Sr Specialist, Process Review (Remote)

Lensa; Austin (TX); Remote; USD 77,000 - 117,000; Full time

Job summary

A leading company in IT services is seeking a professional for a mid-senior level role focused on business process redesign and operations. The successful candidate will be responsible for analyzing processes, ensuring compliance, and collaborating with various departments to enhance operational efficiency. This full-time position offers competitive compensation and benefits.

Qualifications

• Four years of proven 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.
• Collaborate with process owners to maintain business process documentation.
• Serve as liaison for audits and coordinate audit walkthroughs.

Skills

Analytical skills

Problem-solving skills

Communication

Education

Associate's Degree

Bachelor's Degree

Job description

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Lensa is the leading career site for job seekers at every stage of their career. Our client, Molina Healthcare, is seeking professionals. Apply via Lensa today!

Job Description

Job Summary

Responsible for providing business process redesign, communication, and change management for operations. Backend operationalization of policies, standardization of system set-up, 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 within a department or function to ensure compliance with organizational Policies and Procedures, Standard Operating Procedures, and other internal guidelines.
• Review, research, analyze, and evaluate information to assess compliance between a process or function and the corresponding documentation. Use analytical skills to identify variances and apply problem-solving skills to recommend process improvements.
• Summarize and document assessment outcomes and recommendations, ensuring effective communication (written and verbal) to process owners and management.
• Collaborate with process owners to maintain and/or create business process documentation and workflows related to Core Operations functions.
• Serve as liaison between Core Operations and internal/external auditors for all formal audits not related to compliance.
• Coordinate, facilitate, and document audit walkthroughs.
• Research, collect, or generate requested documentation and provide timely, accurate responses.
• Respond to clarifying questions from internal and external auditors, working with other functional areas as needed.

Job Qualifications

Required Education

Associate's Degree or two years of equivalent experience.

Required Experience

• Four years of proven analytical experience within an operations or process-focused environment.
• Additional experience in managed care operations, including enrollment, encounter processing, provider and contract configuration, and claims processing.

Preferred Education

Bachelor's Degree.

Preferred Experience

• Six years of proven analytical experience in operations or process-focused environments.
• Previous audit and/or oversight experience.

Current Molina employees interested in this position should apply through the intranet.

Molina Healthcare offers competitive benefits and compensation. We are an Equal Opportunity Employer (EOE) M/F/D/V.

Pay Range: $77,969 - $116,835 / ANNUAL

• Compensation may vary based on location, experience, education, and skills.

Additional Details

• Seniority level: Mid-Senior level
• Employment type: Full-time
• Job function: Information Technology
• Industries: IT Services and IT Consulting