Analyst, Business - Advanced Excel (Remote)

Molina Healthcare•United States,

4d•$44,937 - $97,363•Remote

About The Position

The Analyst, Business provides analyst support for business requirements activities of moderate complexity. The role is responsible for accurately and promptly receiving and interpreting regulatory and functional requirements—including requirements related to coverage, reimbursement, and processing—to support the development and maintenance of systems solutions. The analyst coordinates with stakeholders and subject matter experts across functions to support business needs and participates in governance committees as applicable. Advanced Excel skills are required. The analyst develops and maintains requirement documentation, monitors regulatory sources, analyzes and documents specifications, supports review processes and committees, and identifies changes and improvement opportunities in existing business processes. The role communicates requirement interpretations, changes, status, and impacts to health plan and product teams, senior leadership, and other stakeholders. It also helps align requirements with system configuration, supports issue interpretation, promotes consistent solution standards and best practices, and facilitates reporting on work efforts and changes that may affect financials. The position conducts industry research, coordinates analysis and implementation of changes affecting health plans or products, supports compliance-related benefit planning reviews, and ensures that end-to-end business requirements are documented, agreed upon, and clearly connected to solutions. It also develops and maintains relationships with health plan and product teams and corporate operations.

Requirements

At least 2 years of operations or 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 or 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 with 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 requirements documents for coverage, reimbursement, and other applicable system changes, ensuring alignment with regulatory and health plan or product requirements.
Monitor regulatory sources and ensure updates are aligned.
Analyze complex problems and clearly define and document unique specifications.
Support the development and ongoing interpretation of review processes, committees, and collaboration with key partner organizations.
Identify and document changes to existing business processes and opportunities for process development and improvement.
Provide status updates to health plan and product team partners, senior leadership, and applicable stakeholders.
Communicate requirement interpretations and changes to health plans, product teams, and impacted functional areas; coordinate meetings and promote operational process best practices.
Codify requirements for system configuration alignment and interpretation where applicable.
Support requirement interpretation inconsistencies and complaints.
Help develop requirement solution standards and best practices, and suggest improvements to promote consistent application across states and products.
Facilitate reporting so health plans, product teams, leaders, and stakeholders understand work efforts and the impact of prospective or retrospective requirement changes on financials.
Conduct industry research and engagement to evaluate opportunities, provide insights, and develop or deploy best practices.
Coordinate with applicable teams to analyze, assess the impact of, and implement changes affecting health plans or 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 solutions are clear to applicable parties.
Develop and maintain relationships with health plan and product teams and corporate operations.