Sr Specialist, Process Review (Remote)

Lensa; Scottsdale (AZ); Remote; USD 77,000 - 117,000; Full time

Job summary

An established industry player is seeking a detail-oriented professional to drive business process redesign and operational efficiency. In this role, you will be responsible for analyzing internal processes, ensuring compliance with policies, and facilitating change management across departments. You will collaborate closely with various stakeholders to document workflows and serve as a key resource during audits. This is an excellent opportunity for someone with a strong analytical background looking to make a significant impact in a dynamic environment. Join a forward-thinking team that values innovation and continuous improvement.

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

Process Improvement

Communication

Compliance Assessment

Education

Associate's Degree

Bachelor's Degree

Job description

Be among the first 25 applicants to this job and get AI-powered advice and exclusive features on Lensa, the leading career site for job seekers at every career stage. Our client, Molina Healthcare, is seeking professionals. Apply via Lensa today!

Job Description

Job Summary

Responsible for business process redesign, communication, and change management for operations. Handles backend operationalization of policies, standardizes system setup, and serves 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.
• 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 related to core operations, coordinating walkthroughs and providing documentation.
• Research and respond to auditor requests and questions accurately and promptly, 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 in an operations or process-focused environment.
• Experience within managed care operations, including enrollment, encounter processing, provider and contract configuration, claims processing, etc.

Preferred Education

Bachelor's Degree.

Preferred Experience

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

Current Molina employees interested in this position should apply through the intranet. Molina offers competitive benefits and is an Equal Opportunity Employer. Pay range: $77,969 - $116,835 annually, with actual compensation varying 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 Consulting