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Molina Healthcare
Actively Hiring
Molina Healthcare is a managed care company
  • B2B
  • Public Stage
    Publicly traded company

Analyst, Configuration Information Management - QNXT/SQL - Remote

Posted: 1 month ago
Hires remotely in
Remote Work Policy

Remote only

Company Location
Visa Sponsorship

Not Available

RelocationAllowed
Skills
SQL
Excel
Microsoft Office Suite
Pivot Tables
Vlookup
QNXT
Claims Processing System

About the job

JOB DESCRIPTION Job Summary

Provides analyst support for configuration information management activities. Responsible for accurate and timely implementation and maintenance of critical information on claims databases, synchronizing operational and claims systems data and application of business rules as they apply to each database, validating data to be housed on databases, and ensuing adherence to business and system requirements of customers as it pertains to contracting, benefits, prior authorizations, fee schedules, and other business requirements.

Essential Job Duties

  • Analyzes and interprets data to determine appropriate configuration changes.
  • Accurately interprets specific state and/or federal benefits, in addition to other business requirements, and converts terms to configuration parameters.
  • Manages coding, updating and maintaining benefit plans, provider contracts, fee schedules and various system tables in the user interface.
  • Applies experience and knowledge to research and resolve claim/encounter issues and pended claims, and updates system(s) as necessary.
  • Manages fluctuating volumes of work, and prioritizes work to meet deadlines and needs of the configuration department and user community.

Required Qualifications

  • At least 2 years of configuration information management experience maintaining databases, and/or analyst experience working within a health care operations setting, or equivalent combination of relevant education and experience.
  • Experience using a claims processing system.
  • Experience verifying documentation related to updates/changes within a claims processing system.
  • Experience validating and confirming information related to provider contracting, network management, credentialing, benefits, prior authorizations, fee schedules, and other business requirements.
  • Analytical and critical-thinking skills.
  • Flexibility to meet changing business requirements, and commitment to high-quality/on-time delivery
  • Attention to detail.
  • Effective verbal and written communication skills.
  • Microsoft Office suite proficiency, including Excel abilities (VLOOKUP/Pivot Tables, etc.), and applicable software programs proficiency.

Preferred Qualifications

  • Experience in a managed care organization supporting Medicaid, Medicare and/or Marketplace programs.
  • Intermediate to advanced Microsoft Excel skills.

To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board.

Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V

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 the company

Molina Healthcare company logo

Molina Healthcare

Actively Hiring
Molina Healthcare is a managed care company5000+ Employees
  • B2B
  • Public Stage
    Publicly traded company
Learn more about Molina Healthcare image

Funding

AMOUNT RAISED
$750M
FUNDED OVER
1 round
Round
S
$750000000
Seed - Nov 2024