Claims Business Analyst - QNXT - CA Remote

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

Job summary

A leading company in IT Services and Consulting is seeking a Claims Business Analyst to design and implement data solutions. The role involves collaborating across departments to analyze data and support business decisions. Ideal candidates will have strong analytical skills, experience with SQL, and a background in healthcare analytics. Join a dynamic team that values communication and teamwork in a diverse environment.

Qualifications

• 1-3 years of experience required.
• Experience with member movement, PCP reassignments, and provider terminations necessary.

Responsibilities

• Designs and implements processes for data analysis to support business decisions.
• Collaborates with clients to define requirements and understand business challenges.
• Develops tools and dashboards to monitor business performance.

Skills

Data Analysis

Communication

Teamwork

Flexibility

Education

Associate's Degree

Bachelor's Degree

Tools

SQL

MS Excel

QNXT

Job description

Claims Business Analyst - QNXT - CA Remote

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Lensa is the leading career site for job seekers at every stage of their career. Our client, Molina Healthcare, is seeking professionals. Apply via Lensa today!

Job Description

Summary: Designs and implements processes and solutions related to data sets used for data/text mining, analysis, modeling, and prediction to support informed business decisions. Gains insights into key business problems by applying statistical analysis techniques to structured and unstructured data from multiple sources. Collaborates across departments and with clients to define requirements and understand business challenges. Uses advanced mathematical, statistical, querying, and reporting methods to develop solutions. Develops tools, algorithms, dashboards, and queries to monitor and improve business performance. Creates solutions from concept to production and communicates results to diverse audiences. Utilizes current and emerging technologies effectively.

Knowledge, Skills, and Abilities

• Extracts and compiles large data sets from various systems to identify outliers.
• Establishes processes for monitoring, tracking, and trending departmental data.
• Prepares state-mandated reports and analyses.
• Works with internal, external, and enterprise clients to research, develop, and document reports or processes.
• Implements and uses analytics software to support departmental goals.
• Experience with member movement, PCP reassignments, enrollment, and provider terminations required.
• Intermediate MS Excel skills required.
• Familiarity with enrollment and managed healthcare essential.
• Proficiency in SQL data analysis required.
• Experience with QNXT preferred.
• Medicare/Medicaid membership experience necessary.

Soft Skills

• Excellent communication skills.
• Team player attitude.
• Ability to work in a diverse environment.
• Flexible and eager to learn new skills.

Qualifications

Education: Associate's Degree or equivalent experience.

Experience: 1-3 years.

Preferred Education: Bachelor's Degree or equivalent experience.

Preferred Experience: 3-5 years.

Current Molina employees interested in this role should apply through the intranet.

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

Pay Range: $68,640 - $111,967 annually. Actual compensation may vary based on location, experience, education, and skills.

Additional Details

• Seniority level: Entry level
• Employment type: Full-time
• Job functions: Research, Analysis, IT
• Industries: IT Services and Consulting

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