Sr Business Analyst, Provider Claims (Remote)

Lensa; Milwaukee (WI); Remote; USD 77,000 - 129,000; Full time

Job summary

A leading company in IT Services is seeking a Senior Business Analyst to analyze complex business problems and provide insights to decision-makers. The role involves data analysis, creating reports, and collaborating with clients to meet specific business needs. Candidates should have a Bachelor's Degree and substantial experience in business analysis and managed care.

Qualifications

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

Responsibilities

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

Skills

Business Analysis

Communication

Organizational Skills

Time Management

Detail-oriented

Proactive Communication

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. 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 and may focus on internal operations or external clients.

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 necessary 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—research, design, programming, testing, and implementation—to ensure the final product meets functional and operational requirements.

Job Qualifications

Required Education: Bachelor's Degree or equivalent experience.

Required Experience:

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

Current Molina employees interested in this role should apply via the intranet. Molina Healthcare offers competitive benefits and is 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