Principal Consultant - Health Plan Operations

Job ID: J105311
Location: Pittsburgh, PA, United States
Full/Part Time: Full time
Job Type: Regular
Posted at:

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Description

JOB SUMMARY

This job leverages combined people, process, and technology competencies  to support large-scale, complex customer engagements; collaborates with Product, Infrastructure, and Security teams to configure solutions and deliver value to customers; acts as subject matter expert and trusted advisor in both practice and customer spaces; and works closely with engagement and practice leadership team to define strategic and tactical direction.

The incumbent will drive customer value through client facing advisory and delivery services in support of HM Health Solutions product offerings. Accountabilities include, but are not limited to, playing key leadership role in practice area (providing knowledge, innovation, professional networks, and eminence), leading major engagements, leading pre-sales and sales activities, building key customer relationships, building and sharing institutional knowledge, and developing junior professionals.

ESSENTIAL RESPONSIBILITIES

  • Lead the delivery and execution of complex, large scale, multi-year (high cost, high complexity and/or high risk) enterprise transformation programs for the Highmark Health Plan Account or within the Consulting Services Operations Practice.
  • Build, share, and maintain expertise in both practice area and client environment, regularly interface with Product, Infrastructure, and Security teams to deliver on customer commitments.
  • Contribute to operational readiness, organizational change management, solution capability, packaging, and estimating, planning and delivery management.
  • Design and owns deliverable artifacts to deliver client value and meet contractual obligations.
  • Lead major engagements projects to meet milestones on time, and to deliver with high quality and within agreed to budgets.
  • Act as senior leader in practice area, support pre-sales and sales activities.
  • Perform personnel management responsibilities including, but not limited to involvement in hiring and termination decisions; coaching, mentoring, and professional development of practitioners; practitioner rewards and recognition; on-going performance management; and evaluation of staff productivity.
  • Plan, organize, staff, direct and controls the day-to-day operations of the department; develops and implements policies and programs as necessary; may have budgetary responsibility and authority.
  • Other duties as assigned or requested.

MINIMUM REQUIRED QUALIFICATIONS

  • Bachelor's Degree in Business Administration, Management Information Science, Health Administration, or relevant field -OR- 6 years of experience working with Healthcare Operations (Claims, Enrollment, Benefit Coding, or Billing) platform/systems/applications in one or more of the following areas:  Application Development, system requirements, system testing, report writing, business process development, OR building system tables.
  • 10 years of consulting/and or industry experience, of which must include  3 years of working with Healthcare Operations (Claims, Enrollment, Benefit Coding, or Billing) platform/systems/applications in one or more of the following areas
  • Application Development, system requirements, system testing, report writing, business process development, OR building system tables.

PREFERRED QUALIFICATIONS

  • Master's Degree in Business Administration, Management Information Science, Health Administration, or relevant field
  • 7 years of healthcare/insurance industry experience
  • 7 year of technology platform delivery experience
  • 7 years of program / project management experience
  • Experience engaging, influencing, and advising senior executive leaders
  • Experience working in complex matrixed environments
  • Strong knowledge around health plan operations
  • Project Management Professional
  • Information Technology Infrastructure Library

Travel Requirement?

75% - 100%

Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities, and prohibit discrimination against all individuals based on their race, color, religion, sex, national origin, sexual orientation/gender identity or any other category protected by applicable federal, state or local law. Highmark Health and its affiliates take affirmative action to employ and advance in employment individuals without regard to race, color, religion, sex, national origin, sexual orientation/gender identity, protected veteran status or disability.
EEO is The Law
Equal Opportunity Employer Minorities/Women/ProtectedVeterans/Disabled/Sexual Orientation/Gender Identity (http://www1.eeoc.gov/employers/upload/eeoc_self_print_poster.pdf)
We endeavor to make this site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact number below.
For accommodation requests, please call HR Services at 844-242-HR4U or visit HR Services Online at HRServices@highmarkhealth.org

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