Analyst, Business - Advanced Excel (Remote)

Molina Healthcare; United States; Remote; USD 45,000 - 97,000; Full time

Benefits offered by this job

Competitive benefits

Equal Opportunity Employer

Job summary

Molina Healthcare seeks an analyst to support business requirements for coverage, reimbursement, and related system changes. You will intake and interpret regulatory and functional requirements, coordinating with stakeholders to support solutions development and governance processes.

The role emphasizes monitoring regulatory updates, documenting specifications, and driving consistent requirements across states and products while collaborating with health plan teams and leadership.

Qualifications

• Analytical and problem-solving skills with ability to synthesize complex requirements.
• Ability to organize and maintain regulatory data including real-time policy changes.
• Experience creating reporting tools and providing project/process updates.
• Effective verbal, written and interpersonal communication with stakeholders.

Responsibilities

• Provides analyst support for regulatory and functional requirements related to coverage and reimbursement.
• Develops and maintains requirement documents and aligns with health plan/product needs.
• Monitors regulatory sources and communicates interpretations to teams.
• Coordinates cross-functionally and supports governance committees.
• Documents changes to business processes and identifies improvement opportunities.
• Supports development of review processes and collaboration with partner organizations.
• Assists with requirement solution standards and best practices across states and products.
• Facilitates reporting to leadership and stakeholders on work efforts and impact.

Skills

Analytical thinking

Problem solving

Communication skills

Cross-functional collaboration

Project coordination

Microsoft Office

Tools

Microsoft Office Suite

Job description

JOB DESCRIPTION Job Summary

Provides analyst support for business requirements activities of moderate complexity. Responsible for accurate and timely intake and interpretation of regulatory and/or functional requirements related to but not limited to coverage, reimbursement and other applicable system changes to support systems solutions development and maintenance. Coordinates cross-functionally with stakeholders and subject matter experts to support business needs, and participates in governance committees as applicable.

Essential Job Duties

• Develops and maintains requirement documents related to coverage, reimbursement and other applicable system changes to ensure alignment with regulatory and health plan/product requirements.
• Monitors regulatory sources to ensure all updates are aligned.
• Navigates analytical problems and clearly defines and documents unique specifications.
• Supports development and ongoing interpretation of review processes, committees and collaboration with key partner organizations.
• Recognizes, identifies and documents changes to existing business processes and identifies new opportunities for process developments and improvements.
• Provides status updates to health plan/product team partners, senior leadership and applicable stakeholders.
• Communicates requirement interpretations and changes to health plans/product teams and various impacted functional areas for requirement interpretation alignment and approval and solution traceability; coordinates meetings and champions/deploys operational process best practices.
• Where applicable, codifies the requirements for system configuration alignment and interpretation.
• Provides support and/or requirement interpretation inconsistencies and complaints.
• Assists with the development of requirement solution standards and best practices, and suggests improvement processes as applicable to consistently apply requirements across states and products.
• Facilitates self-organized reporting to ensure health plans/product teams, leaders, and applicable stakeholders are aware of work efforts and impact for prospective or retrospective requirement changes that impact financials.
• Conducts industry research and engagement to evaluate, provide insights, and develop/deploy best practices.
• Coordinates with applicable teams for analysis, impact and implementation of changes that impact health plan/product.
• Engages with operational leadership and health plan support functions to review compliance-based issues for benefit planning purposes.
• Ensures end-to-end business requirements are documented, interpretation is agreed upon, and solutioning is clear for all applicable parties.
• Develops and maintains relationships with health plan/product teams and corporate operations.

Required Qualifications

• At least 2 years of operations/analyst experience in a managed care organization, health insurance setting or related field, or equivalent combination of relevant education and experience.
• Policy/government and legislative review knowledge.
• Analytical and problem-solving skills.
• Ability to concisely synthesize large and complex requirements.
• Ability to organize and maintain regulatory data including real-time policy changes.
• Self-motivated and ability to take initiative, identify, communicate, and resolve potential problems.
• Experience creating reporting tools/providing project/process updates.
• Familiarity with administration systems.
• Ability to work in a project team setting and complete individually assigned tasks within established timelines to meet desired deployment deadlines.
• Ability to work cross-functionally across a highly matrixed organization.
• Effective verbal, written and interpersonal communication skills, and ability to engage with stakeholders of all organizational levels.
• Microsoft Office suite and applicable software programs proficiency.

Preferred Qualifications

• Project management/implementation experience.
• Health care experience.
• Knowledge and experience with federal regulatory policy resources including Centers for Medicare & Medicaid Services (CMS) and the Affordable Care Act (ACA).
• Certified Business Analysis Professional (CBAP).

Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V

Pay Range: $44,936.59 - $97,362.61 / ANNUAL
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.