Healthplan Enrollment Operations (834 EDI file experience) Sr BA

JOB DESCRIPTION

JOB DESCRIPTION

Will be supporting enrollment data (and 834 EDI transactions). Ideal candidate will have experience working at an MCO supporting staff on enrollment issues, working with Finance to identifying enrollment data issues that impact the business, and working with IT and corporate enrollment operations team to implement data corrections and process improvements.

This role is strategic to the business and dynamic. Must have ability to think big picture but also the desire to work in the weeds.

This position interfaces with leadership team, Finance, Government Contracts, and Compliance on a regular basis as well as external vendors as the enrollment subject matter expert.

Job Summary

Analyzes complex business problems and issues using data from internal and external sources to provide insight to decision-makers.

Identifies and interprets trends and patterns in datasets to locate influences. Constructs forecasts, recommendations and strategic / tactical plans based on business data and market knowledge.

Creates specifications for reports and analysis based on business needs and required or available data elements. Collaborates with clients to modify or tailor existing analysis or reports to meet their specific needs.

May participate in management reviews, including presenting and interpreting analysis results, summarizing conclusions, and recommending a course of action.

This is a general role in which employees work with multiple types of business data. May be internal operations-focused or external client-focused.

KNOWLEDGE / SKILLS / ABILITIES

• Elicit requirements using interviews, document analysis, and requirements workshops, business process descriptions, use cases, business analysis, task and workflow analysis.
• Interpret customer business needs and translate them into application and operational requirements
• Communicate and collaborate with external and internal customers to analyze and transform needs, goals and transforming in to functional requirements and delivering the appropriate artifacts as needed.
• Work with operational leaders within the business to provide recommendations on opportunities for process improvements, medical cost savings or revenue enhancements.
• Create Business Requirements Documents, Test Plans, Requirements Traceability Matrix, User Training materials and other related documentations.
• Actively participates in all stages of project development including research, design, programming, testing and implementation to ensures the released product meets the intended functional and operational requirements.

JOB QUALIFICATIONS

Required Education

Bachelor's Degree or equivalent combination of education and experience

Required Experience

• 5-7 years of business analysis experience,
• 6+ years managed care experience.
• Demonstrates proficiency in a variety of concepts, practices, and procedures applicable to job-related subject areas.

Preferred Education

Bachelor's Degree or equivalent combination of education and experience

Preferred Experience

• 3-5 years of formal training in Project Management
• Experience working with complex, often highly technical teams

Preferred License, Certification, Association

Certified Business Analysis Professional (CBAP), Certification from International Institute of Business Analysis preferred

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 : $49,430.25 - $107,098.87 / ANNUAL

• Actual compensation may vary from posting based on geographic location, work experience, education and / or skill level.
30+ days ago