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Molina Healthcare · 3 months ago

Senior QNXT Analyst - Benefits/ Contract Configuration

200 Oceangate, Long Beach, CA, 90802, US

Full-time

Onsite

Senior Level

5+ years exp

Molina Healthcare is seeking a Senior QNXT Analyst specializing in Benefits and Contract Configuration. The role is responsible for the accurate implementation and maintenance of claims databases, ensuring data synchronization and adherence to business requirements related to contracting and benefits.

Health CareHospitalMedical

Responsibilities

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

Loads and maintain contract, benefit or reference table information into the claim payment system and other applicable systems

Participates in defect resolution for assigned component

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 application upgrades and releases, including development and execution of some test plans

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