Job Description

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.
• Must have end to end Project mgmt experience

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 offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

Job Info

Job Identification: 2027336

Job Category: Operations

Posting Date: 2024-08-29T18:42:12 00:00

Job Schedule: Full time