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Business Analyst (Claims - Remote FLORIDA)
Molina Healthcare • Remote • Posted 2 days ago
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Remote • Full-time • $19.64-$42.55/hr • Mid Level
Job Highlights
Using AI ⚡ to summarize the original job post
The Business Analyst at Molina Healthcare analyzes complex business problems and claims issues using data from internal and external sources to provide insight to decision-makers. This role involves identifying and interpreting trends and patterns in datasets, constructing forecasts, recommendations, and strategic/tactical plans based on business data and market knowledge, and creating specifications for reports and analysis based on business needs. The position is remote and requires the employee to reside in Florida.
Responsibilities
- Analyzes complex business problems and claims issues using data from internal and external sources to provide insight to decision-makers.
- Identifies and interprets trends and patterns in datasets to locate influences.
- Constructs forecasts, recommendations and strategic/tactical plans based on business data and market knowledge.
- Creates specifications for reports and analysis based on business needs and required or available data elements.
- Collaborates with clients to modify or tailor existing analysis or reports to meet their specific needs.
- May participate in management reviews, including presenting and interpreting analysis results, summarizing conclusions, and recommending a course of action.
- Provides analytical, problem solving foundation within claims including: definition and documentation, specifications.
- Recognizes, identifies and documents changes to existing business processes and identifies new opportunities for process developments and improvements.
- Reviews, researches, analyzes and evaluates all data relating to specific area of expertise. Begins process of becoming subject matter expert.
- Conducts analysis and uses analytical skills to identify root cause and assist with problem management as it relates to state requirements.
- Analyzes business workflow and system needs for conversions and migrations to ensure that encounter, recovery and cost savings regulations are met
- Prepares high level user documentation and training materials as needed.
Qualifications
Required
- Associate's Degree or equivalent combination of education and experience
- 3-5 years of business analysis experience
- 4+ years managed care experience
- Demonstrates familiarity in a variety of concepts, practices, and procedures applicable to job-related subject areas.
Preferred
- Bachelor's Degree or equivalent combination of education and experience
- 1-3 years formal training in Business Analysis and/or Systems Analysis
- 1+ years claims background
About Molina Healthcare
Molina Healthcare is a Fortune 500 managed care company operating in the United States. They offer Medicaid, Medicare, and Marketplace health plans, focusing on providing affordable, quality healthcare to underserved populations. The company has expanded through acquisitions, such as acquiring Magellan Complete Care to enter the Florida market and enhance their services.
Full Job Description
**JOB DESCRIPTION**
*******This position is remote and employee must reside in Florida*******
**Job Summary**
Analyzes complex business problems and claims issues using data from internal and external sources to provide insight to decision-makers. Identifies and interprets trends and patterns in datasets to locate influences. Constructs forecasts, recommendations and strategic/tactical plans based on business data and market knowledge. Creates specifications for reports and analysis based on business needs and required or available data elements. Collaborates with clients to modify or tailor existing analysis or reports to meet their specific needs. May participate in management reviews, including presenting and interpreting analysis results, summarizing conclusions, and recommending a course of action. This is a general role in which employees work with multiple types of business data. May be internal operations-focused or external client-focused.
**KNOWLEDGE/SKILLS/ABILITIES**
+ Provides analytical, problem solving foundation within claims including: definition and documentation, specifications.
+ Recognizes, identifies and documents changes to existing business processes and identifies new opportunities for process developments and improvements.
+ Reviews, researches, analyzes and evaluates all data relating to specific area of expertise. Begins process of becoming subject matter expert.
+ Conducts analysis and uses analytical skills to identify root cause and assist with problem management as it relates to state requirements.
+ Analyzes business workflow and system needs for conversions and migrations to ensure that encounter, recovery and cost savings regulations are met
+ Prepares high level user documentation and training materials as needed.
**JOB QUALIFICATIONS**
**Required Education**
Associate's Degree or equivalent combination of education and experience
**Required Experience**
+ 3-5 Years of business analysis
+ 4+ years managed care experience
+ Demonstrates familiarity in a variety of concepts, practices, and procedures applicable to job-related subject areas.
**Preferred Education**
Bachelor's Degree or equivalent combination of education and experience
**Preferred Experience**
+ 1-3 years formal training in Business Analysis and/or Systems Analysis
+ 1+ years claims background
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.
Pay Range: $19.64 - $42.55 / HOURLY
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
*******This position is remote and employee must reside in Florida*******
**Job Summary**
Analyzes complex business problems and claims issues using data from internal and external sources to provide insight to decision-makers. Identifies and interprets trends and patterns in datasets to locate influences. Constructs forecasts, recommendations and strategic/tactical plans based on business data and market knowledge. Creates specifications for reports and analysis based on business needs and required or available data elements. Collaborates with clients to modify or tailor existing analysis or reports to meet their specific needs. May participate in management reviews, including presenting and interpreting analysis results, summarizing conclusions, and recommending a course of action. This is a general role in which employees work with multiple types of business data. May be internal operations-focused or external client-focused.
**KNOWLEDGE/SKILLS/ABILITIES**
+ Provides analytical, problem solving foundation within claims including: definition and documentation, specifications.
+ Recognizes, identifies and documents changes to existing business processes and identifies new opportunities for process developments and improvements.
+ Reviews, researches, analyzes and evaluates all data relating to specific area of expertise. Begins process of becoming subject matter expert.
+ Conducts analysis and uses analytical skills to identify root cause and assist with problem management as it relates to state requirements.
+ Analyzes business workflow and system needs for conversions and migrations to ensure that encounter, recovery and cost savings regulations are met
+ Prepares high level user documentation and training materials as needed.
**JOB QUALIFICATIONS**
**Required Education**
Associate's Degree or equivalent combination of education and experience
**Required Experience**
+ 3-5 Years of business analysis
+ 4+ years managed care experience
+ Demonstrates familiarity in a variety of concepts, practices, and procedures applicable to job-related subject areas.
**Preferred Education**
Bachelor's Degree or equivalent combination of education and experience
**Preferred Experience**
+ 1-3 years formal training in Business Analysis and/or Systems Analysis
+ 1+ years claims background
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.
Pay Range: $19.64 - $42.55 / HOURLY
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
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