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Kaiser Permanente

Integrated healthcare provider and payer platform

Information Technology Consultant 5 - Governance Risk and Compliance

Enterprise ApplicationsUpdated on Nov 11
Full-timeGreensboro, NC, USANo salary listedIn-person

About the Job

Requirements

  • A bachelor's degree in Business Administration, Computer Science, CIS, or a related field and at least eight years of experience in IT consulting, business analysis, or a related field; equivalent additional work experience may substitute for the degree requirement.

Responsibilities

  • Conduct or oversee business-specific projects by applying subject-matter expertise, promoting adherence to procedures and policies, developing work plans, determining processes and methodologies, coordinating resources, partnering with stakeholders, solving complex problems, escalating risks, monitoring results, identifying improvement opportunities, evaluating recommendations, and influencing completion of project tasks.
  • Build relationships with cross-functional stakeholders, communicate information and advice to drive projects forward, influence team members, provide and respond to feedback, adapt to competing demands and change, mentor junior team members, and develop plans to build on strengths and improve opportunity areas.
  • Develop requirements, or lead IT consultants in developing requirements, for complex or specialized process or system solutions across business domains in partnership with stakeholders and IT teams.
  • Use multiple business requirements-gathering methodologies to identify business, functional, and non-functional requirements across the enterprise.
  • Lead and oversee development and documentation of business cases assessing costs, benefits, return on investment, and total cost of ownership for complex solution proposals.
  • Provide insight, guidance, and recommendations on the evolution of applications, systems, and processes toward a desired future state, using an understanding of how current processes affect enterprise operations.
  • Map current-state processes against future-state processes.
  • Define the impact of requirements on upstream and downstream solution components.
  • Advise senior management and business leaders on integrating requirements with current systems and enterprise business processes.
  • Review, evaluate, and prioritize value gaps and opportunities for process enhancements or efficiencies.
  • Influence solution design by advising IT teams in design sessions and translating requirements into workable business solutions.
  • Recommend additional data or services needed to address business issues related to process or solution design.
  • Participate in evaluating third-party vendors as directed.
  • Lead the development, implementation, and maintenance of standardized tools, templates, and processes to drive continuous process improvement across the enterprise.
  • Recommend regional and national process improvements aligned with sustainable best practices and business goals.
  • Support enterprise compliance modernization initiatives, including revenue cycle compliance, revenue integrity, risk adjustment oversight, internal audit, and regulatory change management.
  • Select and implement technology platforms and capabilities for claims audit management, analytics, provider and coder oversight, and continuous compliance monitoring.
  • Partner with business and technology stakeholders to design scalable compliance operating models that improve regulatory responsiveness, process efficiency, organizational transparency, and compliance oversight.

Desired Qualifications

  • Four years of experience working for a health care organization.
  • Four years of experience working for an IT organization.

About the Company

Kaiser Permanente

Integrated healthcare provider and payer platform

Kaiser Permanente runs an integrated healthcare platform that lets members manage and pay medical, premium, and pharmacy bills online. It serves Medicare Advantage, Individual and Family, and non-employer plans, offering options to pay as a guest or set up payment plans. The platform works by presenting a centralized online portal where users can view bills, choose how to pay, and handle multiple types of charges in one place. Revenue comes from premiums and medical services fees, while the service aims to reduce administrative work for both providers and patients and encourage on-time payments. What sets Kaiser Permanente apart is its combination of healthcare services with a single billing experience across multiple plan types, focusing on a user-friendly, centralized payment process rather than handling billing through separate systems. Its goal is to provide a straightforward, reliable way for members to manage and pay their bills, improving convenience and payment timeliness.

Company size
10,001+
Company stage
Grant
Total funding
$7.5M
Headquarters
Oakland, CA
Founded
1945

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