Claims Business Analyst - QNXT - CA Remote

Molina Healthcare • Long Beach, CA

250d • $68,640 - $111,967

About The Position

Designs and implements processes and solutions associated with a wide variety of data sets used for data/text mining, analysis, modeling, and predicting to enable informed business decisions. Gains insight into key business problems and deliverables by applying statistical analysis techniques to examine structured and unstructured data from multiple disparate sources. Collaborates across departments and with customers to define requirements and understand business problems. Uses advanced mathematical, statistical, querying, and reporting methods to develop solutions. Develops information tools, algorithms, dashboards, and queries to monitor and improve business performance. Creates solutions from initial concept to fully tested production, and communicates results to a broad range of audiences. Effectively uses current and emerging technologies.

Requirements

• Must have member movement or PCP reassignment or Enrollment and Provider termination experience.
• Must have intermediate level MS Excel experience.
• Familiarity with Enrollment and Managed Healthcare experience is required.
• Must be able to research and analyze data using SQL.
• Experience with QNXT is preferred.
• Medicare/medicaid membership experience required.

Nice To Haves

• Bachelor's Degree or equivalent combination of education and experience.
• 3-5 years of experience in a related field.

Responsibilities

• Extracts and compiles various sources of information and large data sets from various systems to identify and analyze outliers.
• Sets up process for monitoring, tracking, and trending department data.
• Prepares any state mandated reports and analysis.
• Works with internal, external and enterprise clients as needed to research, develop, and document new standard reports or processes.
• Implements and uses the analytics software and systems to support the departments goals.

Benefits

• Competitive benefits and compensation package.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Industry: Insurance Carriers and Related Activities
• Education Level: Associate degree