QNXT Configuration Analyst

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..
• Ability to write SQL queries
• Experience with QNXT configuration 
• Experience with troubleshooting and analyzing issues. 
• Experience working in a Medicare environment is highly preferred. 
• Claims adjudication experience is highly preferred. 
  
    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.