Sr Specialist, Process Review (Remote)

Lensa; West Valley City (UT); Remote; USD 77,000 - 117,000; Full time

Job summary

An established industry player is seeking a dedicated operations analyst to lead business process redesign and change management efforts. In this vital role, you will assess internal processes, ensure compliance with policies, and recommend improvements to enhance operational efficiency. Your analytical skills will be crucial as you document outcomes and communicate findings to management effectively. Join a dynamic team committed to optimizing operations and making a significant impact in the healthcare sector. If you're ready to elevate your career in a supportive environment, this opportunity is perfect for you.

Qualifications

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

Responsibilities

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

Skills

Analytical Skills

Problem-Solving

Communication

Process Documentation

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. Handles backend operationalization of policies, standardization of 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 and identify variances, using problem-solving skills to recommend process improvements.
• 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.
• Respond to audit inquiries and requests accurately and timely, working with internal and external auditors as needed.

Job Qualifications

Required Education

• Associate's Degree or two years of equivalent experience.

Required Experience

• At least 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 management, and claims processing.

Preferred Education

• Bachelor's Degree.

Preferred Experience

• Six years of analytical experience in operations or process management.
• Audit or oversight experience preferred.

Current Molina employees interested in this position should apply via the intranet. Molina offers competitive benefits and is an EOE M/F/D/V.

Pay Range: $77,969 - $116,835 annually. 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 Consulting