Under general supervision, this position is responsible for the development and maintenance of the Fac Org Data in the Common Provider Master (CPM). The CPM system organizes provider, facility, & department and organizational data used to ensure accurate revenue capture, financial, & compliance with Medicare and Medicaid requirements and reporting needs. In addition, used by multiple clinical and business applications. The CPMSC's are accountable for ensuring the integrity of this regulated data and processes to capture, evaluate, process, and protect the data.
Essential Functions:
- Represents the CPM function w/ KP users region-wide & external parties to departments such as Scheduling, Credentialing, Ancillary Services, Revenue Capture & Collection, Financial Management, & Compliance
- Responds to phone & email inquiries by clarifying policies, procedures, & data categorization
- Collaborates w/ department manager on exceptional issues
- Works w/ KP management to ensure that facility & organization data (Fac Org) is accurately captured in the KP systems & that decisions regarding data utilization at the Site of Service are appropriate
- Screens & enters new & revised data requests from medical centers to ensure conformity w/ the Structures Information Governance Standards Guide & the Local Fac Org Maintenance Policies & Procedures
- Reviews & approves the creation of Hospital Inpatient Fac Org & Clinical Fac Org data in CPM that supports the KP Health Connect application.
- Contributes to the design, requirements, & data standards for the CPM system
- Develops procedures to safeguard data integrity, data access, & to ensure information is compliant
- Attends & collaborates with department manager at the monthly Regional Structures Information Governance meetings
- Responsible for developing yearly enhancements to the Lotus Notes Change Request Database that support SOX requirements, Compliance & Revenue Cycle Integrity business needs while meeting the immediate business/operational needs of the local medical centers
- Audits the database for accuracy to ensure that the information meets all compliance requirements
- Utilizes project management techniques & tools to providing analytical & administrative support to various projects for CPM department use, as well as external KP management information
- Develops & manages complex management information reports for KP management & external organizations used for operational analyses & audits
- Creates monthly project reports, consolidates, & analyzes results to provide variance analyses and performance metrics
- Maintains & publishes the Structures in Governance documents in Docushare & on the Policy website
Qualifications:
Basic Qualifications:
- 5+ years of progressive experience in specified technical area; business analyst experience in health care preferred
- Bachelor's degree or equivalent in Business Administration, Health Care Administration, Operations Research, or other related field, or equivalent experience
- Proven ability to determine key business issues and develop effective responses from multi-disciplinary perspectives
- Demonstrated ability to conduct and interpret quantitative and qualitative analysis
- Demonstration of skill level may be required
- Excellent verbal and written communication skills and interpersonal skills
- Advanced MS Office skills in Word and Excel
- Advanced skills in any of the following skills: MS Project, PowerPoint, Visio, PDF Writer, & Access
- Basic knowledge of the Lotus Notes Change Request Database
- Must be able to work in a Labor/Management Partnership environment
Preferred Qualifications:
- Kaiser experience highly preferred
- CPM experience highly preferred
- PARRS experience highly preferred
External hires must pass a background check/drug screen.
We are proud to be an equal opportunity/affirmative action employer.