Jobs · Analyst

Business Analyst

Molina Healthcare · United States · 2 wk ago
RemoteRemoteAnalyst$45k–$97k/yrFull-time

Job Summary

Job Duties

  • Develops and maintains requirement documents related to coverage, reimbursement and other applicable system changes.
  • Maintains alignment with regulatory baseline requirements and health plan developed requirements.
  • Maintains coordination with stakeholders and subject matter experts on partnering teams and supporting governance committees.
  • Conducts analysis to identify root cause and assists with problem management.
  • Communicates requirement interpretations and changes to health plans/product team and various impacted corporate core functional areas.
  • Supports requirement interpretation inconsistencies and complaints.
  • Reports on work efforts and impact for any prospective or retrospective requirement changes.
  • Engages with operations leadership and Plan Support functions to review compliance-based issues for benefit planning purposes.

Knowledge/Skills/Abilities

  • Maintains relationships with Health Plans/Product Team and Corporate Operations.
  • Meets aggressive timelines and balances multiple lines of business, states, and requirement areas.
  • Communicates effectively with all levels of the company.
  • Synthesizes large and complex requirements.
  • Maintains regulatory data including real-time policy changes.
  • Works independently in a remote environment.
  • Works with those in other time zones than their own.

Job Qualifications

  • At least 2 years of experience in previous roles in a managed care organization, health insurance or directly adjacent field, or equivalent combination of relevant education and experience.
  • Prior experience in policy/government legislative review.
  • Strong analytical and problem-solving skills.
  • Experience with Office Product Suite including Word, Excel, Outlook and Teams.
  • Project implementation experience.
  • Knowledge and experience with federal regulatory policy resources including Centers for Medicare & Medicaid Services (CMS) and the Affordable Care Act (ACA).
  • Medical Coding certification.

Benefits

Pay Range: $44,936.59 - $97,362.61 / ANNUAL

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