Business Analyst (Vendor Relations) - REMOTE

Job Opportunity At Molina Healthcare

Responsible for accurate and timely intake and interpretation of regulatory and / or functional requirements related to coverage, reimbursement, and processing functions to support systems solutions development and maintenance. This role includes coordination with stakeholders and subject matter experts on partnering teams and supporting governance committees where applicable.

Job Duties :

• Develops and maintains requirement documents related to coverage, reimbursement and other applicable system changes in areas to ensure alignment to regulatory baseline requirements and any health plan developed requirements.
• Monitors sources to ensure all updates are aligned.
• Leads coordinated development and ongoing management / interpretation review process, committee structure and timing with key partner organizations.
• Conducts analysis to identify root cause and assist with problem management as it relates to state requirements.
• Communicates requirement interpretations and changes to health plans / product team and various impacted corporate core functional areas for requirement interpretation alignment and approvals as well as solution traceability through regular meetings and other operational process best practices.
• Provides support for requirement interpretation inconsistencies and complaints.
• Self-organized reporting to ensure health plans / product team and other leadership are aware of work efforts and impact for any prospective or retrospective requirement changes that can impact financials.
• Engages with operations leadership and Plan Support functions to review compliance-based issues for benefit planning purposes.

Knowledge / Skills / Abilities :

Job Qualifications :

Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M / F / D / V. Pay Range : $77,969 - $111,967 / ANNUAL Actual compensation may vary from posting based on geographic location, work experience, education and / or skill level.