Senior Enrollment Analytics Lead (Remote)

Molina Healthcare; Northern (KY); Hybrid; USD 64,000 - 107,000; Full time

Job summary

Molina Healthcare is seeking a remote Sr. Business Analyst for Enrollment Research & Analytics to support enrollment operations and analyze member data across lines of business.

You will build reporting and dashboards to help operations run smoothly and ensure compliant coverage across CMS/state regulations. The role provides senior analyst support for high-level requirements, coordinating with stakeholders, and driving improvements in enrollment processes.

Qualifications

• At least 4 years of operations/analyst experience in a managed care organization, health insurance setting or related field, or equivalent combination of relevant education and experience.
• Policy/government and legislative review knowledge.
• Analytical and problem-solving skills.
• Ability to concisely synthesize large and complex requirements.
• Ability to organize and maintain regulatory data including real-time policy changes.
• Self-motivated and ability to take initiative, identify, communicate, and resolve potential problems.
• Experience creating reporting tools/providing project/process updates.
• Familiarity with administration systems.
• Ability to work in a project team setting and complete individually assigned tasks within established timelines to meet desired deployment deadlines.
• Ability to work cross-functionally across a highly matrixed organization.
• Effective verbal, written and interpersonal communication skills, and ability to engage with stakeholders of all organizational levels.
• Microsoft Office suite and applicable software programs proficiency.

Responsibilities

• Develops and maintains requirement documents related to coverage, reimbursement and other applicable system changes to ensure alignment with regulatory and health plan/product requirements.
• Monitors regulatory sources to ensure all updates are aligned.
• Navigates analytical problems and clearly defines and documents unique specifications.
• Supports development and ongoing interpretation of review processes, committees and collaboration with key partner organizations.
• Recognizes, identifies and documents changes to existing business processes and identifies new opportunities for process developments and improvements.
• Provides status updates to health plan/product team partners, senior leadership and applicable stakeholders.
• Communicates requirement interpretations and changes to health plans/product teams and various impacted functional areas for requirement interpretation alignment and approval and solution traceability; coordinates meetings and champions/deploys operational process best practices.
• Where applicable, codifies the requirements for system configuration alignment and interpretation.
• Provides support and/or requirement interpretation inconsistencies and complaints.
• Assists with the development of requirement solution standards and best practices, and suggests improvement processes as applicable to consistently apply requirements across states and products.
• Facilitates self-organized reporting to ensure health plans/product teams, leaders, and applicable stakeholders are aware of work efforts and impact for prospective or retrospective requirement changes that impact financials.
• Conducts industry research and engagement to evaluate, provide insights, and develop/deploy best practices.
• Coordinates with applicable teams for analysis, impact and implementation of changes that impact health plan/product.
• Engages with operational leadership and health plan support functions to review compliance-based issues for benefit planning purposes.
• Ensures end-to-end business requirements are documented, interpretation is agreed upon, and solutioning is clear for all applicable parties.
• Develops and maintains relationships with health plan/product teams and corporate operations.
• Provides training and support to new and existing team members.

Skills

Analytical thinking

Problem solving

MS Office

Reporting tools

Cross-functional collaboration

Stakeholder communication

Education

Bachelor's degree or equivalent

Tools

Microsoft Office Suite

Administration systems

Job description

Molina Healthcare is seeking a remote Sr. Business Analyst for Enrollment Research & Analytics to support enrollment operations and analyze member data across lines of business.

You will build reporting and dashboards to help operations run smoothly and ensure compliant coverage across CMS/state regulations. The role provides senior analyst support for high-level requirements, coordinating with stakeholders, and driving improvements in enrollment processes.