No matter what your job title, the work you do at Kaiser Permanente supports the health and well-being of our members. All 8.7 million of them. That's because each of us-from our financial professionals and IT team members to our RNs and physicians on the front line of care-shares a commitment to providing the best possible care experience. With locations across the United States, we offer the opportunity to build a rewarding career in an environment that supports your success. Join us and put your beliefs into practice.

Kaiser Permanente is heavily investing in new capabilities to support Health Plan claims processing. The HP Claims/EDI Sub-Portfolio Solution Design Consultant will be responsible for all aspects of computer system design related to the implementation of new claims solutions and upgrades to existing ones. The ideal candidate will be a thought partner to internal business partners, information technology professionals and vendors. This is a technology position, but requires a strong business-focused background. The Solution Design Consultant will collaborate with business and IT partners in key areas:

• Understand current KP systems and their functional capabilities
• Help business leaders understand business requirements and performing gap analysis relative to industry standards and future directions for strategic initiatives
• Identify, evaluate and recommend solution alternatives
• Provide solution guidance to junior team members.
• Prepare cost estimates
• Manage cross functional design teams
• Work with development organizations to ensure successful implementations of designed solutions.

The ideal candidate will be able to work as part of the team when required as well as have the capability to lead technical tracks as needed.

Responsibilities:

• Identifying, designing and facilitating the delivery of IT based solutions to meet these needs.
• Prepare, present, and collaborate on all required deliverables of the technical solutions team.
• Analyze and evaluate hardware, software tools, and business and IT processes to support proposed solutions. Develop preliminary solution architectures.
• Document the high-level technical design to enable the integration and implementation of the solution
• Contribute to the development of a Claims systems product strategy for Kaiser Permanente.
• Responsible for understanding the strategic direction, priorities and needs of our business partners.
• Facilitate requirements definition in collaboration with business and key partners
• Function as project lead for the coordination of technical solution design including requirements definition, solution alternatives and recommendations, logical design and coordination with systems teams for physical designs
• Identify and define solution alternatives/strategies along with initial estimates, risks and recommendations.
• Organize, prioritize, and manage multiple tasks and deliverables
• Effectively document, communicate (oral and written) and explain technical material
• Perform root cause analysis, uncover critical business requirements, and facilitate solution delivery
• Create and maintain templates, schedules, estimates and models
• Create and maintain technical documentation for architecture, systems, vendor solutions and strategy
• Coordinate with other project managers and Solutions Design & Consulting staff to identify cross-project dependencies
• Coordinate activities of multiple vendors and subject matter experts and assist in development of SLAs
• Establish and sustain strong ongoing relationships with KP-IT and business partners
• Ensure the effective partnerships and alignment of the various systems strategies

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Basic/Minimum Qualifications:

• A BA/BS in any field or equivalent years of work experience .
• 10 years of progressive IT experience, with demonstrated success in software development, design and implementation of software applications - preferably in health plans or managed care organizations.
• 5 years of experience in a senior solutions design role using software development life cycle methodologies including: Eliciting and documenting business and systems requirements from business partners and applying structured software life cycle & development methodologies (RUP, RM-ODP, RAD, etc.).
• Experience with claims management applications, working with business to understand requirements and solution design needs.

Preferred Qualifications

• Candidate should have a solid understanding of Health Plan business and systems in a specific area or areas (e.g., membership, benefits, claims, pricing/underwriting, call centers, etc.) along with deep technology acumen particularly in system and application architecture, EDI and Web services/SOA.
• Demonstrated experience in a senior solutions design or integration architect role using industry standard system development life cycle methodologies.
• Demonstrated facilitation, collaboration, documentation, and presentation skills.
• Demonstrated capability to work with both Technical and Business resources.
• Demonstrated capability to lead a technical team towards a common project goal.
• Ability to develop and maintain strong working relationships with Business and IT resources.
• Deep technology and business acumen.
• Excellent oral and written communications skills.
• Excellent problem solving and "decision making" skills.
• Healthcare or insurance industry experience is preferred.
• Must have demonstrated success working in a matrix team environment for a large organization
• Ability to understand business needs and translate them into solutions.
• Self Motivated, Independent work capability
• Results orientation - Demonstrated ability to execute in a fast paced environment.
• Experience designing solutions using web and SOA based architectures.
• Experience working at a major consulting organization with an emphasis on delivery of complex enterprise solutions.
• Experience evaluating software packages and working with application vendors and system integrators on Request for Information/Request for Proposals
• Experience working with vendors and systems integrators.
• Must be flexible and have the ability to work in a complex and constantly changing environment.

Primary Location: New York-Latham

Scheduled Hours (1-40): 40

Shift: Day

Working Days: Mon-Fri

Working Hours Start: 8:00am

Working Hours End: 5:00pm

Schedule: Full-time

Job Type: Standard

Employee Status: Regular

Employee Group: Salaried Employees

Job Level: Individual Contributor

Job: Information Technology

Public Department Name: KP-IT - HP-BIO

Travel: No

External hires must pass a background check/drug screen. We are proud to be an equal opportunity/affirmative action employer.