Analyst, Business - Advanced Excel (Remote)

Molina Healthcare•Long Beach, CA

3d•Remote

About The Position

Provides analyst support for moderately complex business requirements activities. The role is responsible for accurately and promptly intake and interpretation of regulatory and functional requirements—including coverage, reimbursement, and processing requirements—to support systems solution development and maintenance. The analyst coordinates with stakeholders and subject matter experts across functions, supports business needs, and participates in governance committees as applicable. Advanced Excel skills are required. The role develops and maintains requirements documentation, monitors regulatory sources, analyzes and documents specifications, supports review processes and committees, and identifies business process changes and improvement opportunities. It communicates requirement interpretations and status updates to health plan/product teams, senior leadership, and other stakeholders; supports alignment, approval, and solution traceability; and, where applicable, codifies requirements for system configuration. The analyst also helps establish consistent requirements practices, supports reporting on prospective and retrospective changes that may affect financials, conducts industry research, coordinates impact analysis and implementation, and ensures requirements and solutioning are clearly documented and agreed upon.

Requirements

At least 2 years of operations/analyst experience in a managed care organization, health insurance setting, or related field, or an equivalent combination of relevant education and experience.
Knowledge of policy, government, and legislative review.
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-motivation and ability to take initiative, identify and communicate potential problems, and resolve them.
Experience creating reporting tools and providing project/process updates.
Familiarity with administration systems.
Ability to work in a project team and complete individually assigned tasks within established timelines and deployment deadlines.
Ability to work cross-functionally in a highly matrixed organization.
Effective verbal, written, and interpersonal communication skills, including the ability to engage stakeholders at all organizational levels.
Proficiency with Microsoft Office suite and applicable software programs.
Advanced Excel skills.

Nice To Haves

Project management or 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).

Responsibilities

Develop and maintain requirement documents for coverage, reimbursement, and other applicable system changes, ensuring alignment with regulatory and health plan/product requirements.
Monitor regulatory sources and ensure updates are aligned.
Analyze complex problems and clearly define and document unique specifications.
Support development and ongoing interpretation of review processes, committees, and collaboration with partner organizations.
Identify and document changes to existing business processes and opportunities for process development and improvement.
Provide status updates to health plan/product partners, senior leadership, and applicable stakeholders.
Communicate requirement interpretations and changes to health plans/product teams and impacted functional areas to support alignment, approval, and solution traceability.
Coordinate meetings and champion or deploy operational process best practices.
Where applicable, codify requirements for system configuration alignment and interpretation, and support requirement interpretation inconsistencies and complaints.
Assist in developing requirements solution standards and best practices and suggest improvements for consistent application across states and products.
Facilitate reporting so health plans/product teams, leaders, and stakeholders understand work efforts and the financial impact of prospective or retrospective requirement changes.
Conduct industry research and engagement to evaluate, provide insights, and develop or deploy best practices.
Coordinate analysis, impact assessment, and implementation of changes affecting health plans/products.
Engage operational leadership and health plan support functions to review compliance-based issues for benefit planning.
Ensure end-to-end business requirements are documented, interpretations are agreed upon, and solutioning is clear to applicable parties.
Develop and maintain relationships with health plan/product teams and corporate operations.