Sr Business Analyst, Provider Claims (Remote)

Lensa; Miami (FL); Remote; USD 77,000 - 129,000; Full time

Job summary

A leading company is seeking a Senior Business Analyst to analyze complex business problems and provide insights to decision-makers. This role requires collaboration with clients and operational leaders to recommend process improvements, and it demands a Bachelor's Degree along with significant experience in business analysis and managed care.

Qualifications

• 5-7 years of business analysis experience.
• 6+ years managed care experience.
• CBAP or similar certification preferred.

Responsibilities

• Analyze complex business problems using data.
• Collaborate with clients to tailor analysis.
• Develop Business Requirements Documents and Test Plans.

Skills

Proactive communication

Detail-oriented

Organizational skills

Time management

Analytical skills

Education

Bachelor's Degree

Tools

Salesforce

Facets

Excel reporting

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. Collaborates with clients to modify or tailor existing analysis or reports to meet their specific needs. May participate in management reviews, presenting and interpreting analysis results, summarizing conclusions, and recommending actions. 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, process descriptions, use cases, and workflow analysis.
• Translate customer business needs into application and operational requirements.
• Communicate and collaborate with internal and external stakeholders to analyze, transform needs into functional requirements, and deliver artifacts.
• Work with operational leaders to recommend process improvements, cost savings, or revenue enhancements.
• Develop Business Requirements Documents, Test Plans, Traceability Matrices, User Training materials, and other documentation.
• Participate in all project stages from research to implementation to ensure the 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, adaptable.
• Strong organizational and time management skills.

Preferred Experience:

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

Preferred Certifications: CBAP or similar from the International Institute of Business Analysis.

To apply, current Molina employees should use the intranet. Molina Healthcare offers competitive benefits. We are an EOE M/F/D/V.

Pay Range: $77,969 - $128,519 annually. 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