Sr Specialist, Process Review (Remote)

Lensa; Savannah (GA); Remote; USD 70,000 - 90,000; Full time

Job summary

A leading career site is assisting Molina Healthcare in finding a professional for business process redesign and change management. The role involves operationalizing policies and serving as a resource across departments. Candidates should possess strong analytical skills and experience in managed care operations.

Qualifications

• Four years of analytical experience in operations or process-focused environment.
• Experience within managed care operations including enrollment and claims processing.

Responsibilities

• Responsible for business process redesign and change management.
• Conduct interviews to assess internal business processes.
• Serve as liaison for audits and coordinate audit walkthroughs.

Skills

Analytical Skills

Communication

Compliance Assessment

Education

Associate's Degree

Bachelor's Degree

Job description

Job Description

Lensa, the leading career site for job seekers at every stage of their career, is assisting our client, Molina Healthcare, in seeking professionals for a key role. Apply via Lensa today!

Job Summary

Responsible for business process redesign, communication, and change management within operations. This role involves backend operationalization of policies, standardization of system setup, and serving as a resource for all departments and health plans company-wide.

Knowledge, Skills, and Abilities

• Conduct interviews with staff and management to assess internal business processes, ensuring compliance with organizational policies, SOPs, and internal guidelines.
• Review, research, analyze, and evaluate information to assess compliance, 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 maintain or create business process documentation and workflows related to core operations.
• Serve as liaison for audits and coordinate audit walkthroughs, providing requested documentation and responding to clarifying questions.

Job Qualifications

Required Education

Associate's Degree or two years of equivalent experience.

Required Experience

• Four years of proven analytical experience in an operations or process-focused environment.
• Experience within managed care operations, including enrollment, encounter processing, provider management, and claims processing.

Preferred Education

Bachelor's Degree.

Preferred Experience

• Six years of analytical experience in operations or process management.
• Previous audit and oversight experience.

Interested Molina employees should apply through the intranet. Molina Healthcare offers competitive benefits. We are an Equal Opportunity Employer (EOE) M/F/D/V.