Senior Analyst, Provider Configuration - QNXT/SQL/Claims
About The Position
JOB DESCRIPTION Job Summary Provides senior level analyst support for provider configuration activities including accurate and timely maintenance of critical provider information on all claims and provider databases. Synchronizes data within multiple claims systems and validates data stored within provider databases - ensuring adherence to business and system requirements as it pertains to contracting, network management, and credentialing. Essential Job Duties Analyses, reviews, and audits provider data for quality and accuracy in systems/databases. Develops standard operating procedures (SOPs) and/or business requirement documents (BRDs) related to provider configuration. Assists with development of configuration standards and best practices, and recommends processes to ensure systems are working efficiently and assessed for continuous improvement/quality. Assists in planning and coordination of claims payment system upgrades and releases, including development and execution of test plans. Participates in the implementation and conversion of new and existing health plans.
Requirements
- At least 4 years of experience in health care, preferably in a customer/provider services setting, or equivalent combination of relevant education and experience.
- Strong critical-thinking skills, and attention to detail.
- Strong organizational and time-management skills; ability to manage simultaneous projects and tasks to meet internal deadlines.
- Customer service experience.
- Effective verbal and written communication skills.
- Microsoft Office suite proficiency (including Excel) and applicable software program(s) experience.
Responsibilities
- Analyses, reviews, and audits provider data for quality and accuracy in systems/databases.
- Develops standard operating procedures (SOPs) and/or business requirement documents (BRDs) related to provider configuration.
- Assists with development of configuration standards and best practices, and recommends processes to ensure systems are working efficiently and assessed for continuous improvement/quality.
- Assists in planning and coordination of claims payment system upgrades and releases, including development and execution of test plans.
- Participates in the implementation and conversion of new and existing health plans.
Benefits
- Molina Healthcare offers a competitive benefits and compensation package.
- Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V
Stand Out From the Crowd
Upload your resume and get instant feedback on how well it matches this job.
What This Job Offers
Job Type
Full-time
Career Level
Senior
Education Level
No Education Listed
