Job Snapshot
Location:
Long Beach, CA 90810
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Industry:
Healthcare - Health Services
Managed Care
Contact Information
Contact:
Please apply online
Phone:
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Description
Molina Healthcare Inc., is among the most experienced managed healthcare companies serving patients who have traditionally faced barriers to quality healthcare-including individuals covered under Medicaid, the Healthy Families Program, the State Children's Health Insurance Program (SCHIP) and other government-sponsored health insurance programs. Molina has health plans in California, Michigan, New Mexico, Missouri, Utah, Ohio, Texas and Washington as well as 19 primary care clinics located in Northern and Southern California. The company's corporate headquarters are in Long Beach, California.
POSITION SUMMARY
Manage activities to support the claims systems and applications that are essential to the core business processes. Activities include but are not limited to coordinating and overseeing updates to various business applications, development and maintenance of department databases, and development and implementation of department standard operating procedures relative to various department systems and/or applications.
Requirements
REQUIRED SKILLS AND QUALIFICATIONS
Education:
- BS/BA in Business Administration, Computer Science, or related field
Experience:
- 5-7 years healthcare industry experience with emphasis in managed care preferred
- 5-7 years IT experience in application development and support
PRINCIPLE ACCOUNTABILITIES
1. Manage the various systems applications required to maintain the daily operations of the Claims Department.
2. Act as a liaison between Claims and IT regarding business requirements to support various systems applications and processes.
3. Conduct appropriate data analysis to determine if changes or updates are required with current system and/or business processes.
4. Meet with department subject matter experts and decision makers to gather and develop operational requirements for the purpose of improving on general business processes.
5. Development, documentation, and ongoing management of department standard operating procedures relative to maintaining and supporting department applications.
6. Special projects as assigned.
Additional Skills and Knowledge:
- Effective problem solving and analytical skills
- Excellent business and technical writing skills
- Excellent communication and interpersonal skills
- Knowledge of claims adjudication process preferred
- Ability to work independently and within a team
- Ability to make effective business decisions
- Advanced working knowledge of MS Office Tools – Access, Word, Excel, Project, PowerPoint, and Visio
DEPARTMENT SPECIFIC FUNCTION:
- Position will support K2 Claims Workflow Application
- Position will monitor and support team email mailbox for relevant project related updates from external departments and the Health Plans
Molina Healthcare offers competitive benefits and compensation package.