Remote Health Plan BA – Regulatory & Reimbursement

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

Job summary

Molina Healthcare, Inc. is seeking an analyst to support business requirements activities of moderate complexity in a managed care context.

You will interpret regulatory and functional requirements related to coverage, reimbursement, and processing to support systems solutions development and maintenance. The role requires advanced Excel skills and experience developing requirement documents for system changes to ensure alignment with regulatory and health plan/product requirements.

Qualifications

• Experience interpreting regulatory requirements related to coverage, reimbursement and processing functions.
• 2+ years of operations/analyst experience in managed care or health insurance setting or equivalent education/experience.
• CBAP certification is a plus.

Responsibilities

• Interpret and document regulatory and functional requirements for systems solutions.
• Coordinate with health plan/product teams and stakeholders to align requirements.
• Develop and maintain requirement documents and reports.
• Provide status updates to leadership and applicable teams.
• Support governance committees and change management processes.
• Identify process improvements and opportunities for optimization.
• Ensure end-to-end requirements are documented and traceable.

Skills

Stakeholder coordination

Regulatory awareness

Documentation

Requirement analysis

Education

Bachelor's degree or higher in related field

Tools

Excel

Job description

Molina Healthcare, Inc. is seeking an analyst to support business requirements activities of moderate complexity in a managed care context.

You will interpret regulatory and functional requirements related to coverage, reimbursement, and processing to support systems solutions development and maintenance. The role requires advanced Excel skills and experience developing requirement documents for system changes to ensure alignment with regulatory and health plan/product requirements.