Sr Specialist, Process Review (Remote)

Lensa; Columbus (OH); Remote; USD 77,000 - 117,000; Full time

Job summary

Join a forward-thinking organization that is dedicated to enhancing operational efficiency and compliance. In this role, you will be responsible for providing business process redesign and change management, ensuring that all operations align with internal policies and procedures. You will conduct interviews, analyze processes, and serve as a vital resource for all departments. This position offers the opportunity to work in a dynamic environment where your analytical skills will directly contribute to improving business operations and supporting a culture of continuous improvement. If you are passionate about operational excellence and want to make a significant impact, this role is for you.

Qualifications

• 4+ years of analytical experience in operations or process-focused environments.
• Experience in managed care enrollment and claims processing is a plus.

Responsibilities

• Provide business process redesign and change management for operations.
• Collaborate with process owners to maintain business process documentation.

Skills

Analytical Skills

Problem-Solving Skills

Communication Skills

Education

Associate's Degree

Bachelor's Degree

Job description

Be among the first 25 applicants

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. This includes the 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 within a department or function, ensuring 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 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 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 that are not compliance-related.
• Coordinate, facilitate, and document audit walkthroughs.
• Research, collect, or generate requested documentation and provide timely, accurate responses in written and verbal forms.
• Respond to clarifying questions from 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 for Corporate Operations includes knowledge of managed care enrollment, encounter processes, provider and contract configuration, provider information management, claims processing, and related functions.

Preferred Education

Bachelor's Degree

Preferred Experience

• Six years of proven analytical experience within an operations or process-focused environment.
• Previous audit and/or oversight experience.

To all current Molina employees: Please apply through the intranet job listing if interested.

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

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

• Actual 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