Lead Analyst, Tech Config Info Mgmt - Edifecs - Remote

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



Pay Range: $73,102 - $142,549 a year*

• Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

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.