Molina Healthcare is a FORTUNE 500 company that is focused exclusively on government-sponsored health care programs for families and individuals who qualify for government sponsored health care.

Molina Healthcare contracts with state governments and serves as a health plan providing a wide range of quality health care services to families and individuals. Molina Healthcare offers health plans in Arizona, California, Florida, Idaho, Illinois, Kentucky, Massachusetts, Michigan, Mississippi, Nevada, New Mexico, New York, Ohio, South Carolina, Texas, Utah, Virginia, Washington and Wisconsin. Molina also offers a Medicare product and has been selected in several states to participate in duals demonstration projects to manage the care for those eligible for both Medicaid and Medicare.

Analyzes complex business problems and issues using data from internal and external sources (CMS and State Regulators) to provide insight to decision-makers. Identifies and interprets trends and patterns in datasets to locate influences. Constructs forecasts, recommendations and strategic/tactical plans based on business data and market knowledge. Creates specifications for reports and analysis based on business needs and required or available data elements. Collaborates with clients to modify or tailor existing analysis or reports to meet their specific needs. May participate in management reviews, including presenting and interpreting analysis results, summarizing conclusions, and recommending a course of action. This is a general role in which employees work with multiple types of business data. May be internal operations-focused or external client-focused.

Knowledge/Skills/Abilities

• Topical knowledge supporting Enrollment, Claims or Configuration.
• Elicit requirements using interviews, document analysis, and requirements workshops, business process descriptions, use cases, business analysis, task and workflow analysis.
• Support CAP’s and internal & external audits, assisting CMS and state regulators.
• Provide State & Federal required deliverables.
• Interpret customer business needs and translate them into application and operational requirements
• Communicate and collaborate with external and internal customers to analyze and transform needs, goals and transforming in to functional requirements and delivering the appropriate artifacts as needed.
• Work with operational leaders within the business to provide recommendations on opportunities for process improvements, medical cost savings or revenue enhancements.
• Create Business Requirements Documents, Test Plans, Requirements Traceability Matrix, User Training materials and other related documentations.
• Actively participates in all stages of project development including research, design, programming, testing and implementation to ensures the released product meets the intended functional and operational requirements.

Required Education

Bachelor's Degree or equivalent combination of education and experience

Required Experience

• 5-7 years of business analysis experience,
• 6+ years managed care experience.
• Demonstrates proficiency in a variety of concepts, practices, and procedures applicable to job-related subject areas.

Preferred Education

Bachelor's Degree or equivalent combination of education and experience

Preferred Experience

• 3-5 years of formal training in Project Management
• Experience working with complex, often highly technical teams
• Enrollment, Claims or Configuration highly preferred
• QNXT experience preferred

Preferred License, Certification, Association

Certified Business Analysis Professional (CBAP), Certification from International Institute of Business Analysis preferred