Sr Specialist, Process Review (Remote)

Lensa; New York (NY); Remote; USD 77,000 - 117,000; Full time

Job summary

An established industry player is seeking a detail-oriented professional to enhance operational efficiency through business process redesign and change management. In this role, you will leverage your analytical skills to assess internal processes and ensure compliance with organizational policies. You will collaborate with various departments to document workflows and serve as a liaison during audits. This full-time position offers a competitive salary and the opportunity to contribute significantly to the company's operational success. If you have a passion for process improvement and a strong analytical background, this role is perfect for you.

Qualifications

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

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

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 set-up, 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 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. Use problem-solving skills and business knowledge to recommend process improvements.
• Summarize and document assessment outcomes and recommendations, and communicate them effectively 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 and 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. Provide timely and accurate responses, both written and verbal.
• 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:
• Analytical experience within managed care operations.
• Knowledge of managed care enrollment processes, 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: If interested, apply through the intranet job listing.

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