Analyst, Config Info Mgmt- QNXT & Networx - Remote - Military Veterans
at Molina Healthcare
JOB DESCRIPTION
Job Summary
Must be able to work in EST hours.
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.
- Must have experience working on QNXT and Networx.
- Experience working on benefits configuration, contract building, contract configuration and amendments.
- Must have solid experience in MS Office suites, Advanced Excel and SQL.
JOB QUALIFICATIONS
Required Education
Associate degree or equivalent combination of education and experience
Required Experience
2-5 years
Preferred Education
Bachelor's Degree or equivalent combination of education and experience
Preferred Experience
5-7 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: $49,430.25 - $107,098.87 / ANNUAL
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
USA
Molina believes every person, family and community deserves access to high-quality health care regardless of their situation. Our mission is to deliver effective, reliable and affordable health care to those who need it most. We strive to meet the physical, social and emotional needs of each member and to strengthen the communities we serve.
We do this by offering a holistic, community-based approach designed specifically to meet the individual needs of our members.
What started in 1980 as one clinic in Long Beach, aimed at addressing the disparities in access to quality health care, has grown into 19 health plans across the country. For over 40-years we’ve been improving the lives of our 5.1 million members across the country by pioneering health care services exclusively for those with government-sponsored health care.
As our membership has grown over the years, so has our commitment to the communities we serve. In 2020, we launched the MolinaCares Accord, which makes substantial investments to improve members’ access to health care.