Claims Business Analyst - QNXT - CA Remote

Molina Healthcare; Long Beach (CA); Remote; USD 68,000 - 112,000; Full time

Job summary

An established industry player is seeking a Claims Business Analyst to design and implement innovative solutions for data analysis and business decision-making. This role involves collaborating across departments to tackle key business challenges using statistical analysis and advanced reporting methods. Ideal candidates will have a strong background in data mining and SQL, along with excellent communication skills. Join a dynamic team where your insights will drive business performance and improve healthcare outcomes. This is a fantastic opportunity to grow in a supportive environment while contributing to meaningful projects.

Qualifications

• 1-3 years of experience in data analysis and reporting.
• Familiarity with Enrollment and Managed Healthcare is required.

Responsibilities

• Extract and analyze data from various sources to identify trends.
• Prepare state mandated reports and collaborate with clients.

Skills

Statistical Analysis

Data Mining

SQL

MS Excel

Data Analysis

Communication Skills

Team Player

Education

Associate's Degree

Bachelor's Degree

Tools

QNXT

Analytics Software

Job description

Claims Business Analyst - QNXT - CA Remote

Join to apply for the Claims Business Analyst - QNXT - CA Remote role at Molina Healthcare

Claims Business Analyst - QNXT - CA Remote

Join to apply for the Claims Business Analyst - QNXT - CA Remote role at Molina Healthcare

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JOB DESCRIPTION Job Summary

Designs and implements processes and solutions associated with a wide variety of data sets used for data/text mining, analysis, modeling, and predicting to enable informed business decisions. Gains insight into key business problems and deliverables by applying statistical analysis techniques to examine structured and unstructured data from multiple disparate sources. Collaborates across departments and with customers to define requirements and understand business problems. Uses advanced mathematical, statistical, querying, and reporting methods to develop solutions. Develops information tools, algorithms, dashboards, and queries to monitor and improve business performance. Creates solutions from initial concept to fully tested production, and communicates results to a broad range of audiences. Effectively uses current and emerging technologies.

• Extracts and compiles various sources of information and large data sets from various systems to identify and analyze outliers.
• Sets up process for monitoring, tracking, and trending department data.
• Prepares any state mandated reports and analysis.
• Works with internal, external and enterprise clients as needed to research, develop, and document new standard reports or processes.
• Implements and uses the analytics software and systems to support the departments goals.
• Must have member movement or PCP reassignment or Enrollment and Provider termination experience.
• Must have intermediate level MS Excel experience,
• Familiarity with Enrollment and Managed Healthcare experience is required.
• Must be able to research and analyze data using SQL is required.
• Experience with QNXT is preferred.

JOB DESCRIPTION Job Summary

Designs and implements processes and solutions associated with a wide variety of data sets used for data/text mining, analysis, modeling, and predicting to enable informed business decisions. Gains insight into key business problems and deliverables by applying statistical analysis techniques to examine structured and unstructured data from multiple disparate sources. Collaborates across departments and with customers to define requirements and understand business problems. Uses advanced mathematical, statistical, querying, and reporting methods to develop solutions. Develops information tools, algorithms, dashboards, and queries to monitor and improve business performance. Creates solutions from initial concept to fully tested production, and communicates results to a broad range of audiences. Effectively uses current and emerging technologies.

Knowledge/Skills/Abilities

• Extracts and compiles various sources of information and large data sets from various systems to identify and analyze outliers.
• Sets up process for monitoring, tracking, and trending department data.
• Prepares any state mandated reports and analysis.
• Works with internal, external and enterprise clients as needed to research, develop, and document new standard reports or processes.
• Implements and uses the analytics software and systems to support the departments goals.
• Must have member movement or PCP reassignment or Enrollment and Provider termination experience.
• Must have intermediate level MS Excel experience,
• Familiarity with Enrollment and Managed Healthcare experience is required.
• Must be able to research and analyze data using SQL is required.
• Experience with QNXT is preferred.
• Medicare/ medicaid membership exp required
  
  

Required soft skill include but are not limited to :

• Excellent communication
• Possess a team player attitude
• Ability to work in a diverse environment.
• Must be flexible and willing to learn new skills.
  
  

Job Qualifications

Required Education

Associate's Degree or equivalent combination of education and experience

Required Experience

1-3 years

Preferred Education

Bachelor's Degree or equivalent combination of education and experience

Preferred Experience3-5 Years

To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.

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

Pay Range: $68,640 - $111,967 / ANNUAL

• Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

Seniority level

• Seniority level

  Entry level

Employment type

• Employment type

  Full-time

Job function

• Job function

  Research, Analyst, and Information Technology

• Industries

  Hospitals and Health Care

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