Sr Business Analyst, Provider Claims (Remote)

Mainstreetwashington; Davenport (IA); Remote; USD 77,000 - 129,000; Full time

Job summary

A leading company in healthcare seeks a Business Analyst to analyze complex business problems, collaborate with clients, and provide insights based on data. The role requires strong communication and organizational skills, with a focus on process improvements in managed care. Candidates should have a Bachelor's degree and relevant experience in business analysis and managed care.

Qualifications

• 5-7 years of business analysis experience.
• 6+ years managed care experience.

Responsibilities

• Analyzes complex business problems using data.
• Collaborates with clients to modify reports.
• Provides recommendations for process improvements.

Skills

Communication

Detail-oriented

Organizational Skills

Time Management

Proactive

Education

Bachelor's Degree

Tools

Salesforce

Excel

Job description

JOB DESCRIPTION

Job Summary

Analyzes complex business problems and issues using data from internal and external sources to provide insight 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 required or 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 a course of action. This is a general role in which employees work with multiple types of business data. May be internal operations-focused or external client-focused.

KNOWLEDGE/SKILLS/ABILITIES

• Elicit requirements using interviews, document analysis, and requirements workshops, business process descriptions, use cases, business analysis, task and workflow analysis.

• Interpret customer business needs and translate them into application and operational requirements

• Communicate and collaborate with external and internal customers to analyze and transform needs, goals and transforming in to functional requirements and delivering the appropriate artifacts as needed.

• Work with operational leaders within the business to provide recommendations on opportunities for process improvements, medical cost savings or revenue enhancements.

• Create Business Requirements Documents, Test Plans, Requirements Traceability Matrix, User Training materials and other related documentations.

• Actively participates in all stages of project development including research, design, programming, testing and implementation to ensures the released product meets the intended functional and operational requirements.

JOB QUALIFICATIONS

Required Education: Bachelor's Degree or equivalent combination of education and experience

Preferred Education: Bachelor's Degree or equivalent combination of education and experience

Required Experience

• 5-7 years of business analysis experience,

• 6+ years managed care experience.

• Demonstrates proficiency in a variety of concepts, practices, and procedures applicable to job-related subject areas.

• Ability to manage escalations independently

• Proactive communicator

• Detail-oriented and adaptable

• Strong organizational and time management skills

Preferred Experience

• 3-5 years of formal training in Project Management

• Experience working with complex, often highly technical teams

• Strong claims investigation experience within managed care

• Background working with providers and internal ops teams

• Familiarity with Salesforce, Facets, and Excel-based reporting

• Managed care or claims research experience

• Strong analytical and documentation skills

Preferred License, Certification, Association

Certified Business Analysis Professional (CBAP), Certification from International Institute of Business Analysis preferred

To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.

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

Pay Range: $77,969 - $128,519 / ANNUAL

*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.