Molina Healthcare
Join to apply for the
Business Systems Analyst - QNXT Claims
role at
Molina Healthcare Join to apply for the
Business Systems Analyst - QNXT Claims
role at
Molina Healthcare Get AI-powered advice on this job and more exclusive features. Job Summary
A successful candidate will have a balance of business insight, critical thinking, strong communication and analytical skills. Possess the ability to work independently, self-navigate organizational and technical challenges. Performs research and analysis of healthcare claims data, pharmacy data, and external data to derive proper courses of action for remediation. This role will support processes for Patient Liability and Medicaid processes. Job Description
Job Summary
A successful candidate will have a balance of business insight, critical thinking, strong communication and analytical skills. Possess the ability to work independently, self-navigate organizational and technical challenges. Performs research and analysis of healthcare claims data, pharmacy data, and external data to derive proper courses of action for remediation. This role will support processes for Patient Liability and Medicaid processes.
Key Responsibilities
Perform research and analysis for inquiries and requests, utilizing technical tools as necessary to provide feedback and resolution within the Service Level Agreement. Assist with research, development and completion of special projects as requested by various internal departments, or in support of requests from regulatory agencies, contracting agencies, or other external organizations. Responsible for timely completion of projects, not limited to timeline development and maintenance; coordinates activities and data collection with internal departments or external requestors. Interpret business needs and translate them into application and operational requirements. Create comprehensive workflows and documentation of operational processes and procedures. Prioritize initiatives based on business needs and requirements. Undertake project tasks as required
Knowledge, Skills & Abilities
Advanced written, oral, and interpersonal skills Demonstrated ability of evaluating the effectiveness and efficiency of existing processes Able to effectively prioritize and execute tasks Able to generate insights from data analysis Able to learn quickly and solve complex problems Experience in partnering with cross-functional teams Experience with documentation and meeting facilitation Flexible and able to work with tight deadlines Knowledge of Healthcare industry standards, concepts, terminology and common practices Claims and SQL knowledge a plus
Job Qualifications
Required Education
Associate degree or equivalent combination of education and experience
Required Experience
1-3 Years
Preferred Education
Bachelor's Degree or equivalent combination of education and experience
Preferred Experience
3-4 Years
To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.
Molina Healthcare offers a competitive benefits and compensation package. 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. Seniority level
Seniority level
Entry level Employment type
Employment type
Full-time Job function
Job function
Information Technology Industries
Hospitals and Health Care Referrals increase your chances of interviewing at Molina Healthcare by 2x Sign in to set job alerts for Business System Analyst roles.
Georgia, United States $75,000.00-$110,000.00 1 week ago Were unlocking community knowledge in a new way. Experts add insights directly into each article, started with the help of AI. #J-18808-Ljbffr
Business Systems Analyst - QNXT Claims
role at
Molina Healthcare Join to apply for the
Business Systems Analyst - QNXT Claims
role at
Molina Healthcare Get AI-powered advice on this job and more exclusive features. Job Summary
A successful candidate will have a balance of business insight, critical thinking, strong communication and analytical skills. Possess the ability to work independently, self-navigate organizational and technical challenges. Performs research and analysis of healthcare claims data, pharmacy data, and external data to derive proper courses of action for remediation. This role will support processes for Patient Liability and Medicaid processes. Job Description
Job Summary
A successful candidate will have a balance of business insight, critical thinking, strong communication and analytical skills. Possess the ability to work independently, self-navigate organizational and technical challenges. Performs research and analysis of healthcare claims data, pharmacy data, and external data to derive proper courses of action for remediation. This role will support processes for Patient Liability and Medicaid processes.
Key Responsibilities
Perform research and analysis for inquiries and requests, utilizing technical tools as necessary to provide feedback and resolution within the Service Level Agreement. Assist with research, development and completion of special projects as requested by various internal departments, or in support of requests from regulatory agencies, contracting agencies, or other external organizations. Responsible for timely completion of projects, not limited to timeline development and maintenance; coordinates activities and data collection with internal departments or external requestors. Interpret business needs and translate them into application and operational requirements. Create comprehensive workflows and documentation of operational processes and procedures. Prioritize initiatives based on business needs and requirements. Undertake project tasks as required
Knowledge, Skills & Abilities
Advanced written, oral, and interpersonal skills Demonstrated ability of evaluating the effectiveness and efficiency of existing processes Able to effectively prioritize and execute tasks Able to generate insights from data analysis Able to learn quickly and solve complex problems Experience in partnering with cross-functional teams Experience with documentation and meeting facilitation Flexible and able to work with tight deadlines Knowledge of Healthcare industry standards, concepts, terminology and common practices Claims and SQL knowledge a plus
Job Qualifications
Required Education
Associate degree or equivalent combination of education and experience
Required Experience
1-3 Years
Preferred Education
Bachelor's Degree or equivalent combination of education and experience
Preferred Experience
3-4 Years
To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.
Molina Healthcare offers a competitive benefits and compensation package. 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. Seniority level
Seniority level
Entry level Employment type
Employment type
Full-time Job function
Job function
Information Technology Industries
Hospitals and Health Care Referrals increase your chances of interviewing at Molina Healthcare by 2x Sign in to set job alerts for Business System Analyst roles.
Georgia, United States $75,000.00-$110,000.00 1 week ago Were unlocking community knowledge in a new way. Experts add insights directly into each article, started with the help of AI. #J-18808-Ljbffr