Analyst, Business - Advanced Excel (Remote)

Molina Healthcare is hiring a Business Analyst to support moderately complex business requirements activities. The role interprets regulatory and functional requirements, coordinates with stakeholders, and supports systems solutions and process improvements across health plans and products.

Responsibilities

Develops and maintains requirement documents related to coverage, reimbursement and other applicable system changes to ensure alignment with regulatory and health plan/product requirements

Monitors regulatory sources to ensure all updates are aligned

Navigates analytical problems and clearly defines and documents unique specifications

Supports development and ongoing interpretation of review processes, committees and collaboration with key partner organizations

Recognizes, identifies and documents changes to existing business processes and identifies new opportunities for process developments and improvements

Provides status updates to health plan/product team partners, senior leadership and applicable stakeholders

Communicates requirement interpretations and changes to health plans/product teams and various impacted functional areas for requirement interpretation alignment and approval and solution traceability; coordinates meetings and champions/deploys operational process best practices

Where applicable, codifies the requirements for system configuration alignment and interpretation

Provides support and/or requirement interpretation inconsistencies and complaints

Assists with the development of requirement solution standards and best practices, and suggests improvement processes as applicable to consistently apply requirements across states and products

Facilitates self-organized reporting to ensure health plans/product teams, leaders, and applicable stakeholders are aware of work efforts and impact for prospective or retrospective requirement changes that impact financials

Conducts industry research and engagement to evaluate, provide insights, and develop/deploy best practices

Coordinates with applicable teams for analysis, impact and implementation of changes that impact health plan/product

Engages with operational leadership and health plan support functions to review compliance-based issues for benefit planning purposes

Ensures end-to-end business requirements are documented, interpretation is agreed upon, and solutioning is clear for all applicable parties

Develops and maintains relationships with health plan/product teams and corporate operations

Preferred

Project management/implementation experience

Health care experience

Knowledge and experience with federal regulatory policy resources including Centers for Medicare & Medicaid Services (CMS) and the Affordable Care Act (ACA)

Certified Business Analysis Professional (CBAP)

Healthcare Experience

Federal Regulatory Policy

CMS Knowledge

Affordable Care Act (ACA)

Company

Government-sponsored health plans for families and individuals

Long Beach, California, USA

https://investors.molinahealthcare.com/

Founded in 1980

10001+ employees

Qualifications

This position requires advanced Excel skills

At least 2 years of operations/analyst experience in a managed care organization, health insurance setting or related field, or equivalent combination of relevant education and experience

Policy/government and legislative review knowledge

Analytical and problem-solving skills

Ability to concisely synthesize large and complex requirements

Ability to organize and maintain regulatory data including real-time policy changes

Self-motivated and ability to take initiative, identify, communicate, and resolve potential problems

Experience creating reporting tools/providing project/process updates

Familiarity with administration systems

Ability to work in a project team setting and complete individually assigned tasks within established timelines to meet desired deployment deadlines

Ability to work cross-functionally across a highly matrixed organization

Effective verbal, written and interpersonal communication skills, and ability to engage with stakeholders of all organizational levels

Microsoft Office suite and applicable software programs proficiency

Project management/implementation experience

Health care experience

Knowledge and experience with federal regulatory policy resources including Centers for Medicare & Medicaid Services (CMS) and the Affordable Care Act (ACA)

Certified Business Analysis Professional (CBAP)

At least 2 years of operations/analyst experience in a managed care organization, health insurance setting or related field, or equivalent combination of relevant education and experience.

Required skills

Advanced Microsoft Excel, Managed Care, Health Insurance, Regulatory Policy Review, Centers for Medicare & Medicaid Services (CMS), Affordable Care Act (ACA), Certified Business Analysis Professional (CBAP), Project Implementation, Microsoft Office

Preferred skills

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Experience

2+ years