Sr Analyst, Tech Config Info Mgmt (remote)
Company: Molina Healthcare
Location: Des Moines
Posted on: November 25, 2022
JOB DESCRIPTIONJob SummaryResponsible 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.KNOWLEDGE/SKILLS/ABILITIES
- Loads and maintain contract, benefit or reference table
information into the claim payment system and other applicable
- 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
- Participates in the implementation and conversion of new and
existing health plans.
- Executes retroactive claims reports
- Runs fee schedule & MRDT update processes
- Writes complex ad-hoc reports
- Writes complex permanent reports
- Creates MRDT and other configuration update scripts
- Pre and post validation of fee schedule, contract, and complex
- Manages all MRDT updates (CPT, HCPCS, ICD-10, NDC, Yost)
including validating the pre-production reports, distribution to
the HPs for approval, follow up and completion notifications.
- Monitors RFC submission mailbox, submit RFCs in iServe, and
notify the Analyst of completion.
- Researches and reviews MRDT issues identified by the HPs and
CIM to determine root cause of the issue and what updates are
needed to resolve it.
- Write requirements and test plans for reports and development
projects for MRDT processes to be built by the TCIM Development
team including new fee schedule processes.
- Performs manual updates for MRDT, service group and fee
schedule that are not made through the RFC process or are small in
- Writes/runs simple SQL scripts to validate retro reports and
- Monitors and tracks fee schedules progress providing updates to
the HPs once they have been completed.
- Monitors MRDT tables that do not have a standard update process
in place to confirm that all HPs are up to date.
- Understands QNXT, AutoQ, and MCG functionality. Requires
assistance with schema from Tech resource or Lead Analyst.
- Writes Requirements for BRDs/FRDs and Reports.
- Complex requirements with some mentoring
- Moderate to Simple requirements without needing mentoring
- Works with Technical resource for schema/solution
- Manage projects from requirements to deployment, including work
assignment, prioritization, issue triage etc.
- Complex projects with some mentoring
- Moderate to Simple projects without mentoring
- Researches issues and sets up proof of concept tests.
JOB QUALIFICATIONSRequired EducationAssociate degree or equivalent
combination of education and experienceRequired Experience3-4
YearsPreferred EducationBachelor's Degree or equivalent combination
of education and experiencePreferred Experience5-6 Years#PJCore
To all current Molina employees: If you are interested in applying
for this position, please apply through the intranet job
listing.Molina Healthcare offers a competitive benefits and
compensation package. Molina Healthcare is an Equal Opportunity
Employer (EOE) M/F/D/V.Pay Range: - $60,414.75 - $117,808.76 a
year**Actual compensation may vary from posting based on geographic
location, work experience, education and/or skill level
Keywords: Molina Healthcare, Des Moines , Sr Analyst, Tech Config Info Mgmt (remote), Professions , Des Moines, Iowa
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