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Business Analyst

2 months ago

Nebraska, United States Molina Healthcare Full time
Job Summary

Molina Healthcare seeks a highly skilled Business Analyst to join our team. As a Business Analyst, you will play a critical role in ensuring the accuracy and completeness of provider data change requests, facilitating the accurate and timely payment of claims. You will analyze complex business problems and issues using data from internal and external sources to provide insight to decision-makers.

Key Responsibilities
  • Manage the provider roster process to ensure accurate and timely data.
  • Resolve provider data issues, including "fall out" Provider Data and Provider Master File, to maintain claim accuracy.
  • Represent the organization for all internal provider data management-related requests.
  • Provide oversight of the Provider Master File and Provider Data accuracy.
  • Partner with the VP of Network to resolve provider data issues.
  • Communicate and collaborate with external and internal customers to analyze and transform business needs into functional requirements.
  • Work with operational leaders to provide recommendations on opportunities for process improvements, medical cost savings, or revenue enhancements.
Requirements
  • Bachelor's Degree or equivalent combination of education and experience.
  • 5-7 years of business analysis experience, with 6+ years managed care experience.
  • Demonstrates proficiency in a variety of concepts, practices, and procedures applicable to job-related subject areas.
Preferred Qualifications
  • 3-5 years of formal training in Project Management.
  • Experience working with complex, often highly technical teams.
  • 3+ years experience working with Provider Data changes within an MCO highly preferred.
About Us

Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. We offer a competitive benefits and compensation package, and are an Equal Opportunity Employer (EOE) M/F/D/V.