Sr Specialist, Process Review (Remote)

Molina Healthcare; Long Beach (CA); Remote; USD 50,000 - 90,000; Full time

Job summary

An established industry player in healthcare services is seeking a skilled analyst to enhance operational efficiency and compliance. This role offers a unique opportunity to engage in meaningful work, collaborating with internal and external auditors while supporting a culture of growth and advancement. Ideal candidates will have a strong background in compliance management and analytical skills, with a commitment to fostering a supportive work environment. If you are passionate about making a difference in healthcare operations, this is the perfect opportunity for you.

Benefits

Competitive benefits

Career advancement opportunities

Supportive work environment

Qualifications

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

Responsibilities

• Conduct interviews to assess compliance with organizational policies.
• Analyze information to identify variances in processes.

Skills

Analytical Skills

Problem-Solving

Compliance Management

Education

Associate's Degree

Bachelor's Degree

Job description

Employer Industry: Healthcare Services

Why consider this job opportunity:
- Opportunity for career advancement and growth within the organization
- Competitive benefits and compensation package
- Collaborate with internal and external auditors, enhancing your professional network
- Engage in meaningful work that influences operational efficiency and compliance
- Supportive and collaborative work environment

What to Expect (Job Responsibilities):
- Conduct interviews with staff and management to assess internal business processes for compliance with organizational policies
- Analyze information to evaluate compliance and identify variances in processes or functions
- Document assessment outcomes and communicate recommendations to process owners and management
- Collaborate with process owners to maintain and create business process documentation and workflows
- Serve as a liaison between Core Operations and auditors for formal audits

What is Required (Qualifications):
- Associate's Degree or two years of equivalent experience
- Minimum of four years of proven analytical experience within an operations or process-focused environment
- Analytical experience within managed care operations
- Knowledge of managed care enrollment processes, claims processing, and related functions
- Exceptional problem-solving skills and business knowledge

How to Stand Out (Preferred Qualifications):
- Bachelor's Degree
- Six years of proven analytical experience within an operations or process-focused environment
- Previous audit and/or oversight experience

#HealthcareServices #OperationalExcellence #CareerGrowth #AnalyticalSkills #ComplianceManagement

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