Manager, Configuration (QNXT / NetworX Pricer) - REMOTE
Molina Healthcare Arizona; Idaho; Kentucky; New Mexico; Ohio; Caldwell, Idaho; Sioux City, Iowa; Louisville, Kentucky; Omaha, Nebraska; Lincoln, Nebraska; Albuquerque, New Mexico; Miami, Florida; Yonkers, New York; Fort Worth, Texas; Madison, Wisconsin; Texas; Washington; Savannah, Georgia; Ann Arbor, Michigan; Las Cruces, New Mexico; Buffalo, New York; Cincinnati, Ohio; Salt Lake City, Utah; Seattle, Washington; Kenosha, Wisconsin; Iowa; Michigan; Nebraska; Macon, Georgia; Nampa, Idaho; Bowling Green, Kentucky; Lexington-Fayette, Kentucky; Sterling Heights, Michigan; Kearney, Nebraska; Phoenix, Arizona; Orlando, Florida; Augusta, Georgia; Syracuse, New York; Cleveland, Ohio; Austin, Texas; Bellevue, Washington; Green Bay, Wisconsin; Florida; Utah; Wisconsin; Grand Island, Nebraska; Jacksonville, Florida; Rio Rancho, New Mexico; Columbus, Ohio; Akron, Ohio; West Valley City, Utah; Provo, Utah; Layton, Utah; Tacoma, Washington; New York; Des Moines, Iowa; Detroit, Michigan; Grand Rapids, Michigan; Bellevue, Nebraska; Mesa, Arizona; St. Petersburg, Florida; Columbus, Georgia; Milwaukee, Wisconsin; Davenport, Iowa; Owensboro, Kentucky; Warren, Michigan; Chandler, Arizona; Dallas, Texas; Racine, Wisconsin; Boise, Idaho; Covington, Kentucky; Scottsdale, Arizona; Santa Fe, New Mexico; Tampa, Florida; Rochester, New York; Dayton, Ohio; Houston, Texas; San Antonio, Texas; Vancouver, Washington; Spokane, Washington; Georgia; Meridian, Idaho; Idaho Falls, Idaho; Cedar Rapids, Iowa; Iowa City, Iowa; Tucson, Arizona; Roswell, New Mexico; New York, New York; Atlanta, Georgia; Orem, Utah Job ID 2029761JOB 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
QNXT
NetworX Pricer
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
Pay Range: $80,412 - $156,803 / ANNUAL
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
About Us
Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
Job Type: Full Time Posting Date: 01/12/2025ABOUT OUR LOCATION
View Map- Director, Finance (Ohio) - REMOTE Arizona, Ohio, Utah, Washington, Idaho, Bellevue Washington, Milwaukee Wisconsin, Chandler Arizona, St. Petersburg Florida, Santa Fe New Mexico, Cleveland Ohio, Houston Texas, New York, San Antonio Texas, Madison Wisconsin, Mesa Arizona, Davenport Iowa, Warren Michigan, Lincoln Nebraska, Las Cruces New Mexico, Yonkers New York, Syracuse New York, Dayton Ohio, Austin Texas, Salt Lake City Utah, Orlando Florida, Meridian Idaho, Rio Rancho New Mexico, Texas, Georgia, New Mexico, Layton Utah, Seattle Washington, Spokane Washington, Racine Wisconsin, Macon Georgia, Sioux City Iowa, Bowling Green Kentucky, Detroit Michigan, Grand Rapids Michigan, Omaha Nebraska, Grand Island Nebraska, New York New York, Florida, Wisconsin, Iowa, Kentucky, Green Bay Wisconsin, Jacksonville Florida, Miami Florida, Atlanta Georgia, Augusta Georgia, Cedar Rapids Iowa, Lexington-Fayette Kentucky, Covington Kentucky, Rochester New York, Nebraska, Fort Worth Texas, Savannah Georgia, Idaho Falls Idaho, Caldwell Idaho, Sterling Heights Michigan, Ann Arbor Michigan, Kearney Nebraska, Columbus Ohio, Cincinnati Ohio, Akron Ohio, West Valley City Utah, Kenosha Wisconsin, Phoenix Arizona, Tampa Florida, Columbus Georgia, Des Moines Iowa, Iowa City Iowa, Louisville Kentucky, Buffalo New York, Michigan, Dallas Texas, Provo Utah, Orem Utah, Tacoma Washington, Vancouver Washington, Tucson Arizona, Scottsdale Arizona, Boise Idaho, Nampa Idaho, Owensboro Kentucky, Bellevue Nebraska, Albuquerque New Mexico, Roswell New Mexico 01/20/2025
- AVP, Health Plan Finance (Wisconsin) - REMOTE Arizona, Louisville Kentucky, Bowling Green Kentucky, Florida, New York, Utah, Grand Rapids Michigan, Omaha Nebraska, Roswell New Mexico, Provo Utah, Seattle Washington, Racine Wisconsin, Mesa Arizona, Scottsdale Arizona, Orlando Florida, Macon Georgia, Savannah Georgia, Idaho Falls Idaho, Davenport Iowa, Covington Kentucky, Michigan, Las Cruces New Mexico, Layton Utah, Tampa Florida, Augusta Georgia, Ohio, Ann Arbor Michigan, Kearney Nebraska, New York New York, Columbus Ohio, Tucson Arizona, Miami Florida, Boise Idaho, Detroit Michigan, Idaho, Sterling Heights Michigan, Buffalo New York, San Antonio Texas, Salt Lake City Utah, Tacoma Washington, Jacksonville Florida, Columbus Georgia, Nampa Idaho, Iowa, Kentucky, Lincoln Nebraska, Cincinnati Ohio, Austin Texas, Fort Worth Texas, Green Bay Wisconsin, Kenosha Wisconsin, Chandler Arizona, Des Moines Iowa, Cedar Rapids Iowa, Owensboro Kentucky, Washington, Wisconsin, Georgia, New Mexico, Warren Michigan, Rochester New York, Dayton Ohio, Dallas Texas, Madison Wisconsin, Atlanta Georgia, Caldwell Idaho, Iowa City Iowa, Lexington-Fayette Kentucky, Nebraska, Bellevue Nebraska, Albuquerque New Mexico, Rio Rancho New Mexico, Santa Fe New Mexico, Akron Ohio, West Valley City Utah, Orem Utah, Vancouver Washington, Bellevue Washington, Milwaukee Wisconsin, St. Petersburg Florida, Meridian Idaho, Texas, Grand Island Nebraska, Yonkers New York, Syracuse New York, Cleveland Ohio, Houston Texas, Spokane Washington, Phoenix Arizona, Sioux City Iowa 01/20/2025
- Case Manager (bilingual Chinese) Arizona, New Mexico, Ohio, Houston Texas, Mesa Arizona, Savannah Georgia, Sioux City Iowa, Sterling Heights Michigan, Buffalo New York, Yonkers New York, Washington, Florida, Michigan, Dayton Ohio, Bellevue Washington, Madison Wisconsin, Green Bay Wisconsin, Scottsdale Arizona, Augusta Georgia, Boise Idaho, Cedar Rapids Iowa, Owensboro Kentucky, Bellevue Nebraska, Albuquerque New Mexico, Utah, New York, Texas, West Valley City Utah, Racine Wisconsin, Miami Florida, Meridian Idaho, Nampa Idaho, Idaho Falls Idaho, Grand Island Nebraska, New York New York, Iowa, Akron Ohio, San Antonio Texas, Seattle Washington, Spokane Washington, Vancouver Washington, Chandler Arizona, Detroit Michigan, Fort Worth Texas, Tucson Arizona, Jacksonville Florida, St. Petersburg Florida, Macon Georgia, Santa Fe New Mexico, Rochester New York, Syracuse New York, Wisconsin, Idaho, Provo Utah, Caldwell Idaho, Des Moines Iowa, Davenport Iowa, Iowa City Iowa, Lexington-Fayette Kentucky, Bowling Green Kentucky, Covington Kentucky, Grand Rapids Michigan, Lincoln Nebraska, Rio Rancho New Mexico, Nebraska, Dallas Texas, Orem Utah, Tacoma Washington, Milwaukee Wisconsin, Phoenix Arizona, Tampa Florida, Atlanta Georgia, Louisville Kentucky, Warren Michigan, Kearney Nebraska, Las Cruces New Mexico, Columbus Ohio, Georgia, Kentucky, Cincinnati Ohio, Austin Texas, Salt Lake City Utah, Layton Utah, Kenosha Wisconsin, Orlando Florida, Columbus Georgia, Ann Arbor Michigan, Omaha Nebraska, Roswell New Mexico, Cleveland Ohio, Los Angeles California, Orange California, Riverside California, San Bernardino California 01/23/2025
- Care Review Clinician, Prior Auth (RN) (Remote, Pacific Hours) California, Arizona, Nevada, San Jose California, Fresno California, Los Angeles California, San Diego California, San Francisco California 01/09/2025