Sr Business Analyst, Provider Claims (Remote)

Lensa; Columbus (GA); Remote; USD 77,000 - 129,000; Full time

Job summary

A leading company in IT Services and Consulting seeks a Senior Business Analyst for Provider Claims. The role involves analyzing business problems, creating reports, and collaborating with clients. Candidates should have a Bachelor's degree and extensive experience in business analysis and managed care.

Qualifications

• 5-7 years of business analysis experience.
• 6+ years in managed care.
• Proficiency in relevant concepts, practices, and procedures.

Responsibilities

• Analyzes complex business problems using data from various sources.
• Creates specifications for reports and analysis based on business needs.
• Collaborates with clients to tailor existing analysis or reports.

Skills

Communication

Analytical Skills

Detail-oriented

Organizational Skills

Time Management

Education

Bachelor's Degree

Tools

Salesforce

Facets

Excel Reporting

Job description

Sr Business Analyst, Provider Claims (Remote)

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Lensa is the leading career site for job seekers at every stage of their career. Our client, Molina Healthcare, is seeking professionals. Apply via Lensa today!

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 actions. This role involves working with various types of business data and can be 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 Matrices, User Training materials, and related documentation.
• Participate in all project stages, including research, design, programming, testing, and implementation, ensuring the product meets requirements.

Job Qualifications

Required Education: Bachelor's Degree or equivalent experience

Required Experience:

• 5-7 years of business analysis experience
• 6+ years in managed care
• 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
• Claims research experience
• Strong analytical and documentation skills

Preferred Certifications: CBAP or similar from IIBA

Interested candidates currently employed at Molina 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 Functions: Research, Analysis, IT
• Industries: IT Services and Consulting