Sr Specialist, Process Review (Remote)

Lensa; Hyde Park Township (IL); Remote; USD 77,000 - 117,000; Full time

Job summary

A leading career site is seeking professionals for a mid-senior level position focused on business process redesign and change management at Molina Healthcare. The role involves collaboration, compliance assessment, and documentation related to Core Operations functions, requiring strong analytical and communication skills.

Benefits

Competitive benefits and compensation

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.
• Collaborate with process owners to maintain business process documentation.
• Serve as liaison for Core Operations audits.

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 setup, and 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 written documentation. Use analytical skills to identify variances. Use problem-solving skills and business knowledge 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 Core Operations audits that are not compliance-related.
• Coordinate, facilitate, and document audit walkthroughs.
• Research, collect, or generate requested documentation, providing timely and accurate responses in writing and verbally.
• Research and 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 for Corporate Operations includes:
• Experience within managed care operations.
• 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.

Current Molina employees interested in applying should do so through the intranet job listing.

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

• 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