Molina HealthcareMH

Lead Analyst, Configuration Information Management - Claims/Regulatory Requireme

Molina Healthcare is a FORTUNE 500 company focused on providing government-sponsored healthcare services, including Medicaid and Medicare, across the United States.

Molina Healthcare

Employee count: 1001-5000

United States only

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

  • Trains staff on configuration functionality, enhancements, and updates.
  • Works with internal and external stakeholders to understand business objectives and processes associated with the enterprise.
  • Problem solves with Health Plans and Corporate to ensure all end-to-end business requirements have been documented.
  • Creates management reporting tools to enhance communication on configurations updates and initiatives.
  • Negotiates expected completion dates with Health Plans.

JOB QUALIFICATIONS

Required Education

Bachelor's Degree or equivalent combination of education and experience

Required Experience

7-9 years

Preferred Education

Graduate Degree or equivalent experience

Preferred Experience

10+ 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.

About the job

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Posted on

Job type

Full Time

Experience level

Senior
Manager

Location requirements

Hiring timezones

United States +/- 0 hours

About Molina Healthcare

Learn more about Molina Healthcare and their company culture.

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Molina Healthcare is a FORTUNE 500, multi-state health care organization dedicated to providing quality health care services under Medicaid and Medicare programs. With a commitment to ensuring that every person and family has access to quality health care, Molina operates in numerous states across the United States. The organization serves over 5 million members through locally operated health plans and strives to address health disparities with innovative solutions.

With a foundation built in 1980 by Dr. C. David Molina, the organization has grown from one clinic in Long Beach, California, to become a leader in government-sponsored health care services. Molina Healthcare specializes in managed care, providing a comprehensive range of health services from preventive care to specialized treatment plans. One of Molina's most significant achievements includes integrating care for those eligible for both Medicaid and Medicare, showing a commitment to delivering high-quality, coordinated health care across diverse populations. Their focus on community engagement ensures that members are empowered to manage their health effectively.

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Molina Healthcare

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