EDI​/API Business Consultant

RESPONSIBILITIES

Kforce is seeking a highly motivated Business Consultant Specialist to support one of our enterprise Healthcare clients. This role is fully remote, but the client would ideally like candidates to sit in one of the following states: CO, CA, OR, or WA.

The Business Consultant will support Business Line leadership in the development and execution of strategic analyses, plans, and business processes. This role collaborates closely with regional and national Health Plan leadership, functional areas, and other business lines to drive impactful initiatives and monitor performance.

• Troubleshooting membership inquiries for individual plans
• Managing integrations and general inquiries
• Leading cross-functional initiatives

• Support the development, execution, and monitoring of regional and national strategies and work streams
• Partner with stakeholders to identify analytic gaps and opportunities, and develop comprehensive solutions
• Lead and support cross-functional/regional projects with clear goals, timelines, milestones, and outcomes
• Monitor environmental changes impacting strategies and develop action plans with leadership
• Coordinate data and reporting across functional areas and regions
• Execute specific initiatives in support of regional goals
• Provide executive-level status reporting and program-wide updates
• Build and maintain relationships across the organization to gain buy-in and move initiatives forward
• Guide projects through complex decision-making regarding scope, resources, and deliverables
• Provide leadership in problem-solving and resolution selection
• Escalate critical issues to VP or executive sponsor level as needed
• Mentor project team members to enhance skills and capabilities

• Bachelor’s degree or 4 years of equivalent experience
• 5 years of experience in healthcare electronic files, including 2-3 years with EDI
• 3 years in a consulting role leading complex, cross-functional initiatives
• Strong independent working ability and thought partnership with leadership
• Excellent written and verbal communication skills tailored to various audiences
• Proficient in Microsoft Excel, PowerPoint, Word, Outlook, Visio, and Project
• Attention to detail
• Customer-focused mindset
• Strong accountability

• Master’s degree
• Project Management or Process Re-engineering certification
• Experience analyzing complex data from multiple sources and developing actionable recommendations
• Familiarity with SharePoint and Power BI

The pay range is the lowest to highest compensation we reasonably in good faith believe we would pay at posting for this role. We may ultimately pay more or less than this range. Employee pay is based on factors like relevant education, qualifications, certifications, experience, skills, seniority, location, performance, union contract and business needs. This range may be modified in the future.

We offer comprehensive benefits including medical/dental/vision insurance, HSA, FSA, 401(k), and life, disability & ADD insurance to eligible employees. Salaried personnel receive paid time off. Hourly employees are not eligible for paid time off unless required by law. Hourly employees on a Service Contract Act project are eligible for paid sick leave.

Note:

Pay is not considered compensation until it is earned, vested and determinable. The amount and availability of any compensation remains in Kforce’s sole discretion unless and until paid and may be modified in its discretion consistent with the law.

This job is not eligible for bonuses, incentives or commissions.

Kforce is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, pregnancy, sexual orientation, gender identity, national origin, age, protected veteran status, or disability status.