• Business Systems Analyst - QNXT Claims

    Molina Healthcare (ID)


    JOB DESCRIPTION

    Job Summary

    A successful candidate will have a balance of business insight, critical thinking, strong communication and analytical skills. Possess the ability to work independently, self-navigate organizational and technical challenges. Performs research and analysis of healthcare claims data, pharmacy data, and external data to derive proper courses of action for remediation. This role will support processes for Patient Liability and Medicaid processes.

    KEY RESPONSIBILITIES

    • Perform research and analysis for inquiries and requests, utilizing technical tools as necessary to provide feedback and resolution within the Service Level Agreement.

    • Assist with research, development and completion of special projects as requested by various internal departments, or in support of requests from regulatory agencies, contracting agencies, or other external organizations.

    • Responsible for timely completion of projects, not limited to timeline development and maintenance; coordinates activities and data collection with internal departments or external requestors.

    • Interpret business needs and translate them into application and operational requirements.

    • Create comprehensive workflows and documentation of operational processes and procedures.

    • Prioritize initiatives based on business needs and requirements.

    • Undertake project tasks as required

    KNOWLEDGE, SKILLS & ABILITIES

    • Advanced written, oral, and interpersonal skills

    • Demonstrated ability of evaluating the effectiveness and efficiency of existing processes

    • Able to effectively prioritize and execute tasks

    • Able to generate insights from data analysis

    • Able to learn quickly and solve complex problems

    • Experience in partnering with cross-functional teams

    • Experience with documentation and meeting facilitation

    • Flexible and able to work with tight deadlines

    • Knowledge of Healthcare industry standards, concepts, terminology and common practices

    • Claims and SQL knowledge a plus

    JOB QUALIFICATIONS

    Required Education

    Associate 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

    3-4 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: $77,969 - $141,371 / ANNUAL

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