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Join PacificSource and help our members access quality, affordable care!

PacificSource is an equal opportunity employer.  All qualified applicants will receive consideration for employment without regard to status as a protected veteran or a qualified individual with a disability, or other protected status, such as race, religion, color, national origin, sex, sexual orientation, gender identity or age.

Diversity and Inclusion:  PacificSource values the diversity of the people we hire and serve. We are committed to creating a diverse environment and fostering a workplace in which individual differences are appreciated, respected and responded to in ways that fully develop and utilize each person’s talents and strengths.

Serve as a leader with accountability for enterprise software systems and development. Lead evaluation, development, and implementation of software solutions which focus on medical management, membership, and provider platforms. Lead planning and execution of work to increase operational efficiency, improve provider processes, data quality, and guarantee scalability. Partner with Line of Business leaders in Health Services, Operations, Quality, and Provider Network to identify opportunities and optimize and develop new processes, including but not limited to automation, real-time transactions, interoperability, and provider management. Supervise and guide managers and teams regarding company policies, procedures, and workflow. As a member of the IT leadership team, contribute to the development and execution of the Enterprise Systems strategy, and ensure alignment with the overall IT and business strategy. Maintain a Capability Roadmap for the department which is in support of the company’s objectives and strategic plan.

Essential Responsibilities:

Develop roadmap and lead department in implementation and optimization of Epic systems in support of operations, medical management, pharmacy, PACE and interoperability strategies.Lead team and staff in the evaluation, development, and implementation of strategies to increase efficiency and quality of business operational processes using innovative technologies, like AI, ML, and NLP.Partner with business teams to consolidate, standardize, and improve the quality in submission processes to regulating entities.Liaise with Provider Network to fulfill regulatory requirements, improve provider data quality, reduce provider burden, and innovate capability for provider data management platforms. Guide the use of technology to reduce credentialing cycle time and lower operational costs.Liaise with business leadership to create capability roadmap and lifecycle for all EDI systems and processes, including the exchange of clinical data.Implement technologies to enable the real-time external access and exchange of member, claim, provider, pharmacy, and clinical data in support of Interoperability and strategic pillars.Analyze, establish, track, and improve measures for key process indicators in the domain of responsibility. Track IT department metrics, and support PacificSource Relative Index of Service Measures.As required, act as project and program manager for multi-disciplinary and cross-functional software development work.Standardize systems and processes to eliminate waste. Maintain quality assurance software testing and automated deployment practices in department.Develop and monitor annual department budgets. Lead department in development and execution of a work plan to support annual objectives.Develop and review department policies and procedures. Foster a culture of secure coding practices and support security and regulatory audits of department assets.Coordinate business activities by maintaining collaborative partnerships with other IT Leaders, key business departments and external partners.Actively participate in various strategic and internal committees to disseminate information within the organization and represent company philosophy.Foster a business-oriented culture and mindset driven by continual service improvement techniques, and champion ongoing professional development in the field of IT and the business.Maintain current on new technologies and service management practices and provide direction on emerging technologies and methods.Work closely with HR to execute a "people strategy" that defines appropriate metrics and aligns with the business and IT strategy. Continually participate in leading-edge and innovative solutions to the recruitment, development and retention of the department’s diverse workforce.Provide leadership, coaching and direction to the department’s management team and staff. Motivate and inspire to pursue excellence. Reward and recognize outstanding performance.Responsible for hiring, staff development, coaching, performance reviews, corrective actions, and termination of employees. Maintain broad knowledge of all positions assigned to lead and develop programs to assure ongoing training and coaching to assigned staff. Evaluate staff performance and review work in department. Analyze and determine staffing, training, and process improvement needs related to department goals. Conduct and submit performance evaluations on a timely basis.

Supporting Responsibilities:

Meet department and company performance and attendance expectations.Follow the PacificSource privacy policy and HIPAA laws and regulations concerning confidentiality and security of protected health information.Perform other duties as assigned.

SUCCESS PROFILE

Work Experience: A minimum of 10 years of software development experience required, including at least 5 years of progressive leadership responsibilities. At least 5 years of experience in implementation or operation of Epic. Experience in effectively managing cross-functional teams, influencing key stakeholders, across the organization and within complex contexts preferred. Proven experience in building and leading Software Development and Integration teams in complex and dynamic environments using varying methodologies like waterfall and agile. Demonstrated experience in developing and embedding the use of Artificial Intelligence (AI), Machine Learning (ML), and Natural Language Processing (NLP) in operational systems. Demonstrated experience in establishing standard processes and managing performance to achieve key metrics required.

Education, Certificates, Licenses: Bachelor's degree in Computer Science, Computer Engineering, Mathematics, or similar related field or equivalent work experience required. Epic certifications in payer systems preferred.

Knowledge: Ability to guide current software development and systems integration practices, such as Object Oriented Programming (OO), containerization, Continuous Integration/Continuous Deployment (CI/CD), messaging architectures, distributed computing, machine learning, and artificial intelligence. A clear track record of system optimization design and implementation of robust change management and software release practices will be required. Proven ability to perform duties with minimal supervision. Experience with Interoperability, claims adjudication, payment, and enrollment processes in Facets is also preferred. Proven ability to manage large programs and multiple projects with competing deadlines. Ability to solve complex problems. Ability to deal responsibly with confidential information. Ability to work in a team environment and manage multiple priorities across the enterprise.

Competencies:

Authenticity

Building Organizational Talent

Coaching and Developing Others

Compelling Communication

Customer Focus

Empowerment/Delegation

Emotional Intelligence

Leading Change

Managing Conflict

Operational Decision Making

Passion for Results

Environment: Work inside in a general office setting with ergonomically configured equipment. Travel is required approximately 10% of the time.

Skills:

Accountable leadership, Business & financial acumen, Empowerment, Influential Communications, Situational Leadership, Strategic Planning

Our Values

We live and breathe our values. In fact, our culture is driven by these seven core values which guide us in how we do business:

We are committed to doing the right thing.We are one team working toward a common goal.We are each responsible for customer service.We practice open communication at all levels of the company to foster individual, team and company growth.We actively participate in efforts to improve our many communities-internally and externally.We actively work to advance social justice, equity, diversity and inclusion in our workplace, the healthcare system and community.We encourage creativity, innovation, and the pursuit of excellence.

Physical Requirements: Stoop and bend. Sit and/or stand for extended periods of time while performing core job functions. Repetitive motions to include typing, sorting and filing. Light lifting and carrying of files and business materials. Ability to read and comprehend both written and spoken English. Communicate clearly and effectively.

Disclaimer: This job description indicates the general nature and level of work performed by employees within this position and is subject to change. It is not designed to contain or be interpreted as a comprehensive list of all duties, responsibilities, and qualifications required of employees assigned to this position. Employment remains AT-WILL at all times.