Lead Analyst, Configuration Information Management - Claims / Regulatory Requirements - Remote

Molina Healthcare; Tucson (AZ); Remote; USD 80,000 - 110,000; Full time

Job summary

A leading healthcare company is hiring for a role focused on managing claims databases and ensuring effective business requirements are met. The position involves collaboration, training, and problem-solving with internal and external stakeholders. Ideal candidates will have a combination of significant experience, a Bachelor's Degree, and an aptitude for analytical tasks.

Qualifications

• 7-9 years of experience in relevant field.
• Bachelor's Degree or equivalent education and experience required.
• Preferred: Graduate Degree and 10+ years of experience.

Responsibilities

• Maintain and implement claims database information.
• Train staff on system updates and enhancements.
• Collaborate with stakeholders on business processes.

Skills

Problem solving

Negotiation

Communication

Education

Bachelor's Degree

Graduate Degree

Job description

Responsible for accurate and timely implementation and maintenance of critical information on claims databases. Maintains critical information on claims databases. Synchronizes data among operational and claims systems and application of business rules as they apply to each database. Validate data to be housed on databases and ensure adherence to business and system requirements of customers as it pertains to contracting, benefits, prior authorizations, fee schedules, and other business requirements.

KNOWLEDGE / SKILLS / ABILITIES

• Trains staff on configuration functionality, enhancements, and updates.
• Works with internal and external stakeholders to understand business objectives and processes associated with the enterprise.
• Problem solves with Health Plans and Corporate to ensure all end-to-end business requirements have been documented.
• Creates management reporting tools to enhance communication on configurations updates and initiatives.
• Negotiates expected completion dates with Health Plans.

JOB QUALIFICATIONS

Required Education

Bachelor's Degree or equivalent combination of education and experience

Required Experience

7-9 years

Preferred Education

Graduate Degree or equivalent experience

Preferred Experience

10+ 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.

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