Molina Healthcare · 3 days ago
Sr Business Solutions Consultant - QNXT SME - Remote
Arizona, United States
Full-time
Remote
Senior Level
$106K/yr - $207K/yr
7+ years exp
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Responsibilities
Builds, manages and maintains effective Business relationships with key stakeholders in business domain across Health plans and Corporate Healthcare functions.
Requires highest level understanding of organization's business and industry requirements.
Focus is on process analysis and re-engineering, with a deep understanding of technical problems and solutions as they relate to the current and future business environment.
Drives process change by integrating new processes with existing ones or introducing modernization and communicating these changes to impacted business teams.
Uses quantitative and qualitative analysis to develop and improve internal processes across the enterprise.
Recommends and facilitates process improvement efforts. Will lead re-engineering team and act as project manager in some cases.
Drives efficiency: looks for and documents ways to increase the efficiency through continuous improvement goals and process maturation taking into account budget impacts.
Maintains management/technical skills that can be utilized in the field to solve complex problems.
Continuous improvements of established reports in production to ensure best performance and use for business value metrics.
Demonstrates use of tools, techniques and communications soft skills to build and maintain effective business relationships.
Works closely with Corporate leadership to deliver key business initiatives, process improvements, managing KPIs and business communication.
Assimilates and documents business needs for project requests and benefit value documentation including high level requirements, compliance implications and cost benefit analysis.
Responsible for business case development. Advises on project benefit calculation drivers and able to explain benefits to Senior Leadership meetings.
Demonstrates advanced knowledge and understanding of business work pipeline, IT roadmap, business impacts and required interactions to link these efforts to portfolio management processes; facilitates with clients to ensure work is considered in pipeline.
Organizes complex project requests or issue successfully into manageable approaches and advise on project set up/structure based on proposed scope.
Facilitates groups for problem solving and service improvement including definition/documentation, business workflow analysis.
Develops effective processes, forums and tracking mechanisms to continuously improve process through Business feedback, proactive handling of Business complaints and facilitation of resolution.
Conducts bi-weekly Operations and Issue Resolution meeting.
Develops and maintains a Service Delivery Plan for individual Health plans or Corporate functions to include Business strategies/needs with corresponding IT strategies/plans, projects, performance measurements, customer satisfaction improvement plans and other items as determined by the health plan.
Effectively manages business escalations by ensuring appropriate accountability, sense of urgency, communication and follow through to closure.
Knowledgeable of State Medicaid contract Service Level Agreements. Demonstrates SME knowledge of MCO contract compliance requirements that impact processes.
Facilitates and leads processes and activities to complete deliverables impacting assigned healthplans including, but not limited to, RFP Responses, audit response/coordination, and evaluation of new contract requirements.
Remain knowledgeable of vendor strategic roadmaps and how they align with business growth and priorities.
Arrange vendor demonstrations and manager proof of concept requirements for new capability value studies.
Other duties, as assigned.
Qualification
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Required
Bachelor’s Degree in Business, Healthcare, Computer Science, Information Systems or 10 years of related field or equivalent experience
7-10 years business function or relations management experience
5-7 years IT or system delivery or related experience.
3 years strategic planning experience.
Project management background.
Preferred
Master’s Degree in Computer Science, Information Systems or Healthcare related field
3+ years management experience.
3 – 5 years managed care experience.
Six Sigma Black Belt
PMI - Project Management Professional (PMP)
Agile Product Owner
Design Thinking Certification
Company
Molina Healthcare
Molina Healthcare is a healthcare company that specializes in government-sponsored healthcare programs for families and individuals.
10,001+ 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
2023 (33)
2022 (36)
2021 (33)
2020 (60)
Funding
Current Stage
Public CompanyTotal Funding
$753.11M2021-11-16Post Ipo Debt· $750M
2014-09-09Post Ipo Equity· $3.11M
2003-07-02IPO· nyse:MOH
Leadership Team
Dave Reynolds
Executive Vice President, Regional Health Plans
Debbie Simkins
Vice President, Office of the CIO
Recent News
2024-11-13
Fierce Healthcare
2024-11-07
Modern Healthcare
2024-11-07
Company data provided by crunchbase
