Senior Analyst, Enrollment & Regulatory Solutions

Socket.dev; Long Beach (CA); On-site; USD 95,000 - 125,000; Full time

Benefits offered by this job

Competitive benefits package

Job summary

Molina Healthcare is seeking a senior analyst to provide expert support for business requirements activities related to coverage, reimbursement, and processing functions. This role supports the Enrollment CoE and focuses on improving enrollment processes and developing clear business requirements.

The ideal candidate will coordinate cross-functionally with stakeholders, monitor regulatory sources, and document interpretations for alignment and traceability across health plans and product teams.

Qualifications

• At least 4 years of operations/analyst experience in a managed care organization, health insurance setting or related field.
• Policy/government and legislative review knowledge.
• Analytical and problem-solving skills.
• Ability to synthesize large and complex requirements concisely.
• Experience creating reporting tools and providing project updates.
• Familiarity with administration systems.
• Ability to work in a matrixed, cross-functional environment.

Responsibilities

• Develops and maintains requirement documents related to coverage, reimbursement and system changes to align with regulatory and health plan requirements.
• Monitors regulatory sources to ensure updates are aligned.
• Documents unique specifications and navigates analytical problems.
• Supports governance processes and collaborates with partner organizations.
• Identifies changes to business processes and opportunities for improvements.
• Provides status updates to leadership and stakeholders.
• Communicates requirement interpretations to health plans/teams and coordinates meetings.
• Codifies requirements for system configuration as needed.
• Assists with development of requirement standards and best practices.
• Facilitates self-organized reporting on impact of changes for financials.
• Conducts industry research to deploy best practices.
• Coordinates with teams for analysis and implementation of changes.
• Reviews compliance-based issues with operational leadership.
• Ensures end-to-end business requirements are documented and clear.

Skills

Operations/analyst experience

Policy/government review

Analytical problem solving

Communication skills

Microsoft Office proficiency

Cross-functional collaboration

Tools

Microsoft Office

Job description

Molina Healthcare is seeking a senior analyst to provide expert support for business requirements activities related to coverage, reimbursement, and processing functions. This role supports the Enrollment CoE and focuses on improving enrollment processes and developing clear business requirements.

The ideal candidate will coordinate cross-functionally with stakeholders, monitor regulatory sources, and document interpretations for alignment and traceability across health plans and product teams.