JOB DESCRIPTION

　　Job Summary

　　Manages a team of professional Configuration Analysts. Responsible for operational activities for the assigned team, including accurate and timely implementation and maintenance of critical information on claims databases. Validate data to be housed on databases and ensure adherence to business and system requirements of Health Plans as it pertains to contracting, benefits, prior authorizations, fee schedules, and other business requirements.

　　KNOWLEDGE/SKILLS/ABILITIES

　　Meet and exceed all performance metrics and department goals.

　　Understand conflicts with teams and provide solutions.

　　Ensure all team members comply with company and legal requirements.

　　Ensure tasks are completed with accuracy and efficiency. Sets the right priorities and systematically identifies the root cause of challenges.

　　Works with the business and project development teams to assess and recommend the appropriate configuration design, solutions, and methodology for new and existing business.

　　Develops standard operating procedures and guidelines for the Configuration team.

　　Provides status reports and project updates to management and stakeholders.

　　Ensure staff have all the resources they need to perform at a high level.

　　Conduct performance reviews, training, and corrective action as appropriate.

　　Understanding of complex payment methodologies

　　Understanding of complex configuration solutions

　　Advanced knowledge of health care benefits.

　　Advanced knowledge of healthcare claims and claim processing from receipt through encounter submission.

　　Ability to adopt and utilize work tracking software

　　Strong business writing skills; proficient user of Microsoft Products including Word, Excel, Outlooks, Teams, SharePoint, PowerPoint, and Visio

　　Advanced knowledge of Excel preferred

　　SQL knowledge preferred

　　Coding certification preferred

　　Knowledge of configuration in QNXT strongly preferred

　　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

　　Pay Range: $72,370.82 - $156,803.45 / ANNUAL

　　*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.