Sr Specialist, Process Review (Remote)

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

Job summary

A leading career site is seeking a Business Process Analyst for Molina Healthcare. This role involves redesigning business processes, ensuring compliance, and collaborating with various departments. Ideal candidates will have strong analytical skills and experience in managed care operations. Competitive compensation and benefits are offered.

Qualifications

• Four years of proven analytical experience within an operations or process-focused environment.
• Experience within managed care operations.

Responsibilities

• Conduct interviews to assess internal business processes.
• Review and analyze information for compliance.
• Collaborate to create and maintain business process documentation.

Skills

Analytical skills

Compliance assessment

Process improvement

Education

Associate's Degree

Bachelor's Degree

Job description

Be among the first 25 applicants to apply for this job and get AI-powered advice and exclusive features.

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 to ensure compliance with organizational policies, procedures, and guidelines.
• Review, research, analyze, and evaluate information to assess compliance between processes and documentation. Use analytical skills to identify variances and recommend process improvements.
• Summarize and document assessment outcomes and communicate findings effectively to process owners and management.
• Collaborate with process owners to create and maintain business process documentation and workflows related to core operations.
• Serve as liaison for audits related to core operations, including coordinating and facilitating audit walkthroughs and providing documentation.
• Research and respond to audit requests and 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.
• Experience within managed care operations, including enrollment, encounter processing, provider and contract configuration, and claims processing.

Preferred Education

Bachelor's Degree.

Preferred Experience

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

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

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

Pay Range: $77,969 - $116,835 annually. Actual compensation may vary based on location, experience, education, and skills.

Additional Information

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