Specialist, Process Review

Molina Healthcare Spokane , WA 99201

Posted 2 months ago

Job Description:

Job Summary

Responsible for providing business process redesign, communication and change management for operations. Backend operationalization of policies, standardization of system set-up and a resource for all departments and health plans company-wide.

Knowledge/Skills/Abilities

  • Participate in interviews with staff and management to assess internal business processes within a department or function to ensure compliance with existing organizational Policies and Procedures, Standard Operating Procedures and other internal guidelines

  • Review and research information to evaluate compliancy between a process or function and the corresponding written documentation. Use analytical skills to identify variances

  • Document assessment outcomes and recommendations

  • Collaborate with the team to maintain business process documentation and workflows related to Core Operations functions

  • Coordinate audit walkthroughs

  • Research requested documentation and work in partnership with team and other functional areas as needed

Job Qualifications

Required Education

High School Diploma or GED

Required Experience

  • 2 years proven analytical experience within an operations or process-focused environment.

Additional required experience for Corporate Operations:

  • Analytical experience within managed care operations.

  • Knowledge of managed care enrollment processes, encounter processes, provider and contract configuration, provider information management, claims processing and other related functions.

Preferred Education

Associate's Degree or two years of equivalent experience

Preferred Experience

  • 4 years proven analytical experience within an operations or process-focused environment.

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.


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Specialist, Process Review

Molina Healthcare