Kaiser Permanente Business Analyst-Sr in Pleasanton, California
Responsible for identifying and documenting business processes through interviewing clients and reviewing and analyzing existing systems and processes. Articulates interrelationships and recasts business flow into system specifications. Conducts gap analyses to document discrepancies between business requirements and system capabilities. May develop project plans and ensure plan adherence. As system development progresses, may have input into reporting requirements/report development, user interfaces, and coordinates or conducts UAT and the final evaluation of the system solution. Serves as liaison between line business (client) and the IT organization.
Essential Functions -Responsible for researching Epic and troubleshooting software and workflow issues to understand software build steps needed for production environment of business application. -Configures Epic application based on analysis and collaborations to create builds. -Researches Epic application issues, performs root cause analysis, present findings and recommendations. -Identifies areas for work flow and process improvements in Epic. Vets ideas with team and works through applications improvements to implement. -Analysis: Responsible for Epic analysis of complex business requirements, systems upgrades, workflows and application capabilities. Utilizes analysis to collaborate with users, analysts and consultants to determine solutions and required configurations to meet business requirements. -Testing: Tests Epic application configurations and builds or does unit testing in non-production environment and reports on outcomes noting issues. Corrects issues found in testing. -Change Management: -to ensure process design, interface development, testing and implementation and user training are performed to quality standards. Prepares Epic builds for implementation into production. Trains on Epic application functions, changes, and improvements. Plans and communicates Epicproject implementations. Monitors Epic implementations into production, makes adjustments, as necessary. Monitors Epic cues of tasks to trend tasks for issues discrepancies, analyzes and implements solutions.
Business & Analytics Scope of work -7 Regions, 21 Environments, 3 Training Environments -Colorado -Hawaii -Mid-Atlantic States (VA, MD, DC) -Northern California -Northwest (Oregon/Washington) -Southern California -*Georgia Business Support -Troubleshoot production issues -Support for configuration build/enhancements -Research and design of build from an application and design management standpoint -Version testing and upgrades -Designing configuration efficiency -Improved design of mapping configuration -Report creation Standard/Ad-hoc Support triplets build in Tapestry ensuring that accurate linkages exist between Vendor ,Provider ,Place of service -Perform extracts/ad-hoc requests from other teams -Extract large amounts of data from chronicles and text to support triplet research/build -Analyze data and perform data manipulations and or calculations -Annual maintenance(loading of codes across contracts) of code sets -Coordination with regional HealthConnect teams -Data Management(MDM) across multiple environments -Multiple File Types -Multiple Data Sources(internal/external) -JXPORT (Epic utility) -Fee Schedule Data Collection(provided by appropriate KP resources not PSA-BASS) -Normalization -Loading -Long term maintenance -CMS -State -Medicaid -Reasonable and Customary -Prepare import specs to load initial provider build data and to migrate build from env to env -Review import error logs -Import build from one environment to another -Set up and prepare import spec for Fee Schedule -Defect correction/ correct errors on import logs -Data validation between environments -Research and resolve pended queue items in support of PV and UAT testing -Train/coach/mentor team members -Create/Modify reports in Reporting Workbench (Clarity)
Preferred Requirements: - Significant experience in documentation, research and reporting. - Proficiency in Tapestry Core AND AP OR Benefits Modules within 6 months of hire into the job. Additional time to acquire certification may be permitted at management's discretion. Proficiency requires a minimum of 75% exam score with a 100% score on the associated projects. Both, Certification and Proficiency levels, must be achieved within three times of completing Epic testing. If certification/KP proficiency is a requirement of the position, the individual must pass the application test by the third try. If not, consequences include termination or transition to a different role. - Training and testing maybe delivered at Epic or KP Facility. - Demonstrated intermediate competency in medical coding, medical terminology, claims processing, logical thinking and understanding of relational database is required. - Knowledge of state and federal regulations. - Strong critical thinking and analysis skills; verbal and written communications, and interpersonal interactions (e.g. partnering, conflict management, consulting, etc.). - Advanced proficiency in MS Office Suite of products. - Thorough understanding of relational databases. - Excellent interpersonal, communication, and listening skills are required. - Complete understanding and application of principles, concepts, practices, and standards. - Advanced knowledge in healthcare benefits, benefit administration and health care delivery from either/both a payor or provider perspective, EDI and paper claim lifecycle, along with health insurance industry practices and standards.
Preferred Qualifications: - Prefer Certification in other Tapestry modules in addition to Core, AP and Benefits. Certification requires a minimum of 80% exam score with a 100% score on the associated projects - Basis proficiency in Statistical analysis. - Knowledge of Certification/Accreditation Standards (NCQA, JCAHO, CMS, etc.). - Knowledge of Kaiser Permanente Internal processes. - Knowledge of Epic Tapestry Modules
Qualifications: Basic Qualifications: Experience - Minimum eight (8) years of related professional experience. Education - Bachelor's degree, OR four (4) years of experience in a directly related field. - High School Diploma or General Education Development (GED) required. License, Certification, Registration - N/A
Additional Requirements: - Contributes to the development of concepts, techniques and standards in general business analysis, as well as IT principles and practices. Skills required: - Analysis/documentation of processes, methods, solutions, etc. - Interpretive - translates business processes and requirements into system specifications - Must be able to work in a Labor/Management Partnership environment.
COMPANY Kaiser Permanente
TITLE Business Analyst-Sr
LOCATION Pleasanton, CA