Sr Business Analyst, Provider Claims (Remote)

Molina Healthcare; Savannah (GA); Remote; USD 77,000 - 129,000; Full time

Job summary

Molina Healthcare is seeking a Sr Business Analyst for Provider Claims to analyze complex business issues and provide insights to decision-makers. This remote role requires collaboration with clients and internal teams to improve processes and deliver actionable reports. Candidates should have a Bachelor's degree and extensive experience in business analysis, particularly in managed care.

Qualifications

• 5-7 years of business analysis experience required.
• Proficient in business process descriptions and requirements workshops.
• Experience with managed care preferred.

Responsibilities

• Analyze complex business problems using data from various sources.
• Create specifications for reports based on business needs.
• Collaborate with clients to tailor analysis to specific needs.

Skills

Business analysis

Data analysis

Communication

Organizational skills

Detail-oriented

Education

Bachelor's Degree

Tools

Salesforce

Facets

Excel

Job description

Sr Business Analyst, Provider Claims (Remote)

Join to apply for the Sr Business Analyst, Provider Claims (Remote) role at Molina Healthcare

Sr Business Analyst, Provider Claims (Remote)

Join to apply for the Sr Business Analyst, Provider Claims (Remote) role at Molina Healthcare

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.

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.

Seniority level

• Seniority level

  Mid-Senior level

Employment type

• Employment type

  Full-time

Job function

• Job function

  Research, Analyst, and Information Technology

• Industries

  Hospitals and Health Care

Referrals increase your chances of interviewing at Molina Healthcare by 2x

Sign in to set job alerts for “Senior Business Analyst” roles.

BAS/HVAC Controls Specialist - International Travel

Savannah, GA $90,000.00-$115,000.00 3 days ago

Lead BAS/HVAC Controls Service Technician - Relocation to Tampa with Assistance!

Savannah, GA $90,000.00-$120,000.00 4 days ago

We’re unlocking community knowledge in a new way. Experts add insights directly into each article, started with the help of AI.