Remote Business Analyst - Health Plans & Regulatory

Molina Healthcare, Inc.; Lansing (MI); Remote; USD 65,000 - 90,000; Full time

Job summary

Molina Healthcare, Inc. is seeking a business requirements analyst to support regulatory and functional requirements related to coverage, reimbursement, and processing functions.

The role coordinates with stakeholders, documents complex specifications, and ensures alignment with health plan requirements. Ideal candidates bring advanced Excel skills, at least 2 years in a managed care/health insurance setting, and CBAP certification.

Qualifications

• Advanced Excel skills.
• At least 2 years of operations/analyst experience in a managed care organization or health insurance setting.
• Policy/government and legislative review knowledge.
• Experience creating reporting tools and providing project updates.
• Ability to work in a project team and meet deployment deadlines.
• CBAP certification.

Responsibilities

• Interpret and document regulatory and/or functional requirements for coverage, reimbursement, and processing.
• Coordinate with stakeholders and SMEs and participate in governance committees.
• Develop and maintain requirement documents ensuring alignment with regulatory and health plan requirements.
• Provide status updates to leadership and stakeholders.
• Communicate requirement interpretations and changes across teams for alignment and traceability.
• Codify requirements for system configuration alignment where applicable.
• Support requirement interpretation issues and complaints.
• Facilitate self-organized reporting for awareness of work impact on financials.
• Coordinate with teams for analysis, impact and implementation of changes affecting health plan.
• Engage with operational leadership to review compliance issues for benefit planning.
• Ensure end-to-end business requirements are documented and understood by all parties.
• Develop and maintain relationships with health plan/product teams and corporate operations.

Skills

Advanced Excel

Analytical thinking

Project coordination

Communication skills

Education

CBAP Certification

Tools

Microsoft Office

Job description

Molina Healthcare, Inc. is seeking a business requirements analyst to support regulatory and functional requirements related to coverage, reimbursement, and processing functions.

The role coordinates with stakeholders, documents complex specifications, and ensures alignment with health plan requirements. Ideal candidates bring advanced Excel skills, at least 2 years in a managed care/health insurance setting, and CBAP certification.