KP ORG Employee Reviews for Anonymous Employee

"Business Asset, Technical Resource, Innovation Ambassador •Conducting enterprise-wide PMO portfolio analysis,delivery & operational readiness assessments •Proven-track record of project success at prior engagements as demonstrated by supporting implementations that increase KPIs, PMPM savings, ROI, First Call Resolutions, Rating Quality Measures, HEDIS Measures •Seasoned in supporting seamless migration and integration of legacy systems, mergers, acquisitions & new lines of business •Veteran in executing strategic program initiatives that are continuously monitored by executive leadership •Business Process Improvement: Effective Knowledge Transfer, Minimization of Desk Level Procedures, Decision Support, Standardization of Service Level Agreements, Delegation Oversight, Ad-Hoc Reports and Dashboards •Subject matter expertise in standard X12 EDI transactions (834,837I/P,835,270/271, 277U, 277CA, 278 Prior Auth, 999, TA1), Capitated Claims, Encounters, Rx Claims, HL7, CCDA, Clinical APIs, Admit Discharge Transfer Notifications, HIE Alerts, EMR and other structured and non-structured data sets •Extensive knowledge of HMO, PPO, HSA, Medicaid, Medicare, Dual Eligible demonstrations, BPCI bundled payments model and various complex care programs including PACE, TANF, CHIP, DSNP, LTSS/MLTC, •Worked on innovative features to further advance adoption of CMS Social Determinants, Home Health & Tele-Medicine in-conjunction with holistic integrative approach to Healthcare Delivery •Hands on experience with US Title 21 CFR Part 11 (FDA regulations), HIPAA, HITECH, Privacy Rules, U.S TCPA, FEDRAMP, GDPR (EU) & CANSPAM"