JOB DESCRIPTION

Job Summary
Responsible for accurate and timely implementation and maintenance of critical information on claims databases. Maintains critical information on claims databases. Synchronizes data among operational and claims systems and application of business rules as they apply to each database. Validate data to be housed on databases and ensure adherence to business and system requirements of customers as it pertains to contracting, benefits, prior authorizations, fee schedules, and other business requirements.

KNOWLEDGE/SKILLS/ABILITIES

Loads and maintain contract, benefit or reference table information into the claim payment system and other applicable systems.
Participates in defect resolution for assigned component
Assists with development of configuration standards and best practices while suggesting improvement processes to ensure systems are working more efficiently and improve quality.
Assists in planning and coordination of application upgrades and releases, including development and execution of some test plans.
Participates in the implementation and conversion of new and existing health plans.
Analyze and interpret data to determine appropriate configuration changes.
Accurately interprets specific state, federal, and business requirements and converting these terms to configuration parameters
Write easy ad-hoc SQL reports.
Manage task from requirements to deployment, including work assignment, prioritization, issue triage etc
Moderate to Complex task with mentoring
Simple projects without mentoring

JOB QUALIFICATIONS

Required Education
Bachelor’s Degree or equivalent combination of education and experience
Required Experience
5-7 years of applicable experience
Must have strong experience with Benefits configuration in QNXT
Preferred Education
Graduate Degree or equivalent experience
Preferred Experience
7-9 years of applicable experience
SQL knowledge preferred
Advanced knowledge of Excel preferred
Coding certification preferred
To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

Pay Range: $77,969 - $141,371 / ANNUAL

• Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

Please refer the Job description for details