Sr Specialist, Process Review (Remote)

Lensa; Aurora (IL); Remote; USD 77,000 - 117,000; Full time

Job summary

An established industry player is seeking a skilled professional to enhance business processes through effective redesign and change management. This role involves conducting in-depth assessments, collaborating with various departments, and ensuring compliance with organizational policies. The ideal candidate will have strong analytical skills and experience in managed care operations. Join a dynamic team where your insights will shape operational excellence and drive meaningful improvements across the organization.

Qualifications

• Four years of analytical experience in operations or process-focused environments.
• Experience in managed care operations including enrollment and claims processing.

Responsibilities

• Conduct interviews to assess internal business processes for compliance.
• Collaborate with process owners to maintain business process documentation.

Skills

Business Process Redesign

Change Management

Communication Skills

Analytical Skills

Education

Associate's Degree

Bachelor's Degree

Job description

Job Description

Responsible for providing business process redesign, communication, and change management for operations. Backend operationalization of policies, standardization of system setup, and serving as a resource for all departments and health plans company-wide.

Knowledge/Skills/Abilities

• Conduct interviews with staff and management to assess internal business processes, ensuring compliance with organizational Policies, Procedures, and SOPs.
• Review, analyze, and evaluate information to assess compliance, identify variances, and recommend process improvements.
• Summarize and communicate assessment outcomes and recommendations effectively.
• Collaborate with process owners to maintain and create business process documentation and workflows.
• Serve as liaison during audits, facilitate walkthroughs, and respond to audit inquiries.

Job Qualifications

Required Education

Associate's Degree or two years of equivalent experience.

Required Experience

• Four years of analytical experience in operations or process-focused environments.
• Experience in managed care operations, including enrollment, claims processing, provider management, etc.

Preferred Education

Bachelor's Degree.

Preferred Experience

• Six years of analytical experience in relevant environments.
• Audit and oversight experience preferred.

To apply, current Molina employees should use the intranet. Molina offers competitive benefits. Equal Opportunity Employer. Pay Range: $77,969 - $116,835 annually.