Sr Business Analyst, Provider Claims (Remote)

Lensa; Tucson (AZ); Remote; USD 77,000 - 129,000; Full time

Job summary

A leading company is seeking a Sr Business Analyst to analyze complex business problems and provide insights to decision-makers. This role involves collaborating with stakeholders, creating detailed documentation, and recommending process improvements. Candidates should have a Bachelor's degree and 5-7 years of relevant experience, with a focus on managed care.

Qualifications

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

Responsibilities

• Analyze complex business problems using internal and external data.
• Collaborate with clients to tailor reports and meet specific needs.
• Create Business Requirements Documents and Test Plans.

Skills

Business analysis

Communication

Organizational skills

Analytical skills

Detail-oriented

Education

Bachelor's Degree

Tools

Salesforce

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 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, and workshops, including business 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 needs, goals, and deliver functional requirements and artifacts.
• Work with operational leaders to recommend process improvements, cost savings, or revenue enhancements.
• Create Business Requirements Documents, Test Plans, Traceability Matrices, User Training materials, and other documentation.
• Participate in all project stages, including research, design, testing, and implementation, ensuring the final product meets requirements.

Job Qualifications

Required 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 and adaptable.
• Strong organizational and time management skills.

Preferred Experience

• 3-5 years 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, and Excel reporting.
• Strong analytical and documentation skills.

Preferred Certifications

CBAP or similar certifications from the International Institute of Business Analysis are preferred.

To apply, current Molina employees should use the intranet job listing. Molina Healthcare offers competitive benefits. We are an Equal Opportunity Employer (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