Lead Analyst, Tech Config Info Mgmt - QA/Automation/SQL - Remote

$87,722 - $171,058/Yr

Molina Healthcare

Full-time

Remote

Insurance Carriers and Related Activities

About the position

The position is responsible for the accurate and timely implementation and maintenance of critical information on claims databases. This role involves synchronizing data among operational and claims systems, validating data, and ensuring adherence to business and system requirements related to contracting, benefits, prior authorizations, fee schedules, and other business needs. The individual will also train staff, problem-solve with health plans, create management reporting tools, and lead complex configuration maintenance processes.

Responsibilities

• Implement and maintain critical information on claims databases.
• Synchronize data among operational and claims systems.
• Validate data to ensure adherence to business and system requirements.
• Train staff on configuration functionality and updates.
• Work with stakeholders to understand business objectives and processes.
• Problem-solve with Health Plans and Corporate to document business requirements.
• Create management reporting tools for configuration updates.
• Negotiate expected completion dates with Health Plans.
• Write complex ad-hoc reports and develop configuration update scripts.
• Assist manager in establishing standards and best practices for the team.
• Lead peer reviews and design complex configuration processes.
• Research new tools and techniques and provide recommendations.
• Maintain MRDT, fee schedule, premium, AutoQ, and other file load packages.
• Architect and design comprehensive solutions for business initiatives.
• Communicate solutions through meetings, specifications, and workflow diagrams.
• Drive solutions to successful implementation during the software development life cycle.
• Gain a deep understanding of Molina claims life cycle and processes affecting claims payment.
• Mentor junior analysts and participate in project meetings.
• Manage complex projects from requirements to deployment.

Requirements

• Bachelor's Degree or equivalent combination of education and experience.
• 5-6 years of relevant experience.

Nice-to-haves

• Graduate Degree or equivalent experience.
• 7+ years of relevant experience.

Benefits

• Competitive benefits and compensation package.