Molina Healthcare
Senior Analyst, Provider Configuration
Molina Healthcare, Albuquerque, New Mexico, United States, 87101
JOB DESCRIPTION
Job Summary
Responsible for accurate and timely maintenance of critical provider information on all claims and provider databases. Maintains critical provider information (using SQL, PowerBI, and Excel) on all claims and provider databases. Synchronizes data among multiple claims systems and application of business rules as they apply to each database. Validate data to be housed on provider databases and ensure adherence to business and system requirements of customers as it pertains to contracting, network management and credentialing.
KNOWLEDGE/ SKILLS/ ABILITIES
Generates data to support continuous quality of provider data and developing SOPs and/or BRDs.
Develops and maintains documentation and guidelines for all assigned areas of responsibility.
Assists with development of configuration standards and best practices while suggesting improvement processes to ensure systems are working more efficiently and improve quality.
Assists in planning and coordination of the claim payment system upgrades and releases, including development and execution of some test plans.
Participates in the implementation and conversion of new and existing health plans.
JOB QUALIFICATIONS Required Education Bachelor's Degree or equivalent combination of education and experience
Required Experience 5-7 years Healthcare analytical experience
Preferred Education Graduate Degree or equivalent combination of education and experience
Preferred Experience 7-9 years healthcare analytical experience
SQL, PowerBI, and Excel
QNXT
Benefits & Compensation Molina Healthcare offers a competitive benefits and compensation package.
Equal Opportunity Employer Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
Pay Range $77,969 - $141,371 / ANNUAL
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
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Responsible for accurate and timely maintenance of critical provider information on all claims and provider databases. Maintains critical provider information (using SQL, PowerBI, and Excel) on all claims and provider databases. Synchronizes data among multiple claims systems and application of business rules as they apply to each database. Validate data to be housed on provider databases and ensure adherence to business and system requirements of customers as it pertains to contracting, network management and credentialing.
KNOWLEDGE/ SKILLS/ ABILITIES
Generates data to support continuous quality of provider data and developing SOPs and/or BRDs.
Develops and maintains documentation and guidelines for all assigned areas of responsibility.
Assists with development of configuration standards and best practices while suggesting improvement processes to ensure systems are working more efficiently and improve quality.
Assists in planning and coordination of the claim payment system upgrades and releases, including development and execution of some test plans.
Participates in the implementation and conversion of new and existing health plans.
JOB QUALIFICATIONS Required Education Bachelor's Degree or equivalent combination of education and experience
Required Experience 5-7 years Healthcare analytical experience
Preferred Education Graduate Degree or equivalent combination of education and experience
Preferred Experience 7-9 years healthcare analytical experience
SQL, PowerBI, and Excel
QNXT
Benefits & Compensation Molina Healthcare offers a competitive benefits and compensation package.
Equal Opportunity Employer Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
Pay Range $77,969 - $141,371 / ANNUAL
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
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