Senior Analyst, Provider Configuration (Remote) at Molina Healthcare

Long Beach, California, United States -

Full Time

Start Date

Immediate

Expiry Date

13 Jun, 26

Salary

0.0

Posted On

15 Mar, 26

Experience

2 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Provider Configuration, Data Maintenance, Data Synchronization, Data Validation, Contracting, Network Management, Credentialing, Data Auditing, SOP Development, BRD Development, Configuration Standards, Process Improvement, Claims Payment System Upgrades, Test Plan Execution, Critical Thinking, Time Management

Industry

Hospitals and Health Care

Description

JOB DESCRIPTION Job Summary Provides senior level analyst support for provider configuration activities including accurate and timely maintenance of critical provider information on all claims and provider databases. Synchronizes data within multiple claims systems and validates data stored within provider databases - ensuring adherence to business and system requirements as it pertains to contracting, network management and credentialing. Essential Job Duties • Analyses, reviews, and audits provider data for quality and accuracy in systems/databases. • Develops standard operating procedures (SOPs) and/or business requirement documents (BRDs) related to provider configuration. • Assists with development of configuration standards and best practices, and recommends processes to ensure systems are working efficiently and assessed for continuous improvement/quality. • Assists in planning and coordination of claims payment system upgrades and releases, including development and execution of test plans. • Participates in the implementation and conversion of new and existing health plans. Required Qualifications * At least 4 years of experience in health care, preferably in a customer/provider services setting, or equivalent combination of relevant education and experience. * Strong critical-thinking skills, and attention to detail. * Strong organizational and time-management skills; ability to manage simultaneous projects and tasks to meet internal deadlines. * Customer service experience. * Effective verbal and written communication skills. * Microsoft Office suite proficiency (including Excel) and applicable software program(s) experience. Preferred Qualifications * Healthcare application experience (even if not QNXT, just being familiar with member/provider modules, claims, etc) * Experience with creating/documenting process changes (Visio) * Flexible in priorities changing * Self-starter, minimal direction * Word/Powerpoint/excel/visio savvy * Comfortable presenting at Executive Level * Comfortable leading projects * Some SQL knowledge To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V

Responsibilities

This role provides senior analyst support for provider configuration, focusing on the accurate and timely maintenance of critical provider information across claims and provider databases. Responsibilities include synchronizing data across multiple claims systems and validating stored data to ensure compliance with business and system requirements related to contracting, network management, and credentialing.