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Molina Healthcare

Runs health plans for government programs

Senior Specialist - Process Improvement & Operational Excellence

Business OperationsConfirmed live in the last 24 hours
Full-timeUnited States$44.9k - $97.4k /yrIn-person

About the Job

Requirements

  • At least 3 years of process improvement or analytics experience, or an equivalent combination of relevant education and experience.
  • Data analysis skills.
  • Knowledge of managed care enrollment processes, encounter processes, provider and contract configuration, provider information management, claims processing, and other related functions.
  • Strong organizational and time-management skills, including the ability to manage simultaneous projects and tasks to meet internal deadlines.
  • Ability to work collaboratively across a highly matrixed organization and establish and maintain effective relationships with internal and external stakeholders.
  • Effective verbal and written communication skills.
  • Proficiency with the Microsoft Office suite, including Excel, and applicable software programs.

Responsibilities

  • Partner with business functions and units to identify, document, and baseline relevant processes.
  • Use industry techniques to improve the effectiveness and efficiency of business processes.
  • Conduct interviews with staff and leadership to assess internal processes and review compliance with organizational policies, procedures, standard operating procedures, and internal, external, and regulatory guidelines.
  • Review and research information to evaluate process or function compliance and corresponding written documentation.
  • Research and analyze fundamental issues in business process development.
  • Use analytical skills and data insights to identify process and information variances.
  • Diagram and evaluate existing processes.
  • Develop metrics for process measurement and identify indicators for future improvement opportunities.
  • Recommend, implement, and document continuous-improvement best practices to support the business.
  • Summarize and document assessment outcomes and recommendations, and communicate them to process owners and leadership in writing and verbally.
  • Collaborate with process owners to maintain or create business process documentation and workflows related to core operations.
  • Conduct ongoing reviews and update complex business processes in collaboration with subject matter experts and other stakeholders.
  • Serve as liaison between core operations and internal and external auditors for formal core operations audits that are not compliance-related.
  • Coordinate, facilitate, and document audit walkthroughs.
  • Research, collect, or generate requested documentation and provide timely and accurate written and verbal responses.
  • Research and respond to questions submitted by internal and external auditors.
  • Research requested documentation and collaborate with teams and other functional areas as needed.
  • Provide training and support to new and existing process improvement team members.

Desired Qualifications

  • Proven analytical experience within an operations- or process-focused environment.
  • Health care experience.
  • Lean Six Sigma certification.
  • Previous audit or oversight experience.

About the Company

Molina Healthcare

Runs health plans for government programs

Molina Healthcare runs health insurance plans for people covered by Medicaid, Medicare and state insurance marketplaces, with a focus on people who need affordable access to care. Its local health plans coordinate medical services and support members with complex health needs, including people eligible for both Medicaid and Medicare. Members receive care through networks of doctors, hospitals and other providers, while the plans manage benefits, process claims and arrange care support. The company earns premiums from government programs and members, and pays the cost of covered healthcare services. Molina was founded in 1980 and is headquartered in Long Beach, California.

Company size
10,001+
Company stage
IPO
Headquarters
Long Beach, CA
Founded
1980

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