JOB DESCRIPTION Job Summary
Provides analyst support for business requirements activities of moderate complexity. Responsible for accurate and timely intake and interpretation of regulatory and/or functional requirements related to but not limited to coverage, reimbursement, and processing functions to support systems solutions development and maintenance. Coordinates cross-functionally with stakeholders and subject matter experts to support business needs, and participates in governance committees as applicable.
This position requires advanced Excel skills. Please update your resume with any relevant experience.
Essential Job Duties
• Develops and maintains requirement documents related to coverage, reimbursement and other applicable system changes to ensure alignment with regulatory and health plan/product requirements.
• Monitors regulatory sources to ensure all updates are aligned.
• Navigates analytical problems and clearly defines and documents unique specifications.
• Supports development and ongoing interpretation of review processes, committees and collaboration with key partner organizations.
• Recognizes, identifies and documents changes to existing business processes and identifies new opportunities for process developments and improvements.
• Provides status updates to health plan/product team partners, senior leadership and applicable stakeholders.
• Communicates requirement interpretations and changes to health plans/product teams and various impacted functional areas for requirement interpretation alignment and approval and solution traceability; coordinates meetings and champions/deploys operational process best practices.
• Where applicable, codifies the requirements for system configuration alignment and interpretation.
Provides support and/or requirement interpretation inconsistencies and complaints.
• Assists with the development of requirement solution standards and best practices, and suggests improvement processes as applicable to consistently apply requirements across states and products.
• Facilitates self-organized reporting to ensure health plans/product teams, leaders, and applicable stakeholders are aware of work efforts and impact for prospective or retrospective requirement changes that impact financials.
• Conducts industry research and engagement to evaluate, provide insights, and develop/deploy best practices.
• Coordinates with applicable teams for analysis, impact and implementation of changes that impact health plan/product.
• Engages with operational leadership and health plan support functions to review compliance-based issues for benefit planning purposes.
• Ensures end-to-end business requirements are documented, interpretation is agreed upon, and solutioning is clear for all applicable parties.
• Develops and maintains relationships with health plan/product teams and corporate operations.
Required Qualifications
• At least 2 years of operations/analyst experience in a managed care organization, health insurance setting or related field, or equivalent combination of relevant education and experience.
• Policy/government and legislative review knowledge.
• Analytical and problem-solving skills.
• Ability to concisely synthesize large and complex requirements.
• Ability to organize and maintain regulatory data including real-time policy changes.
• Self-motivated and ability to take initiative, identify, communicate, and resolve potential problems.
• Experience creating reporting tools/providing project/process updates.
• Familiarity with administration systems.
• Ability to work in a project team setting and complete individually assigned tasks within established timelines to meet desired deployment deadlines.
• Ability to work cross-functionally across a highly matrixed organization.
• Effective verbal, written and interpersonal communication skills, and ability to engage with stakeholders of all organizational levels.
• Microsoft Office suite and applicable software programs proficiency.
Preferred Qualifications
• Project management/implementation experience.
• Health care experience.
• Knowledge and experience with federal regulatory policy resources including Centers for Medicare & Medicaid Services (CMS) and the Affordable Care Act (ACA).
• Certified Business Analysis Professional (CBAP).
To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V
Skills Required
- At least 2 years of operations or analyst experience in a managed care organization, health insurance setting, related field, or equivalent education and experience
- Policy, government, and legislative review knowledge
- Analytical and problem-solving skills
- Ability to synthesize large and complex requirements concisely
- Ability to organize and maintain regulatory data, including real-time policy changes
- Self-motivation, initiative, and ability to identify, communicate, and resolve potential problems
- Experience creating reporting tools and providing project or process updates
- Familiarity with administration systems
- Ability to work in a project team and complete assigned tasks within established timelines
- Ability to work cross-functionally in a highly matrixed organization
- Effective verbal, written, and interpersonal communication skills
- Microsoft Office suite and applicable software proficiency, including advanced Excel skills
- Project management or implementation experience
- Healthcare experience
- Knowledge of federal regulatory policy resources, including CMS and ACA
- Certified Business Analysis Professional certification
Molina Healthcare Inc. Compensation & Benefits Highlights
The following summarizes recurring compensation and benefits themes identified from responses generated by popular LLMs to common candidate questions about Molina Healthcare Inc. and has not been reviewed or approved by Molina Healthcare Inc..
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Healthcare Strength — Health coverage is described as solid, including medical, dental, and vision insurance alongside options like HSA/FSA and disability coverage. Benefits are often seen as a meaningful part of the overall package.
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Retirement Support — A 401(k) with employer matching and an ESPP are offered, and the retirement plan is commonly regarded as a plus. These features help round out compensation even when base pay is seen as only acceptable.
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Leave & Time Off Breadth — PTO, paid holidays, and paid parental leave are part of the offering, with time‑off benefits generally viewed favorably. Backup family care and an employee assistance program add practical support.
Molina Healthcare Inc. Insights
What We Do
Molina Healthcare Inc. is dedicated to delivering effective, reliable, and affordable health care to those who need it most. The company focuses on improving the health and well-being of its members and positively impacting the communities it serves. Recognized as a leader in the health insurance category, it provides essential healthcare services to ensure accessible and quality care for its members.
