Manager, Configuration - Marketplace Benefit Maintenance/QNXT - Remote

About the position

Molina Healthcare is in search of a Manager, Configuration. This role is remote and can be worked from a variety of locations. The Manager will oversee a team of professional Configuration Analysts and will be responsible for operational activities for the assigned team, including accurate and timely implementation and maintenance of critical information on claims databases. The role involves validating data to be housed on databases and ensuring adherence to business and system requirements of Health Plans as it pertains to contracting, benefits, prior authorizations, fee schedules, and other business requirements.

Responsibilities

• Manage a team of professional Configuration Analysts.
• Oversee operational activities for the assigned team.
• Ensure accurate and timely implementation and maintenance of critical information on claims databases.
• Validate data to be housed on databases and ensure adherence to business and system requirements.
• Meet and exceed all performance metrics and department goals.
• Resolve conflicts within teams and provide solutions.
• Ensure compliance with company and legal requirements by all team members.
• Complete tasks with accuracy and efficiency.
• Set priorities and systematically identify root causes of challenges.
• Work with business and project development teams to assess and recommend configuration design and solutions.
• Develop standard operating procedures and guidelines for the Configuration team.
• Provide status reports and project updates to management and stakeholders.
• Ensure staff have necessary resources to perform at a high level.
• Conduct performance reviews, training, and corrective actions as appropriate.

Requirements

• Bachelor's Degree or equivalent combination of education and experience.
• 5-7 years of relevant experience.
• Strong SQL skills.
• Understanding of the QNXT Schema.
• Advanced knowledge of healthcare benefits.
• Advanced knowledge of healthcare claims and claim processing from receipt through encounter submission.
• Ability to adopt and utilize work tracking software.
• Strong business writing skills; proficient in Microsoft Products including Word, Excel, Outlook, Teams, SharePoint, PowerPoint, and Visio.

Nice-to-haves

• Graduate Degree or equivalent combination of education and experience.
• 7-9 years of relevant experience.
• Advanced knowledge of Excel preferred.
• SQL knowledge preferred.
• Coding certification preferred.
• Knowledge of configuration in QNXT strongly preferred.

Benefits

• Competitive benefits and compensation package.