Sr Business Analyst, Provider Claims (Remote)

Lensa; City of Syracuse (NY); Remote; USD 77,000 - 129,000; Full time

Job summary

A leading healthcare company is seeking a Sr Business Analyst to analyze complex business problems and provide insights to decision-makers. The role involves collaborating with clients, creating specifications for reports, and participating in project stages. Candidates should have a Bachelor's Degree and 5-7 years of business analysis experience, preferably in managed care.

Qualifications

• 5-7 years of business analysis experience required.
• 6+ years managed care experience preferred.
• Certified Business Analysis Professional (CBAP) preferred.

Responsibilities

• Analyze complex business problems using data from various sources.
• Collaborate with clients to tailor analysis to their needs.
• Create Business Requirements Documents and participate in all project stages.

Skills

Proactive communication

Detail-oriented

Strong organizational skills

Time management skills

Education

Bachelor's Degree

Tools

Salesforce

Facets

Excel

Job description

Sr Business Analyst, Provider Claims (Remote)

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Job Description

Job Summary

Analyzes complex business problems and issues using data from internal and external sources to provide insights to decision-makers. Identifies and interprets trends and patterns in datasets to locate influences. Constructs forecasts, recommendations, and strategic/tactical plans based on business data and market knowledge. Creates specifications for reports and analysis based on business needs and available data elements. Collaborates with clients to modify or tailor existing analysis or reports to meet their specific needs. May participate in management reviews, including presenting and interpreting analysis results, summarizing conclusions, and recommending courses of action. This role involves working with various types of business data, either internal operations-focused or external client-focused.

Knowledge/Skills/Abilities

• Elicit requirements through interviews, document analysis, workshops, business process descriptions, use cases, and workflow analysis.
• Interpret customer business needs and translate them into application and operational requirements.
• Communicate and collaborate with internal and external customers to analyze needs, goals, and translate them into functional requirements, delivering appropriate artifacts.
• Work with operational leaders to recommend process improvements, cost savings, or revenue enhancements.
• Create Business Requirements Documents, Test Plans, Requirements Traceability Matrix, User Training materials, and other documentation.
• Participate in all project stages—research, design, programming, testing, and implementation—to ensure the final product meets requirements.

Job Qualifications

Required Education: Bachelor's Degree or equivalent experience.

Preferred Education: Bachelor's Degree or equivalent experience.

Required Experience:

• 5-7 years of business analysis experience
• 6+ years managed care experience
• Proficiency in relevant concepts, practices, and procedures
• Ability to manage escalations independently
• Proactive communication skills
• Detail-oriented and adaptable
• Strong organizational and time management skills

Preferred Experience

• 3-5 years of formal project management training
• Experience with complex technical teams
• Claims investigation within managed care
• Experience working with providers and internal operations teams
• Familiarity with Salesforce, Facets, and Excel reporting
• Strong analytical and documentation skills

Preferred License, Certification, Association

Certified Business Analysis Professional (CBAP) or similar certification is preferred.

Current Molina employees interested in this role should apply through the intranet.

Molina Healthcare offers competitive benefits and compensation. We are an Equal Opportunity Employer (EOE) M/F/D/V.

Pay Range: $77,969 - $128,519 annually. Actual compensation may vary based on location, experience, education, and skills.

Additional Details

• Seniority level: Mid-Senior level
• Employment type: Full-time
• Job function: Research, Analyst, IT
• Industries: IT Services and Consulting