Sr Specialist, Process Review (Remote)
Molina Healthcare Albany, New York; Everett, Washington; Boise, Idaho; Davenport, Iowa; Utah; Idaho; Florida; New Mexico; Cleveland, Ohio; Idaho Falls, Idaho; Rio Rancho, New Mexico; Spokane, Washington; Detroit, Michigan; Bellevue, Nebraska; Tacoma, Washington; Nebraska; Santa Fe, New Mexico; Madison, Wisconsin; Sterling Heights, Michigan; Meridian, Idaho; Kenosha, Wisconsin; Grand Island, Nebraska; Macon, Georgia; Houston, Texas; Roswell, New Mexico; Savannah, Georgia; Nampa, Idaho; New York; Layton, Utah; San Antonio, Texas; Salt Lake City, Utah; Ann Arbor, Michigan; Ohio; Kentucky; Racine, Wisconsin; Texas; Akron, Ohio; Georgia; Wisconsin; Phoenix, Arizona; Warren, Michigan; Seattle, Washington; Mesa, Arizona; Scottsdale, Arizona; Austin, Texas; Columbus, Ohio; Kearney, Nebraska; Cedar Rapids, Iowa; Miami, Florida; Yonkers, New York; Owensboro, Kentucky; Sioux City, Iowa; Covington, Kentucky; Green Bay, Wisconsin; St. Petersburg, Florida; Omaha, Nebraska; Jacksonville, Florida; Las Cruces, New Mexico; Buffalo, New York; Tampa, Florida; New York, New York; Bellevue, Washington; Tucson, Arizona; Rochester, New York; Caldwell, Idaho; Lincoln, Nebraska; Iowa City, Iowa; Dayton, Ohio; Bowling Green, Kentucky; Albuquerque, New Mexico; Syracuse, New York; Milwaukee, Wisconsin; Fort Worth, Texas; Columbus, Georgia; Michigan; Iowa; Orem, Utah; Lexington-Fayette, Kentucky; Dallas, Texas; Provo, Utah; Des Moines, Iowa; Augusta, Georgia; Atlanta, Georgia; West Valley City, Utah; Washington; Grand Rapids, Michigan; Chandler, Arizona; Orlando, Florida; Cincinnati, Ohio; Louisville, Kentucky; Vancouver, Washington Job ID 2031487
Job Description
Job Summary
Responsible for providing business process redesign, communication and change management for operations. Backend operationalization of policies, standardization of system set-up and a resource for all departments and health plans company-wide.
Knowledge/Skills/Abilities
• Conduct interviews with staff and management to assess internal business processes within a department or function to ensure compliance with existing organizational Policies and Procedures, Standard Operating Procedures and other internal guidelines.
• Review, research, analyze and evaluate information to assess compliancy between a process or function and the corresponding written documentation. Use analytical skills to identify variances. Use problem solving skills and business knowledge to make recommendations for process remediation or improvement.
• Summarize and document assessment outcomes and recommendations. Ensure that they are appropriately communicated (written and verbal) to process owners and management.
• Collaborate with process owners to maintain and/or create business process documentation and workflows related to Core Operations functions.
• Serve as liaison between Core Operations and internal and external auditors for all formal Core Operations audits that are not compliance related.
• Coordinate, facilitate and document audit walkthroughs.
• Research, collect or generate requested documentation. Provide timely and accurate responses, both written and verbal.
• Research and respond to clarifying questions submitted by internal and external auditors. Work in partnership with other functional areas as needed..
Job Qualifications
Required Education
Associate's Degree or two years of equivalent experience
Required Experience
• Four years proven analytical experience within an operations or process-focused environment. Additional required experience for Corporate Operations:
• Analytical experience within managed care operations.
• Knowledge of managed care enrollment processes, encounter processes, provider and contract configuration, provider information management, claims processing and other related functions.
Preferred Education
Bachelor's Degree
Preferred Experience
• Six years proven analytical experience within an operations or process-focused environment.
• Previous audit and/or oversight experience.
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 Summary
Responsible for providing business process redesign, communication and change management for operations. Backend operationalization of policies, standardization of system set-up and a resource for all departments and health plans company-wide.
Knowledge/Skills/Abilities
• Conduct interviews with staff and management to assess internal business processes within a department or function to ensure compliance with existing organizational Policies and Procedures, Standard Operating Procedures and other internal guidelines.
• Review, research, analyze and evaluate information to assess compliancy between a process or function and the corresponding written documentation. Use analytical skills to identify variances. Use problem solving skills and business knowledge to make recommendations for process remediation or improvement.
• Summarize and document assessment outcomes and recommendations. Ensure that they are appropriately communicated (written and verbal) to process owners and management.
• Collaborate with process owners to maintain and/or create business process documentation and workflows related to Core Operations functions.
• Serve as liaison between Core Operations and internal and external auditors for all formal Core Operations audits that are not compliance related.
• Coordinate, facilitate and document audit walkthroughs.
• Research, collect or generate requested documentation. Provide timely and accurate responses, both written and verbal.
• Research and respond to clarifying questions submitted by internal and external auditors. Work in partnership with other functional areas as needed..
Job Qualifications
Required Education
Associate's Degree or two years of equivalent experience
Required Experience
• Four years proven analytical experience within an operations or process-focused environment. Additional required experience for Corporate Operations:
• Analytical experience within managed care operations.
• Knowledge of managed care enrollment processes, encounter processes, provider and contract configuration, provider information management, claims processing and other related functions.
Preferred Education
Bachelor's Degree
Preferred Experience
• Six years proven analytical experience within an operations or process-focused environment.
• Previous audit and/or oversight experience.
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: $77,969 - $116,835 / ANNUAL
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
About Us
Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
Job Type: Full Time Posting Date: 04/30/2025ABOUT OUR LOCATION
View Map- Representative, Pharmacy Atlanta Georgia, St. Petersburg Florida, Spokane Washington, Iowa City Iowa, Kenosha Wisconsin, Caldwell Idaho, Owensboro Kentucky, Columbus Georgia, Utah, Washington, Yonkers New York, Covington Kentucky, Dayton Ohio, Jacksonville Florida, Austin Texas, Louisville Kentucky, Kearney Nebraska, Vancouver Washington, Scottsdale Arizona, Mesa Arizona, West Valley City Utah, Green Bay Wisconsin, Racine Wisconsin, Bellevue Washington, Bellevue Nebraska, Fort Worth Texas, New Mexico, Florida, Phoenix Arizona, Orem Utah, Albuquerque New Mexico, Sterling Heights Michigan, Warren Michigan, Nampa Idaho, Everett Washington, Albany New York, Rio Rancho New Mexico, Michigan, Nebraska, Kentucky, San Antonio Texas, Rochester New York, Miami Florida, Detroit Michigan, Lexington-Fayette Kentucky, Milwaukee Wisconsin, Houston Texas, Boise Idaho, Sioux City Iowa, Davenport Iowa, Akron Ohio, Bowling Green Kentucky, Cincinnati Ohio, Tucson Arizona, Idaho, Georgia, Syracuse New York, Augusta Georgia, Orlando Florida, Grand Island Nebraska, Meridian Idaho, Chandler Arizona, Tampa Florida, Lincoln Nebraska, Ann Arbor Michigan, Iowa, Cleveland Ohio, Madison Wisconsin, Las Cruces New Mexico, Cedar Rapids Iowa, Buffalo New York, Macon Georgia, Provo Utah, Tacoma Washington, Omaha Nebraska, Layton Utah, Columbus Ohio, New York, Texas, Wisconsin, Santa Fe New Mexico, Grand Rapids Michigan, Idaho Falls Idaho, Salt Lake City Utah, Dallas Texas, Savannah Georgia, Des Moines Iowa, Roswell New Mexico, Ohio 05/27/2025
- Pharmacy Technician Syracuse New York, Las Cruces New Mexico, Columbus Georgia, Tucson Arizona, New York, Nebraska, Austin Texas, Cedar Rapids Iowa, Augusta Georgia, Green Bay Wisconsin, St. Petersburg Florida, Akron Ohio, Cleveland Ohio, Santa Fe New Mexico, Chandler Arizona, Idaho, Utah, Buffalo New York, Nampa Idaho, Tacoma Washington, Yonkers New York, Racine Wisconsin, Dayton Ohio, Orem Utah, Madison Wisconsin, Meridian Idaho, Georgia, Ohio, Florida, Scottsdale Arizona, Bellevue Washington, Owensboro Kentucky, Roswell New Mexico, Kearney Nebraska, West Valley City Utah, Atlanta Georgia, Milwaukee Wisconsin, Albuquerque New Mexico, Tampa Florida, Kenosha Wisconsin, Des Moines Iowa, Michigan, Texas, Sterling Heights Michigan, Savannah Georgia, Sioux City Iowa, Rochester New York, Davenport Iowa, Jacksonville Florida, Bowling Green Kentucky, Grand Island Nebraska, Provo Utah, Wisconsin, New Mexico, Houston Texas, Lexington-Fayette Kentucky, Covington Kentucky, Ann Arbor Michigan, Macon Georgia, Dallas Texas, Warren Michigan, Columbus Ohio, Salt Lake City Utah, Spokane Washington, Bellevue Nebraska, Caldwell Idaho, Boise Idaho, Lincoln Nebraska, Miami Florida, Idaho Falls Idaho, Phoenix Arizona, Louisville Kentucky, Rio Rancho New Mexico, Orlando Florida, Omaha Nebraska, Iowa City Iowa, Vancouver Washington, San Antonio Texas, Mesa Arizona, Cincinnati Ohio, Fort Worth Texas, Kentucky, Iowa, Washington, Grand Rapids Michigan, Everett Washington, Albany New York, Detroit Michigan, Layton Utah 05/27/2025
- Account Rep, Medicare-Dallas-Texas Dallas Texas, Nebraska, New York, Wisconsin, Michigan, New Mexico, Arizona, Idaho, Washington, Ohio, Utah, Kentucky, Iowa, Georgia, Florida, Texas 05/27/2025
- Rep, MTM Pharmacy Services I Everett Washington, Albany New York, Utah, Wisconsin, New Mexico, Florida, Kentucky, New York, Michigan, Ohio, Georgia, Idaho, Washington, Iowa, Nebraska, Texas, Atlanta Georgia, Miami Florida, Covington Kentucky, Cedar Rapids Iowa, Cincinnati Ohio, Augusta Georgia, Caldwell Idaho, Meridian Idaho, Rochester New York, Las Cruces New Mexico, Bellevue Nebraska, Omaha Nebraska, Des Moines Iowa, Dayton Ohio, Columbus Ohio, Savannah Georgia, Green Bay Wisconsin, Racine Wisconsin, Warren Michigan, Orlando Florida, Spokane Washington, Phoenix Arizona, Idaho Falls Idaho, San Antonio Texas, Roswell New Mexico, Bowling Green Kentucky, Kearney Nebraska, Columbus Georgia, Ann Arbor Michigan, Bellevue Washington, Provo Utah, Owensboro Kentucky, Louisville Kentucky, Sioux City Iowa, Davenport Iowa, Akron Ohio, Cleveland Ohio, Grand Rapids Michigan, Sterling Heights Michigan, Detroit Michigan, Buffalo New York, Santa Fe New Mexico, New York New York, Grand Island Nebraska, Madison Wisconsin, Kenosha Wisconsin, Mesa Arizona, Tucson Arizona, Fort Worth Texas, West Valley City Utah, Lincoln Nebraska, Macon Georgia, Milwaukee Wisconsin, Yonkers New York, Vancouver Washington, Tampa Florida, Austin Texas, Orem Utah, Boise Idaho, Nampa Idaho, Syracuse New York, Tacoma Washington, Seattle Washington, St. Petersburg Florida, Jacksonville Florida, Chandler Arizona, Scottsdale Arizona, Dallas Texas, Houston Texas, Albuquerque New Mexico, Rio Rancho New Mexico, Layton Utah, Salt Lake City Utah, Lexington-Fayette Kentucky, Iowa City Iowa 05/27/2025
No recently viewed jobs.
View All JobsNo saved jobs.
View All Jobs