Process Consultant - QNXT SME
Molina Healthcare Grand Island, Nebraska; Roswell, New Mexico; Rochester, New York; Cincinnati, Ohio; Washington; Tacoma, Washington; Phoenix, Arizona; Savannah, Georgia; Idaho Falls, Idaho; Warren, Michigan; New Mexico; Dayton, Ohio; Texas; San Antonio, Texas; Salt Lake City, Utah; Green Bay, Wisconsin; Chandler, Arizona; Miami, Florida; Florida; Des Moines, Iowa; Iowa; Nampa, Idaho; Idaho; Covington, Kentucky; Bowling Green, Kentucky; Grand Rapids, Michigan; Kearney, Nebraska; Syracuse, New York; New York, New York; Caldwell, Idaho; Louisville, Kentucky; Detroit, Michigan; Nebraska; Fort Worth, Texas; Dallas, Texas; Seattle, Washington; Milwaukee, Wisconsin; Iowa City, Iowa; Davenport, Iowa; Lexington-Fayette, Kentucky; Omaha, Nebraska; Lincoln, Nebraska; Orem, Utah; Bellevue, Washington; Wisconsin; Kenosha, Wisconsin; Jacksonville, Florida; Georgia; Columbus, Georgia; Cedar Rapids, Iowa; Meridian, Idaho; Kentucky; Bellevue, Nebraska; Las Cruces, New Mexico; New York; Ohio; Layton, Utah; Vancouver, Washington; Racine, Wisconsin; Scottsdale, Arizona; Mesa, Arizona; Orlando, Florida; Atlanta, Georgia; Owensboro, Kentucky; Ann Arbor, Michigan; Michigan; Rio Rancho, New Mexico; Albuquerque, New Mexico; Buffalo, New York; Columbus, Ohio; Cleveland, Ohio; Akron, Ohio; Austin, Texas; Houston, Texas; West Valley City, Utah; Madison, Wisconsin; Tampa, Florida; Augusta, Georgia; Macon, Georgia; Sioux City, Iowa; Boise, Idaho; Santa Fe, New Mexico; Yonkers, New York; Utah; Provo, Utah; Spokane, Washington; Tucson, Arizona; St. Petersburg, Florida; Sterling Heights, Michigan; Long Beach, California Job ID 2030431Job Summary
Leads business process improvement initiatives that result in operational efficiencies and/or an increase in customer satisfaction. Assists in development of MHI's business process improvement methodology and in the implementation of a business process improvement capability.
Knowledge/Skills/Abilities
• Facilitates groups for problem solving and service improvement including definition/documentation, business workflow analysis.
• Requires high level understanding of the organization’s business and industry requirements.
• Knowledgeable of State Medicaid contract Service Level Agreements. Demonstrates SME knowledge of MCO contract compliance requirements that impact processes.
• Works with the business and project development teams to assess and recommend the appropriate configuration design, solutions, and methodology for new and existing business.
• Focus is on process analysis and re-engineering, with an understanding of technical problems and solutions as they relate to the current and future business environment.
• Creates process change by integrating new processes with existing ones and communicating these changes to impacted business teams.
• Recommends and facilitates process improvement efforts. May lead re-engineering team and act as project manager in some cases.
• Demonstrates use of tools, techniques and communications soft skills to build and maintain effective business relationships.
• Understanding of complex payment methodologies, configuration solutions, health care benefits.
• Advanced knowledge of healthcare claims and claim processing from receipt through encounter submission.
• Advanced knowledge of Excel and SQL knowledge preferred
• Knowledge of configuration in QNXT strongly preferred
Job Qualifications
Required Education
Bachelor's degree required in a related field (Business Administration, Healthcare, Engineering, etc.) or 5 years of related field or equivalent experience
Required Experience
• 5 years of process improvement experience
Required License, Certification, Association
LEAN certification and/or Lean Six Sigma Green Belt
Preferred Experience
• Project management
• 2 years of process improvement experience with demonstrable successes in application of Lean/Six-Sigma
Preferred License, Certification, Association
Lean Six Sigma Black Belt
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: $77,969 - $155,508 / 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: 03/18/2025ABOUT OUR LOCATION
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