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Long Beach,
CA
(Click company name to view employer profile and all available
positions.) |
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Career Field |
Claims
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| Insurance
Discipline |
Managed Care
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| Relocation
Assistance |
Not Available
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| Job
Duration |
Full Time |
| Salary
Offered |
Open |
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Molina Healthcare Inc., is among the most experienced managed healthcare companies serving patients who have traditionally faced barriers to quality healthcare-including individuals covered under Medicaid, the Healthy Families Program, the State Children's Health Insurance Program (SCHIP) and other government-sponsored health insurance programs. Molina has health plans in California, Michigan, New Mexico, Missouri, Utah, Ohio, Texas and Washington as well as 19 primary care clinics located in Northern and Southern California. The company's corporate headquarters are in Long Beach, California.
POSITION SUMMARY
Perform configuration management duties in support of existing legacy Health Plans, new Health Plan implementations and reconfiguration of legacy Health Plans. The Configuration Manager shall use standard and consistent methodologies to develop and enhance existing environments in the core processing system.
PRINCIPLE ACCOUNTABILITIES
Manage a team of professional health insurance configuration analysts
Provide subordinates with the resources needed to attain results
Provide configuration expertise to internal staff, external departments, and the Health Plans
Work with the business and project development teams to assess and recommend the appropriate configuration methodology for new and existing business
Develop standard operating procedures and guidelines for the Configuration team
Ensure the proper unit testing is conducted and documented
Ensure the proper reporting and audit protocols are documented and managed to ensure quality control
Enforces strict conformance to written configuration policies and guidelines
Develop appropriate project and/or work plans to document work in progress and overall work effort
Ensure service level agreements are met
Provide status reports and project updates to management and stakeholders
DEPARTMENT/STATE SPECIFIC JOB FUNCTIONS
Configuration Manager – Implementation
· Follow a standard configuration methodology for new business – Molina Configuration Methodology
· Follow a standard reconfiguration methodology for existing business – Molina Standard Configuration Method
· Participate in workgroups to support the implementation of new business
· Participate in workgroups to support the reconfiguration of existing business
Configuration Manager – Medicaid
· Manage the timely completions of Configuration Change Request Forms (CCRF’s)
· Manage the inventory of claims assigned to the Configuration Analysts
· Research and recommend improvements to the existing configuration in order to enhance the overall claims payment process
Participate in corporate and Health Plan meetings as it relates to existing business
REQUIRED SKILLS AND QUALIFICATIONS
Education:
· Bachelors Degree in business related disciplines
Experience:
· 5 – 7 years in management of health insurance payor systems
· 5 – 7 years of QNXT configuration management experience
Additional Skills and Knowledge:
SQL Server
Microsoft Office Programs – Excel, Outlook, PowerPoint, Project, Visio, and Word
Knowledge of health plan business processes
Strong analytical skills
Strong verbal and written communication skills
Effective time management skills
Strong leadership skills
Molina Healthcare offers competitive benefits and compensation package.
Molina Healthcare is an Equal Opportunity Employer.(EOE). M/F/V/D
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