Sr Analyst, Config Info Mgmt- QNXT
2 months ago
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.
- Must have configuration experience in QNXT or NetworX Pricer or CTP ( Claim Test Pro) or QCS (QNXT Configuration Solution)
- Must have healthcare experience.
- Experience working with SQL is highly preferred.
JOB QUALIFICATIONS
Required Education
Bachelor's Degree or equivalent combination of education and experience
Required Experience
5-7 years
Preferred Education
Graduate Degree or equivalent experience
Preferred Experience
7-9 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.
-
Lead Analyst, Config Info Mgmt
1 month ago
Long Beach, United States Molina Healthcare Full timeJob DescriptionJOB DESCRIPTIONJob 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...
-
Sr Analyst, Config Info Mgmt
2 weeks ago
Long Beach, United States Molina Healthcare Full timeJob DescriptionJOB DESCRIPTIONJob 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...
-
Sr Analyst, Config Info Mgmt
1 month ago
Long Beach, United States Molina Healthcare Full timeJob DescriptionJOB DESCRIPTIONJob 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...
-
Senior Configuration Analyst
2 weeks ago
Long Beach, California, United States Molina Healthcare Full timeJob OverviewPosition SummaryThe Senior Configuration Analyst is accountable for the precise and prompt execution and upkeep of essential data within claims databases. This role is pivotal in maintaining vital information across operational and claims systems, ensuring the application of business rules relevant to each database. The analyst will validate the...
-
Senior Configuration Analyst
2 weeks ago
Long Beach, California, United States Molina Healthcare Full timeDescripción del Trabajo RESUMEN DEL PUESTO Encargado de la implementación precisa y oportuna, así como del mantenimiento de información crítica en las bases de datos de reclamaciones. Administra información esencial en los sistemas de reclamaciones. Sincroniza datos entre sistemas operativos y de reclamaciones, aplicando las reglas de negocio...
-
Sr Analyst, Healthcare Analytics
1 month ago
Long Beach, California, United States Molina Healthcare Full timeJob DescriptionJOB DESCRIPTIONJob SummaryThis Sr. Analyst, Healthcare Analytics role will support Molina's Risk Adjustment Analytics team. The job responsibilities include developing risk score models with Databricks, organizing and managing large and varied data sets, analyzing healthcare data for decision support, and communicating findings. Qualified...
-
Sr Analyst, Provider Configura
2 weeks ago
Long Beach, United States Molina Healthcare Full timeJob DescriptionJOB DESCRIPTIONJob Summary Responsible for accurate and timely maintenance of critical provider information on all claims and provider databases. Maintains critical provider information on all claims and provider databases. Synchronizes data among multiple claims systems and application of business rules as they apply to each database....
-
IT Programmer Analyst, Sr
1 month ago
Juno Beach, United States Mindlance Full timePR:$51.95/hr Responsible for the development and integration of new or existing applications into the technical infrastructure and existing business processes. Provides technical or functional guidance to project or work teams as needed within a specific discipline. Collaborates on an on-going basis with the Business Systems Analyst. Analyzes, designs,...
-
Laboratory Analyst
3 months ago
Long Beach, United States Applied Microbiological Services Full timeJob DescriptionJob DescriptionA leading Southern California environmental laboratory, located in Long Beach, CA, is searching for a full-time analyst. This professional position will require some driving, so a reliable car and current insurance is necessary. The ideal candidate will have a bachelor’s degree in biology, chemistry, or a related...
-
Sr Analyst, Healthcare Analytics
4 weeks ago
Long Beach, United States Molina Healthcare Full timeJob DescriptionJOB DESCRIPTIONJob SummaryThis Sr. Analyst, Healthcare Analytics role will support Molina's Risk Adjustment Analytics team. The job responsibilities include developing risk score models with Databricks, organizing and managing large and varied data sets, analyzing healthcare data for decision support, and communicating findings. Qualified...
-
Direct to Consumer Strategy Sr. Analyst
1 month ago
Long Island City, United States Bloomingdale's Full timeAbout:Bloomingdale's makes fashion personal and fun, aspirational yet approachable. Our mission is to guide and inspire our customers to make style a source of creative energy in their lives. We will always strive to make Bloomingdale's like no other store in the world. Everyone plays a critical role to bring our mission to life. Regardless of position, we...
-
Sr. Business Analyst, Pharmacy
2 weeks ago
Long Beach, United States SCAN Full timeAbout SCAN SCAN Group is a not-for-profit organization dedicated to tackling the most pressing issues facing older adults in the United States. SCAN Group is the sole corporate member of SCAN Health Plan, one of the nation's leading not-for-profit Medicare Advantage plans, serving more than 270,000 members in California, Arizona, Nevada, Texas and New...
-
Business Analyst Sr
2 days ago
Juno Beach, United States AP Recruiters Full timeJob Summary Job Name: Business Analyst Sr Job Location: Juno Beach Fl Job Type W2 Contract/Temporary Assignment Duration: 11 months Per Diem: No Salary (up to): $59 /hr About the client: This is a temporary assignment with NextEra Energy a leading clean energy company...
-
SR Project Analyst- Healthcare | Newport Beach, Ca |
3 months ago
Newport Beach, United States eTeam Inc Full timeTitle: Sr.Project Analyst Location: Hospital Facility- Newport Beach, CA 92663 Shift: M-F 8 am-5 pm, 40 GWW Duration: 6 month(s) Pay:$55/hr to $65/hr based on exp. Remote is available - but must be within 1 hour drive of Newport Beach. Duties: The Sr. Project Analyst – Value Management is responsible for supporting the implementation of initiatives...
-
Financial Mgmt Analyst
3 months ago
Fort Walton Beach, United States Lockheed Martin Corporation Full timeJob ID: 668800BR Date posted: Jun. 23, 2024 Program: SOF GLSS Description:This position operates as a Multi-Functional Finance Analyst, Sr. and works in the business operations organization supporting program/product areas. Performs activities that cultivate efficient planning and implementation of financials and resource analysis (FTE's) across various...
-
Sr Information Security Analyst
1 month ago
West Palm Beach, Florida, United States Vets Hired Full timeAbout the job Sr Information Security Analyst (Remote)Basic administration and management of security operations solutions and programs, such as our database security program, PKI and SIEM managementCertification in at least one of the following: CompTIA Security+, SANS GSEC, ISC2 SSCP, CompTIA CySA+Intermediate knowledge of Information Security concepts,...
-
Senior Cost Analyst
4 weeks ago
Long Beach, California, United States Galorath Incorporated Full timeSenior Cost Analyst Secret Clearance Required Galorath is an Employee Owned Company - Be a Part of an exciting industry leading organization with Galorath's competitive Employee Stock Ownership Plan (ESOP) offered to all employees at no cost Role and ResponsibilitiesThe Sr Cost Analyst will support a broad range of program, acquisition, and financial Support...
-
Sr. Analyst, Network Strategy
2 months ago
Long Beach, United States Molina Healthcare Full timeJob DescriptionJob Description Job SummarySr. Analyst, Network Strategy, Pricing & Analytics guides the investment of our network partners through contract valuation and analysis to ensure access to quality healthcare services for people receiving government assistance. Strengthens access to quality care with improved outcomes through better coordination and...
-
Sr. Analyst, Network Strategy
2 months ago
Long Beach, United States Molina Healthcare Full timeJob DescriptionJob DescriptionJob Summary Sr. Analyst, Network Strategy, Pricing & Analytics guides the investment of our network partners through contract valuation and analysis to ensure access to quality healthcare services for people receiving government assistance. Strengthens access to quality care with improved outcomes through better coordination and...
-
Reporting Analyst, SIU
1 month ago
Long Beach, United States Molina Healthcare Full timeJob DescriptionJob DescriptionJob Summary Under direct supervision of the Manager, the Reporting Analyst, SIU supports a team in the Special Investigation Unit (SIU). The Reporting Analyst, SIU will ensures FWA referrals are logged, documented, assigned for investigation and appropriately reported to state and federal regulators. and/or law enforcement as...