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Business Systems Analyst - QNXT Claims
Molina Healthcare Macon, Georgia; West Valley City, Utah; Cleveland, Ohio; Washington; New Mexico; Kentucky; Grand Rapids, Michigan; Des Moines, Iowa; Florida; Orlando, Florida; Provo, Utah; Davenport, Iowa; Racine, Wisconsin; Orem, Utah; Iowa; Michigan; Buffalo, New York; Fort Worth, Texas; Roswell, New Mexico; Wisconsin; Rochester, New York; Atlanta, Georgia; Milwaukee, Wisconsin; Austin, Texas; Ann Arbor, Michigan; Iowa City, Iowa; Nebraska; Santa Fe, New Mexico; Las Cruces, New Mexico; Idaho; Georgia; Salt Lake City, Utah; Tucson, Arizona; Ohio; New York; Warren, Michigan; Kearney, Nebraska; Detroit, Michigan; Everett, Washington; Bellevue, Nebraska; Owensboro, Kentucky; Lincoln, Nebraska; Nampa, Idaho; St. Petersburg, Florida; Akron, Ohio; Syracuse, New York; Mesa, Arizona; Cincinnati, Ohio; Miami, Florida; Grand Island, Nebraska; Albany, New York; Boise, Idaho; Tacoma, Washington; Green Bay, Wisconsin; Layton, Utah; Bowling Green, Kentucky; Albuquerque, New Mexico; Sterling Heights, Michigan; Dallas, Texas; Columbus, Georgia; Meridian, Idaho; Chandler, Arizona; Scottsdale, Arizona; Houston, Texas; Spokane, Washington; Bellevue, Washington; Covington, Kentucky; Omaha, Nebraska; Madison, Wisconsin; Lexington-Fayette, Kentucky; Utah; Yonkers, New York; Idaho Falls, Idaho; Caldwell, Idaho; Sioux City, Iowa; Dayton, Ohio; Phoenix, Arizona; Tampa, Florida; Kenosha, Wisconsin; Louisville, Kentucky; Rio Rancho, New Mexico; Cedar Rapids, Iowa; Vancouver, Washington; Savannah, Georgia; Jacksonville, Florida; San Antonio, Texas; Columbus, Ohio; Texas; Augusta, Georgia Job ID 2032789JOB DESCRIPTION
Job Summary
A successful candidate will have a balance of business insight, critical thinking, strong communication and analytical skills. Possess the ability to work independently, self-navigate organizational and technical challenges. Performs research and analysis of healthcare claims data, pharmacy data, and external data to derive proper courses of action for remediation. This role will support processes for Patient Liability and Medicaid processes.
KEY RESPONSIBILITIES
• Perform research and analysis for inquiries and requests, utilizing technical tools as necessary to provide feedback and resolution within the Service Level Agreement.
• Assist with research, development and completion of special projects as requested by various internal departments, or in support of requests from regulatory agencies, contracting agencies, or other external organizations.
• Responsible for timely completion of projects, not limited to timeline development and maintenance; coordinates activities and data collection with internal departments or external requestors.
• Interpret business needs and translate them into application and operational requirements.
• Create comprehensive workflows and documentation of operational processes and procedures.
• Prioritize initiatives based on business needs and requirements.
• Undertake project tasks as required
KNOWLEDGE, SKILLS & ABILITIES
• Advanced written, oral, and interpersonal skills
• Demonstrated ability of evaluating the effectiveness and efficiency of existing processes
• Able to effectively prioritize and execute tasks
• Able to generate insights from data analysis
• Able to learn quickly and solve complex problems
• Experience in partnering with cross-functional teams
• Experience with documentation and meeting facilitation
• Flexible and able to work with tight deadlines
• Knowledge of Healthcare industry standards, concepts, terminology and common practices
• Claims and SQL knowledge a plus
JOB QUALIFICATIONS
Required Education
Associate degree or equivalent combination of education and experience
Required Experience
1-3 Years
Preferred Education
Bachelor's Degree or equivalent combination of education and experience
Preferred Experience
3-4 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.
Pay Range: $77,969 - $141,371 / 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 07/29/2025Job Alerts
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