• US Citizen

• Green Card

• EAD (OPT/CPT/GC/H4)

• H1B Work Permit

• Corp-Corp

• Consulting/Contract

• UG :- - Not Required

• PG :- - Not Required

• No of position :- ( 1 )

• Post :- 13th Aug 2022

People withstrong Financial ops and payer experience.  They realized that thefinancialops people don’t know requirements.  The need someone who candocumentrequirements, but also make recommendations on how to change them,improvedthem, etc.  He keeps saying Process Engineer.  Theperson willprobably need some BA, maybe PM background but also have enoughknowledge tomake recommendations for change.  Could also do somechangemanagement.  They need to design processes that will scale, documentandpropose how it should change.  They need to be patient – the guywholeads this function is a real talker, he’ll also dive down intominutedetails.  Helpful is local, but can be anywhere.  Ithink inorder to make recommendations for change, this person will needthathealthcare payer experience, Financial background is a plus.

You will work with the Financial Operations team to ensureprocesses and technology can scale to support rapid growth.

This includes working with teams across the _____ to develop andexecute a plan for integrating with and migrating to new systems for managingthe flow of funds across providers, plansponsors, and reinsurance companies andplan sponsor billing.  

In this engagement, the consultant will: 

• Understand the current operational processes and identify opportunities to streamline and automate the processes 
• Establish and document features required of the target financial systems 
• Evaluate and confirm target system capabilities, including identifying any gaps in needed functionality 
• Evaluate and integrate solutions and processes across vendors and trading partners 
• Develop a plan for integrating with and migrating to the target systems, inclusive of any interim solutions 
• Negotiate with partners across the enterprise to establish support for the plan 
• Own and drive a product roadmap in coordination with finance, operations, product, and technology to support near-term features in the existing system as well as requirements for the integration with the target system 
• Write user stories and prioritize the product backlog 
• Drive Agile development practices 
• Work with the financial operations team to redesign processes for efficiency and accuracy 

Qualifications: 

• Deep understanding of health plan operations, including the ‘call for funds’ process and health plan billing 
• Process redesign expertise 
• Product mindset that can identify and execute on automation opportunities 
• Ability to navigate and negotiate a complex organization 

Unique balance of disciplined analytical thinking,creative passion, and a willingness to be hands-on