Remote Health Plan Analyst - Regulatory & Requirements

Molina Healthcare; Michigan; Remote; USD 50,000 - 97,000; Full time

Benefits offered by this job

Competitive benefits

Job summary

Molina Healthcare in the United States (Michigan) is seeking an analyst to support business requirements activities of moderate complexity, focusing on coverage, reimbursement, and processing functions to back systems solutions.

The role requires advanced Excel skills, strong analytical capability, and the ability to collaborate across matrixed teams, governance committees, and health plan partners to ensure accurate, timely requirements interpretation and deployment.

Qualifications

• 2+ years in operations/analyst role within health care or managed care.
• Ability to review policy updates and translate to requirements.
• Strong analytical and problem-solving abilities.
• Capability to organize large regulatory data and real-time changes.
• Experience creating updates and reports for projects.

Responsibilities

• Develops and maintains requirement documents related to coverage, reimbursement and system changes.
• Monitors regulatory sources to ensure updates are aligned.
• Navigates analytical problems and documents specifications clearly.
• Supports development and interpretation of review processes and collaborations with partner organizations.
• Documents changes to business processes and identifies opportunities for improvements.
• Provides status updates to health plan/product teams and leadership.
• Communicates interpretations and changes to multiple stakeholders for alignment and traceability.
• Codifies requirements for system configuration alignment where applicable.
• Supports interpretation inconsistencies and complaints.
• Assists in developing requirement standards and best practices across states and products.
• Facilitates self-organized reporting to ensure stakeholders are aware of work impact.
• Conducts industry research to provide insights and best practices.
• Coordinates with teams for analysis, impact and implementation of changes.
• Engages with leadership to review compliance-based issues for benefit planning.
• Ensures end-to-end requirements are documented and agreed.

Skills

Operations/analyst experience

Policy/ government review

Analytical problem solving

Synthesize complex requirements

Regulatory data management

Initiative & proactive

Reporting tools proficiency

Cross-functional collaboration

Verbal & written communication

Tools

Microsoft Office

Job description

Molina Healthcare in the United States (Michigan) is seeking an analyst to support business requirements activities of moderate complexity, focusing on coverage, reimbursement, and processing functions to back systems solutions.

The role requires advanced Excel skills, strong analytical capability, and the ability to collaborate across matrixed teams, governance committees, and health plan partners to ensure accurate, timely requirements interpretation and deployment.