Sr Specialist, Process Review (Remote)

Lensa; Kearney (NE); Remote; USD 77,000 - 117,000; Full time

Job summary

Join a forward-thinking organization that values process improvement and operational excellence. In this role, you will be responsible for redesigning business processes and ensuring compliance across departments. Your expertise in analytics will help identify variances and recommend improvements, making a significant impact on the organization's efficiency. This full-time position offers a chance to work in a dynamic environment, collaborating with various stakeholders to enhance operational practices. If you are passionate about driving change and optimizing processes, this opportunity is perfect for you.

Qualifications

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

Responsibilities

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

Skills

Analytical Skills

Communication Skills

Process Improvement

Compliance Assessment

Education

Associate's Degree

Bachelor's Degree

Job description

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Job Description

Job Summary

Responsible for business process redesign, communication, and change management for operations. This role involves 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, ensuring compliance with organizational policies, SOPs, and internal guidelines.
• Research, analyze, and evaluate information to assess compliance, identify variances, and recommend process improvements.
• Summarize and document assessment outcomes and communicate findings effectively.
• Collaborate with process owners to maintain or create business process documentation and workflows.
• Serve as liaison for audits related to Core Operations, coordinating walkthroughs and providing documentation.
• Respond to audit inquiries with timely and accurate information, working with internal and external auditors.

Job Qualifications

Required Education

Associate's Degree or two years of equivalent experience.

Required Experience

• Four years of analytical experience in an operations or process-focused environment.
• For Corporate Operations: experience within managed care operations, including enrollment, encounter, provider/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.

Interested Molina employees should apply through the intranet. Molina Healthcare offers competitive benefits and is an EOE M/F/D/V.

Pay Range: $77,969 - $116,835 annually. Actual compensation varies based on location and experience.

Additional Details

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