SR ANALYST, PROVIDER CONFIGURATION
Posted on: 4 Feb 2022
Long Beach, CA
Job Description
Job Summary
Responsible for accurate and timely maintenance of critical provider information on all claims and provider databases. Maintains critical provider information on all claims and provider databases. Synchronizes data among multiple claims systems and application of business rules as they apply to each database. Validate data to be housed on provider databases and ensure adherence to business and system requirements of customers as it pertains to contracting, network management and credentialing.
KNOWLEDGE/SKILLS/ABILITIES
Generates data to support continuous quality of provider data and developing SOPs and/or BRDs.
Develops and maintains documentation and guidelines for all assigned areas of responsibility.
Assists with development of configuration standards and best practices while suggesting improvement processes to ensure systems are working more efficiently and improve quality.
Assists in planning and coordination of the claim payment system upgrades and releases, including development and execution of some test plans.
Participates in the implementation and conversion of new and existing health plans.
JOB QUALIFICATIONS
Required Education
Bachelor's Degree or equivalent combination of education and experience
Required Experience
5-7 years
Preferred Education
Graduate Degree or equivalent combination of education and experience
Preferred Experience
7-9 years
To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.
Molina Healthcare
Long Beach, CA
Molina Healthcare, Inc., a multi-state healthcare organization, provides managed health care services to low-income families and individuals under the Medicaid and Medicare programs and through the state insurance marketplaces. As of December 31, 2018, it served approximately 3.8 million members in 14 states and the Commonwealth of Puerto Rico, who are eligible for Medicaid, Medicare, and other government-sponsored health care programs. The company offers its health care services for its members through contracts with a network of providers, including physicians and physician groups, hospitals, ancillary providers, and pharmacies. Molina Healthcare, Inc. was founded in 1980 and is headquartered in Long Beach, California.
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IndustryHealthcare
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No. of Employees11, 000
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Website
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Jobs Posted261
