JOB DESCRIPTION

　　Job Summary

　　Responsible for accurate and timely maintenance of critical provider information on all claims and provider databases. Maintains critical provider information on all claims and provider databases. Synchronizes data among multiple claims systems and application of business rules as they apply to each database. Validate data to be housed on provider databases and ensure adherence to business and system requirements of customers as it pertains to contracting, network management and credentialing.

　　KNOWLEDGE/SKILLS/ABILITIES

　　Generates data to support continuous quality of provider data and developing SOPs and/or BRDs.

　　Develops and maintains documentation and guidelines for all assigned areas of responsibility.

　　Assists with development of configuration standards and best practices while suggesting improvement processes to ensure systems are working more efficiently and improve quality.

　　Assists in planning and coordination of the claim payment system upgrades and releases, including development and execution of some test plans.

　　Participates in the implementation and conversion of new and existing health plans.

　　Must have a background in Healthplan operations.

　　Must be able to understand relational databases

　　Must have analytics experience using SQL

　　Must have experience with Power BI and MS Excel.

　　Project management experience is required.

　　Must be a self starter and a multi tasker.

　　Experience working on Salesforce CRM, Agile framework (using Jira) is 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: $54,373.27 - $117,808.76 / ANNUAL

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