Sr Business Analyst Compliance (Managed Care) REMOTE in US

Molina Healthcare is hiring for a Sr Business Analyst with experience in Managed Care Compliance.

This role is 100% Remote and open to all locations within the US.

This Compliance Team oversees Compliance-related tasks for Enrollment Operations. This includes managing Key Performance Indicators (KPI) governance, policy and procedure governance, corrective action plans (CAPs), and internal/external audits. This Team is essential in helping operations identify and manage risks by ensuring proper controls are in place. This in tun eliminates compliance gaps for both members and providers. This team supports all lines of business (LOBs) within Enrollment Operations, including any vendors involved.

Highly Qualified Candidates Will Have the Following:

• Compliance experience (audits, CAPs, regulatory requirements, etc.).
• Be able to review contractual requirements and put them into a policy and procedure. Know how to break down contractual requirements in order to communicate them into a document.
• Enrollment experience
• Expertise in the various LOBs.
• Communication skills - highly important as you will work with Directors and above, as well as cross functional teams.
• Be a strong individual key player
• Organizational skills, capability to manage multiple items
• Microsoft outlook, excel, word, ppt

If this sounds like you, please Apply Today!

KNOWLEDGE/SKILLS/ABILITIES

• Elicit requirements using interviews, document analysis, and requirements workshops, business process descriptions, use cases, business analysis, task and workflow analysis.
• Interpret customer business needs and translate them into application and operational requirements
• Communicate and collaborate with external and internal customers to analyze and transform needs, goals and transforming in to functional requirements and delivering the appropriate artifacts as needed.
• Collaborate with operational leaders within the business to provide recommendations on opportunities for process improvements, medical cost savings or revenue enhancements.
• Create Business Requirements Documents, Test Plans, Requirements Traceability Matrix, User Training materials and other related documentations.
• Actively participates in all stages of project development including research, design, programming, testing and implementation to ensures the released product meets the intended functional and operational requirements.
• #LI-TR1

JOB QUALIFICATIONS

Required Education: Bachelor's Degree or equivalent combination of education and experience
Preferred Education: Bachelor's Degree or equivalent combination of education and experience

Required Experience

• 5-7 years of business analysis experience
• 6+ years managed care experience
• Demonstrates proficiency in a variety of concepts, practices, and procedures applicable to job-related subject areas.

Preferred Experience

• 3-5 years of formal training in Project Management
• Experience working with complex, often highly technical teams

Preferred License, Certification, Association
Certified Business Analysis Professional (CBAP), Certification from International Institute of Business Analysis preferred

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.

Key Words: Enrollment, Enrollment Analyst, Analyst, Business Analyst, BA, Sr Business Analyst, Healthcare, Managed Care, MCO, Member, Member Enrollment, Enrollment, Medicaid, Medicare, Marketplace, BRD, Critical Thinking, Organization Skills, Troubleshooting, Analysis, Communication, Presentation, Collaborate, Jira, Agile, Waterfall, Agile Software, Facilitation, Analytical, Accuracy, Accurate, Stakeholder Analysis, Healthcare, Managed Care, MCO, A&G, Appeals,

Pay Range: $49,430.25 - $107,098.87 / ANNUAL
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

About Us

Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
Job Type: Full Time Posting Date: 10/24/2024

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