Molina Healthcare

Lead Analyst, Technical Configuration Information Management - SQL/QNXT/Documentation - Remote

Molina Healthcare$85K — $110K *
Healthcare
5 - 7 years of experience
Job Overview by Ladders

Qualifications

  • Bachelor's Degree or equivalent experience
  • 5-6 years of relevant experience
  • Graduate Degree preferred
  • 7+ years preferred experience
  • Strong knowledge of claims life cycle, QNXT, AutoQ, and MCG functionality.

Responsibilities

  • Implement and maintain accuracy of claims databases
  • Synchronize data across operational and claims systems
  • Validate data adherence to business and system requirements
  • Create management reporting tools for updates and initiatives
  • Lead project meetings and manage complex projects from requirements to deployment
  • Mentor junior analysts and assist in establishing best practices
  • Research new tools and techniques for continuous improvement.

Benefits

  • Comprehensive healthcare benefits
  • Flexible work arrangements
  • Professional development opportunities
  • Retirement savings plan
  • Employee assistance programs.
Full Job Description
Job Description

JOB DESCRIPTION

Job Summary

Responsible for accurate and timely implementation and maintenance of critical information on claims databases. Maintains critical information on claims databases. Synchronizes data among operational and claims systems and application of business rules as they apply to each database. Validate data to be housed on databases and ensure adherence to business and system requirements of customers as it pertains to contracting, benefits, prior authorizations, fee schedules, and other business requirements.

KNOWLEDGE/SKILLS/ABILITIES
  • Trains staff on configuration functionality, enhancements, and updates.
  • Works with internal and external stakeholders to understand business objectives and processes associated with the enterprise.
  • Problem solves with Health Plans and Corporate to ensure all end-to-end business requirements have been documented.
  • Creates management reporting tools to enhance communication on configurations updates and initiatives.
  • Negotiates expected completion dates with Health Plans.
  • Writes complex ad-hoc reports
  • Creates complex MRDT and other configuration update scripts
  • Assists manager in establishing standards, guidelines, and best practices for the team
  • Designs and develop templates for complex reports and automated configuration processes/solutions
  • Assist manager in establishing peer review standards and methodology
  • Leads peer reviews
  • Leads the design and development of large, complex, critical configuration maintenance processes/solutions
  • Research and review new tools and techniques and provide recommendations to management
  • Builds complex configuration processes/solutions
  • Maintains MRDT, fee schedule, premium, AutoQ, and other file load packages
  • Designs/document AutoQ solutions (FRD, Schema, etc.)
  • Interprets complex business problems and technical issues
  • Architects and design comprehensive solutions that meet the business and technical requirements for the given initiative
  • Effectively communicates solutions through review meetings, written specifications, workflow diagrams, and/or proof of concept demonstrations
  • Helps drive solution to successful implementation by directing technical and business resources during all phases of the software development life cycle
  • Gains a deep understanding of Molina claims life cycle and all processes that affect claims payment
  • Develops and maintain standards and best practices for the team
  • Mentors junior analysts
  • Participates in or leads project meetings
  • Understands QNXT, AutoQ, and MCG functionality and schema
  • Determines if a project is AutoQ, MCG, or other
  • Writes Requirements for BRDs/FRDs and Reports without needing mentoring
  • Suggests schema/solution. Works with technical resource to determine best solution.
  • Manages complex projects from requirements to deployment, including work assignment, prioritization, issue triage etc.
  • Understands QNXT, AutoQ, and MCG functionality and schema
  • Determines if a project is AutoQ, MCG, or other
  • Writes Requirements for BRDs/FRDs and Reports without needing mentoring
  • Suggests schema/solution. Works with technical resource to determine best solution.
  • Manages complex projects from requirements to deployment, including work assignment, prioritization, issue triage etc.
  • Researches complex issues, and set up complicated proof of concept tests without needing mentoring
  • E.g., Medicare Exclusion POC
  • Acts as a team lead, assigning and prioritizing work for other team members as needed.

JOB QUALIFICATIONS

Required Education

Bachelor's Degree or equivalent combination of education and experience

Required Experience

5-6 Years

Preferred Education

Graduate Degree or equivalent experience

Preferred Experience

7+ 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.

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

Similar Jobs

More Jobs at Molina Healthcare

More Healthcare Jobs

Find similar Lead Analyst, Technical Configuration Information Management - SQL/QNXT/Documentation - Remote jobs: