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  • Claims Business Analyst - QNXT - CA Remote

    Molina Healthcare (Long Beach, CA)



    Apply Now

    JOB DESCRIPTION** **Job Summary

     

    _Designs and implements processes and solutions associated with a wide variety of data sets used for data/text mining, analysis, modeling, and predicting to enable informed business decisions. Gains insight into key business problems and deliverables by applying statistical analysis techniques to examine structured and unstructured data from multiple disparate sources. Collaborates across departments and with customers to define requirements and understand business problems. Uses advanced mathematical, statistical, querying, and reporting methods to develop solutions. Develops information tools, algorithms, dashboards, and queries to monitor and improve business performance. Creates solutions from initial concept to fully tested production, and communicates results to a broad range of audiences. Effectively uses current and emerging technologies._

    _KNOWLEDGE/SKILLS/ABILITIES_

    + Extracts and compiles various sources of information and large data sets from various systems to identify and analyze outliers.

    + Sets up process for monitoring, tracking, and trending department data.

    + Prepares any state mandated reports and analysis.

    + Works with internal, external and enterprise clients as needed to research, develop, and document new standard reports or processes.

    + Implements and uses the analytics software and systems to support the departments goals.

    + Must have member movement or PCP reassignment or Enrollment and Provider termination experience.

    + Must have intermediate level MS Excel experience,

    + Familiarity with Enrollment and Managed Healthcare experience is required.

    + Must be able to research and analyze data using SQL is required.

    + Experience with QNXT is preferred.

    + Medicare/ medicaid membership exp required

    Required soft skill include but are not limited to :

    + Excellent communication

    + Possess a team player attitude

    + Ability to work in a diverse environment.

    + Must be flexible and willing to learn new skills.

    JOB QUALIFICATIONS

    Required Education

    Associate's Degree or equivalent combination of education and experience

    Required Experience

    1-3 years

    Preferred Education

    Bachelor's Degree or equivalent combination of education and experience

    **Preferred Experience** 3-5 years

     

    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: $68,640 - $111,967 / ANNUAL

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

     


    Apply Now



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