Business Consultant, Lead (Oakland, CA) Job in Oakland, California US
Business Consultant, Lead (Oakland, CA)
Business Consultant Lead Oakland, Pleasanton or Corona, CA Responsible as seasoned analyst for business deliverables on projects under the Health Plan Data Strategy Program. Under the overall guidance of the Program Business Lead and/or Manager, and in collaboration with other project team members and functional subject matter experts,the candidate will be required to lead a team and/or perform the following:collect business requirements, review logical and physical designs, test, and deploy solutions. In addition, the candidate will be responsible for researching data, performing analyses, presenting results, and making recommendations as needed to various levels of functional and project leadership. Solution will provide improved capabilities to access information for operational, tactical, and strategic decision making. Essential Functions: - Develop and document business requirements in support of strategic initiatives such as the Health Plan Data Strategy. Provide subject matter expertise and collaborate with associates in National and Regional Actuarial and Underwriting associates as well as other various Health Plan functional areas. Participates in testing/validating of requirements. - Responsible for documenting all data attributes and working closely with the KPIT resources to insure the attributes and data model are accurately translated into technical specifications. - Demonstrates initiative in identifying alternative solutions to issues which are reasonably complex and require an understanding of how the outcome will affect multiple areas/departments. - Responsible for the implementation and maintenance of the HPDS Data Dictionary, working with business stakeholders on implementation of those definitions. - Participates and may lead various project phases and other duties as needed. - Directs the validation of results to insure that deliverables meet defined requirements. Qualifications: Basic Qualifications: - Minimum of 5 years of business and data analysis experience. - Demonstrated ability to determine key business issues and develop appropriate analysis plans. - Must exhibit efficiency, collaboration and results orientation. - Solid analytical skills, problem solving, and critical thinking. - Strong organizational skills, excellent verbal and written communication skills. - Must be able to work in a Labor/Management Partnership environment. - Bachelor's degree Preferred Qualifications: - Health care experience is preferred with a focus on Claims and Membership. - Familiar with standard health care coding (CPT, HCPCS, ICD9, DRG, and NDC) and administrative data (UB and HCFA, 837/835). Relevant experience should include knowledge of software to support accessing and analyzing large data sets. - Familiar with KP source systems which capture and create claim and encounter data or experience with Practice Management and Claims Processing Systems. - Training in relational databases, SQL and database programming.