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

Remote Telesales Associate USA

Remote

Manager, Contracts Management (FULL TIME REMOTE)

Remote

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

Remote

Urgently Hiring: Want Temporary Workforce Management Real Time

Remote

Data Scientist, ML - Insurance Underwriting

Remote

Remote AI Content Reviewer at Outlier

Remote

Dataloader – Revenue Solutions Inc – Pembroke, MA

Remote

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

Remote

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

Remote

Temporary- Health Economics Analyst- Remote - L...

Remote

Cybersecurity Program Manager

Remote

**Experienced Data Entry Clerk (Typist) – Remote Work Opportunity with Flexible Scheduling**

Remote

Experienced Remote Customer Service Representative – Delivering Exceptional Travel Experiences through Web, Phone, and Email Support at blithequark

Remote

Salesforce Admin Entry Level- Immediate Joiners Needed- BR Jobs in New York, NY at Magnus Technologies inc

Remote

Experienced Part-Time Inside Sales Support and Customer Service Representative – Delivering Exceptional Client Experiences and Driving Business Growth at blithequark

Remote

Drug Safety Specialist at Pressable

Remote

Remote Data Analyst/ Dashboard Developer

Remote

Senior Associate Product Manager, Remote Deposit Capture and Cashier Check

Remote

**Experienced Senior Assistant Manager – Hobby Lobby Remote Store Operations**

Remote
← Back