health Administration, or relevant field

Substitutions

  • None

Preferred

  • Master's Degree in Business Administration, Management Information Science, Health Administration, or relevant field

EXPERIENCE

Required

  • 8 years in Consulting/and or Industry experience

Preferred

  • 5 years in the Healthcare/Insurance Industry

  • 5 years in Technology Platform Delivery

  • 5 years in Program/Project Management

  • Experience engaging, influencing, and advising senior executive leaders

  • Experience working in complex matrixed environments.

PREFERRED LICENSURE

Project Management Professional, Information Technology Infrastructure Library

TRAVEL REQUIREMENT: - Up to80%

Position requires relocation to WY/ND or Colorado area within 6 months or currently res

Referral Level Payout 4

REQNUMBER: J131027

Equal Opportunity Employer Minorities/Women/ProtectedVeterans/Disabled/Sexual Orientation/Gender Identity