Molina Healthcare

Business Analyst

Molina Healthcare$70K — $95K *
Healthcare
Less than 5 years of experience
Job Overview by Ladders

Qualifications

  • 2+ years in managed care or health insurance.
  • Knowledge of policy and government legislation.
  • Strong analytical and problem-solving abilities.
  • Proficient in Office Products, especially Excel and Teams.
  • Successful track record in autonomous work environments.

Responsibilities

  • Develops requirement documents for coverage and reimbursement.
  • Monitors updates for alignment with regulations.
  • Leads management and review processes with partners.
  • Analyzes root causes related to state requirements.
  • Communicates requirement changes to stakeholders and teams.
  • Supports resolution of requirement interpretation issues.
  • Maintains reporting for leadership on impact of changes.

Benefits

  • Competitive benefits package.
  • Support for remote work environments.
Full Job Description
Job Description

JOB DESCRIPTION

Job Summary

Responsible for accurate and timely intake and interpretation of regulatory and/or functional requirements related to but not limited to coverage, reimbursement, and processing functions to support systems solutions development and maintenance. This role includes coordination with stakeholders and subject matter experts on partnering teams and supporting governance committees where applicable.

JOB DUTIES
  • Develops and maintains requirement documents related to coverage, reimbursement and other applicable system changes in areas to ensure alignment to regulatory baseline requirements and any health plan developed requirements.
  • Monitors sources to ensure all updates are aligned.
  • Leads coordinated development and ongoing management /interpretation review process, committee structure and timing with key partner organizations.
  • Conducts analysis to identify root cause and assist with problem management as it relates to state requirements.
  • Communicates requirement interpretations and changes to health plans/product team and various impacted corporate core functional areas for requirement interpretation alignment and approvals as well as solution traceability through regular meetings and other operational process best practices.
  • Provides support for requirement interpretation inconsistencies and complaints.
  • Self-organized reporting to ensure health plans/product team and other leadership are aware of work efforts and impact for any prospective or retrospective requirement changes that can impact financials.
  • Engages with operations leadership and Plan Support functions to review compliance-based issues for benefit planning purposes.

KNOWLEDGE/SKILLS/ABILITIES
  • Maintains relationships with Health Plans/Product Team and Corporate Operations to ensure all end-to-end business requirements have been documented and interpretation is agreed on and clear for solutioning.
  • Ability to meet aggressive timelines and balance multiple lines of business, states, and requirement areas.
  • Strong interpersonal and (oral and written) communication skills and ability to communicate with those in all positions of the company.
  • Ability to concisely synthesize large and complex requirements.
  • Ability to organize and maintain regulatory data including real-time policy changes.
  • Self-motivated and ability to take initiative, identify, communicate, and resolve potential problems.
  • Ability to work independently in a remote environment.
  • Ability to work with those in other time zones than your own.

JOB QUALIFICATIONS

Required Qualifications
  • At least 2 years of experience in previous roles in a managed care organization, health insurance or directly adjacent field, or equivalent combination of relevant education and experience.
  • Policy/government legislative review knowledge.
  • Strong analytical and problem-solving skills.
  • Robust knowledge of Office Product Suite including Word, Excel, Outlook and Teams.
  • Previous success in a dynamic and autonomous work environment.

Preferred Qualifications
  • Project implementation experience
  • Knowledge and experience with federal regulatory policy resources including Centers for Medicare & Medicaid Services (CMS) and the Affordable Care Act (ACA).
  • Medical Coding certification.


To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board.

Molina Healthcare offers a competitive benefits and compensation package.

About Molina Healthcare

Molina Healthcare focuses exclusively on government-sponsored health care programs for families and individuals who qualify for government-sponsored health care. It contracts with state governments and serves as a health plan, providing a wide range of quality health care services to families and individuals.

Molina Healthcare Careers

Join the dedicated team at Molina Healthcare, a leader in providing quality healthcare services to families and individuals who qualify for government-sponsored programs, including Medicaid and Medicare. As one of the most respected companies in the health services industry, Molina Healthcare offers unparalleled job opportunities aimed at empowering your career growth and professional development.

Work You’ll Do

At Molina Healthcare, you will engage in meaningful work that directly impacts lives across the country. Our team is committed to innovation in healthcare, ensuring that all members receive the best care possible. By joining us, you will collaborate with skilled professionals dedicated to our mission of providing accessible, high-quality healthcare.

Career Opportunities and Growth

Whether you are looking for your first job, seeking a leadership role, or aiming to specialize in healthcare professions, Molina Healthcare offers a range of career paths. Our job opportunities span across various functions, including clinical services, customer support, IT, project management, and more. We believe in fostering the growth of our employees through professional development, leadership training, and diversity initiatives.

Internship Programs

Kickstart your career with a Molina Healthcare internship. Our internships provide invaluable workplace experience, offering a glimpse into the healthcare industry through hands-on projects and mentorship. Interns at Molina Healthcare gain critical skills that prepare them for future employment, making them competitive candidates in the job market.

Culture and Benefits

Molina Healthcare is not just a company; it’s a community. We prioritize a culture of inclusivity and respect, where all team members are encouraged to bring their whole selves to work. Our employees enjoy comprehensive benefits, including health insurance, retirement plans, and wellness programs, all designed to support both their professional and personal lives.

Join Our Team

Explore the various positions available at Molina Healthcare and find where your skills and interests align with our needs. We are continuously hiring talented individuals who are passionate about making a difference in healthcare. Prepare your resume, sharpen your interview skills, and become part of a team that values hard work and creativity.

Stay Connected

Keep up to date with the latest at Molina Healthcare: - **Career Growth and Networking:** Advance your career through our professional development and networking opportunities. Learn from leaders and peers alike to build connections that propel your career forward. - **Innovation and Leadership:** Drive change and lead with confidence by participating in our leadership and innovation training programs.

Apply Now

Ready to take the next step in your healthcare career? Search open positions that match your skills and interests on the Molina Healthcare Jobs portal. We look for driven, curious, and compassionate team players ready to make an impact.

Stay Informed

Subscribe to Molina Healthcare job alerts and receive updates on new openings and company news directly to your inbox. Tailor your subscription to match your career preferences and stay ahead in the dynamic field of healthcare. Join Molina Healthcare, where your career is nurtured, your contributions are valued, and your growth is guaranteed.
Learn more about Molina Healthcare
Size
14,000 employees
Market Cap
$19.5 billion
Industry
Net Income
$673 million
Founded
1980
5 Year Trend
+9.3%
Revenue
$19.4 billion
NASDAQ

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