Manager, Configuration - Benefits/Regulatory Requirements - Remote

Remote Full-time
Job Description JOB DESCRIPTION Job Summary Manages a team of professional Configuration Analysts. Responsible for operational activities for the assigned team, including accurate and timely implementation and maintenance of critical information on claims databases. Validate data to be housed on databases and ensure adherence to business and system requirements of Health Plans as it pertains to contracting, benefits, prior authorizations, fee schedules, and other business requirements. KNOWLEDGE/SKILLS/ABILITIES • Meet and exceed all performance metrics and department goals. • Understand conflicts with teams and provide solutions. • Ensure all team members comply with company and legal requirements. • Ensure tasks are completed with accuracy and efficiency. Sets the right priorities and systematically identifies the root cause of challenges. • Works with the business and project development teams to assess and recommend the appropriate configuration design, solutions, and methodology for new and existing business. • Develops standard operating procedures and guidelines for the Configuration team. • Provides status reports and project updates to management and stakeholders. • Ensure staff have all the resources they need to perform at a high level. • Conduct performance reviews, training, and corrective action as appropriate. • Understanding of complex payment methodologies • Understanding of complex configuration solutions • Advanced knowledge of health care benefits. • Advanced knowledge of healthcare claims and claim processing from receipt through encounter submission. • Ability to adopt and utilize work tracking software • Strong business writing skills; proficient user of Microsoft Products including Word, Excel, Outlooks, Teams, SharePoint, PowerPoint, and Visio • Advanced knowledge of Excel preferred • SQL knowledge preferred • Coding certification preferred • Knowledge of configuration in QNXT strongly preferred JOB QUALIFICATIONS Required Education Bachelor's Degree or equivalent combination of education and experience Required Experience 5-7 years Preferred Education Graduate Degree or equivalent combination of education and experience Preferred Experience 7-9 years 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 Apply tot his job
Apply Now →

Similar Jobs

Business Internship - Talent Pool

Remote Full-time

Remote Telesales Associate USA

Remote Full-time

Manager, Contracts Management (FULL TIME REMOTE)

Remote Full-time

Client Accounting Specialist (Electra-Remote | Long-Term Contract)

Remote Full-time

Urgently Hiring: Want Temporary Workforce Management Real Time

Remote Full-time

Data Scientist, ML - Insurance Underwriting

Remote Full-time

Remote AI Content Reviewer at Outlier

Remote Full-time

Dataloader – Revenue Solutions Inc – Pembroke, MA

Remote Full-time

[Remote] Inside Sales Closer (Remote) – Work From Anywhere

Remote Full-time

If you are accountable, have a strong work ethic and can maintain emotional control, we're hiring.

Remote Full-time

Consulting Expert

Remote Full-time

Assistant Bank Manager - Leadership and Sales Expert in Retail Banking

Remote Full-time

Experienced Part-Time Customer Support Representative – Delivering World-Class Service and Driving Business Growth at arenaflex

Remote Full-time

[Remote] Regional Finance Controller, West

Remote Full-time

Restaurant Crew – Amazon Store

Remote Full-time

Experienced Customer Support Representative – Chat Support Specialist for E-commerce Leader in Canada

Remote Full-time

Experienced Remote Customer Service Representative for Personal Injury Cases – Utilizing Excellent Communication Skills and HIPAA Knowledge to Deliver Top-Notch Service

Remote Full-time

Software Implementation Consultant

Remote Full-time

Experienced Customer Service Representative – Remote Work Opportunity – Part-Time Position at arenaflex

Remote Full-time

Experienced Remote Virtual Customer Care Representative - Delivering Happiness to Pet Parents through Exceptional Service and Support

Remote Full-time
← Back to Home