Molina Healthcare · 1 month ago
QNXT Configuration Analyst
200 Oceangate, Long Beach, CA, 90802, US
Full-time
Onsite
Mid, Senior Level
4+ years expMolina Healthcare is a leading managed care organization, and they are seeking a QNXT Configuration Analyst to enhance business processes and ensure compliance across operations. The role involves conducting assessments, collaborating with process owners, and serving as a liaison during audits to improve operational efficiency.
Health CareHospitalMedical
Responsibilities
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
Qualification
Required
Associate's Degree or two years of equivalent experience
Four years proven analytical experience within an operations or process-focused environment
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
Ability to write SQL queries
Experience with QNXT configuration
Experience with troubleshooting and analyzing issues
Preferred
Bachelor's Degree
Six years proven analytical experience within an operations or process-focused environment
Experience working in a Medicare environment is highly preferred
Claims adjudication experience is highly preferred
Previous audit and/or oversight experience
Benefits
Competitive benefits and compensation package
Company
Molina Healthcare
Molina Healthcare is a healthcare company that specializes in government-sponsored healthcare programs for families and individuals.
10001+ employees
H1B Sponsorship
Molina Healthcare has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2025 (56)
2024 (45)
2023 (43)
2022 (31)
2021 (35)
2020 (55)
Funding
Current Stage
Public CompanyTotal Funding
$2.35B2025-11-17Post Ipo Debt· $850M
2024-11-13Post Ipo Debt· $750M
2021-11-16Post Ipo Debt· $750M
Leadership Team
Dave Reynolds
Executive Vice President, Health Plans & Medicaid Chief Operating Officer
Debbie Simkins
Vice President, Office of the CIO
Recent News
Sherwood News
2026-01-09
2026-01-03
Company data provided by crunchbase