Analyst, Technical Configuration Information Management

JOB DESCRIPTION

Job Summary

Responsible for accurate and timely implementation and maintenance of critical information on claims databases. Maintains critical information on claims databases. Synchronizes data among operational and claims systems and application of business rules as they apply to each database. Validate data to be housed on databases and ensure adherence to business and system requirements of customers as it pertains to contracting, benefits, prior authorizations, fee schedules, and other business requirements.

KNOWLEDGE / SKILLS / ABILITIES

• Analyze and interpret data to determine appropriate configuration changes.
• Accurately interprets specific state and / or federal benefits, contracts as well as additional business requirements and converting these terms to configuration parameters.
• Handles coding, updating and maintaining benefit plans, provider contracts, fee schedules and various system tables through the user interface.
• Apply previous experience and knowledge to research and resolve claim / encounter issues, pended claims and update system(s) as necessary.
• Works with fluctuating volumes of work and is able to prioritize work to meet deadlines and needs of user community.
• Writes easy ad-hoc reports.
• Executes daily and simple retro reports.
• Understands QNXT, AutoQ, and MCG functionality.
• Writes Requirements for BRDs / FRDs and Reports :
• Moderate to Complex requirements with mentoring
• Simple requirements without needing mentoring
• Works with Technical resource for schema / solution
• Manage projects from requirements to deployment, including work assignment, prioritization, issue triage etc.
• Moderate to Complex projects with mentoring
• Simple projects without mentoring
• Researches issues and sets up proof of concept tests
• Moderate to Complex issues / POC with mentoring
• Simple issues / POC without mentoring.

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

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