Business Analyst, Clinical Value (Remote)

Job Description

Molina Healthcare is hiring for a Clinical Values, Business Analyst.

As part of the Molina enterprise Clinical Operations team, analyze and interpret various operational, outcome and financial datasets and reports that quantify, qualify and track the performance of clinical programs and processes that bring organizational value. Work closely with analysts, managers and leaders from enterprise clinical, health plan, Medical Economics and Finance teams. Will participate in management reviews, including presenting and interpreting analysis results, summarizing conclusions, and recommending a course of action.

KNOWLEDGE/SKILLS/ABILITIES

• Provides analytical, problem-solving foundation 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 as needed.
• Collaborate with and leverage supporting areas and processes - Enterprise Clinical Vendor, Clinical Centers of Excellence, Clinical Analytics, Clinical Systems, Medical Economics, Market Engagement, etc. as part of data analysis and synthesis.
• Package data-centric source material for senior leaders, up to and including for C Suite executives and the Molina CEO

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

• Excel Power User, Power BI
• Previous experience making cumbersome data/workbooks into easily digestible stories for various audiences.
• Abstracting experience.
• 1-3 years formal training in Business Analysis and/or Systems Analysis
• Utilization Management and/or Case Management understanding – processes, data, metrics, KPIs
• Finance and/or Accounting experience, aptitude

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.

Key Words: Clinical, Payment Integrity, Excel, Power User, Power BI, Enrollment, Enrollment Analyst, Analyst, Business Analyst, BA, Sr Business Analyst, Healthcare, Managed Care, MCO, Member, Member Enrollment, Enrollment, Medicaid, Medicare, Marketplace, BRD, Critical Thinking, Organization Skills, Troubleshooting, Analysis, Communication, Presentation, Collaborate, Jira, Agile, Waterfall, Agile Software, Facilitation, Analytical, Accuracy, Accurate, Stakeholder Analysis, Healthcare, Managed Care, MCO, Claims, Payor

Job Info

Job Identification: 2029064

Job Category: Cross-Enterprise Roles

Posting Date: 2024-12-05T16:36:10 00:00

Job Schedule: Full time