Sr Analyst, Config Info Mgmt

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

• Loads and maintain contract, benefit or reference table information into the claim payment system and other applicable systems.

• Participates in defect resolution for assigned component

• Assists with development of configuration standards and best practices while suggesting improvement processes to ensure systems are working more efficiently and improve quality.

• Assists in planning and coordination of application upgrades and releases, including development and execution of some test plans.

• Participates in the implementation and conversion of new and existing health plans.

• Develops and maintain standards and best practices for the team

• Has a deep understanding of Molina claims life cycle and all processes that affect claims payment

• Leads peer reviews

• Working experience with SQL Reporting is required.

• Experience with QNXT module, claim, contract, benefits, and fee modules are highly preferred.

• Accurately interprets specific state and/or federal benefits, contracts as well as additional business requirements and converting these terms to configuration parameters.

• Familiarity with Ohio Administrative Code rules or State code rules is highly preferred, etc.

• Trains staff on processes, configuration functionality, enhancements, and updates.

• Prepares, tracks, and provides audit findings.

• Presents audit findings and makes recommendations to management for improvements based on audit results.

JOB QUALIFICATIONS

Required Education

Bachelor's Degree or equivalent combination of education and experience

Required Experience

5-7 years

Preferred Education

Graduate Degree or equivalent experience

Preferred Experience

7-9 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.

Pay Range: $54,373.27 - $117,808.76 / ANNUAL

*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.