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Sr Business Analyst Compliance (Managed Care) REMOTE in US
Molina Healthcare - Georgetown, KY
posted 2 months ago
About the position
The Sr Business Analyst Compliance role at Molina Healthcare focuses on overseeing compliance-related tasks within Enrollment Operations. This includes managing Key Performance Indicators (KPI) governance, policy and procedure governance, corrective action plans (CAPs), and internal/external audits. The position is essential for identifying and managing risks, ensuring proper controls are in place, and eliminating compliance gaps for both members and providers. The role supports all lines of business (LOBs) within Enrollment Operations and is fully remote, open to candidates across the US.
Responsibilities
- Elicit requirements using interviews, document analysis, and requirements workshops.
- Interpret customer business needs and translate them into application and operational requirements.
- Communicate and collaborate with external and internal customers to analyze and transform needs into functional requirements.
- Collaborate with operational leaders to provide recommendations on process improvements, medical cost savings, or revenue enhancements.
- Create Business Requirements Documents, Test Plans, Requirements Traceability Matrix, User Training materials, and other related documentation.
- Participate in all stages of project development including research, design, programming, testing, and implementation.
Requirements
- Bachelor's Degree or equivalent combination of education and experience.
- 5-7 years of business analysis experience.
- 6+ years of managed care experience.
- Demonstrates proficiency in a variety of concepts, practices, and procedures applicable to job-related subject areas.
Nice-to-haves
- 3-5 years of formal training in Project Management.
- Experience working with complex, often highly technical teams.
- Certified Business Analysis Professional (CBAP) or certification from the International Institute of Business Analysis preferred.
Benefits
- Competitive benefits and compensation package.
