Molina Healthcare · 3 weeks ago
Lead Networx Analyst, Contract Configuration Info Mgmt
200 Oceangate, Long Beach, CA, 90802, US
Full-time, Contract
Onsite
Senior Level
5+ years expMolina Healthcare is looking for a Lead Networx Analyst to provide lead level analyst support for configuration information management activities. The role involves managing databases, ensuring accurate implementation and maintenance of claims data, and collaborating with stakeholders to meet business requirements.
Health CareHospitalMedical
Responsibilities
Analyzes and interprets data to determine appropriate configuration changes
Accurately interprets specific state and/or federal benefits, in addition to other business requirements, and converts terms to configuration parameters
Manages coding, updating and maintaining benefit plans, provider contracts, fee schedules and various system tables in the user interface
Applies experience and knowledge to research and resolve claim/encounter issues and pended claims, and updates system(s) as necessary
Loads and maintains contracts, benefit and/or reference table information into the claims payment system and other applicable systems
Participates in defect resolution for assigned component(s)
Participates in the implementation and conversion of new and existing health plans
Assists in planning and coordination of application upgrades and releases, including development and execution of some test plans
Assists with development of configuration standards and best practices, and suggests improvement processes to ensure systems are working efficiently and enhance quality
Creates reporting tools to enhance communication on configuration updates and initiatives
Negotiates expected configuration information management completion dates with health plans
Collaborates with internal and external stakeholders to understand business objectives and processes
Solutions with health plans and corporate functions to ensure all end-to-end business requirements have been documented
Assists leadership in establishing standards, guidelines, and best practices for the configuration information management team
Represents as a departmental configuration information management subject matter expert
Supports various department-wide configuration information management projects
Provides training and support to new and existing configuration information management team members, including configuration functionality, enhancements and updates
Manages fluctuating volumes of work, and prioritizes work to meet deadlines and needs of the configuration department and user community
Qualification
Required
At least 5 years of configuration information management experience maintaining databases, and/or analyst experience within a health care operations setting in a managed care organization supporting Medicaid, Medicare, and/or Marketplace programs, or equivalent combination of relevant education and experience
Must have Contract configuration experience in Networx
Advanced experience using a claims processing system
Advanced experienced verifying documentation related to updates/changes within a claims processing system
Advanced experience validating and confirming information related to provider contracting, network management, credentialing, benefits, prior authorizations, fee schedules, and other business requirements
Analytical and critical-thinking skills
Flexibility to meet changing business requirements, and commitment to high-quality/on-time delivery
High attention to detail
Effective verbal and written communication skills
Microsoft Office suite proficiency, including intermediate to advanced Excel abilities (VLOOKUP/Pivot Tables, etc.), and applicable software programs proficiency
Preferred
Experience with QNXT is preferred
Benefits
Competitive benefits and compensation package
Company
Molina Healthcare
Molina Healthcare is a healthcare company that specializes in government-sponsored healthcare programs for families and individuals.
10001+ employees
H1B Sponsorship
Molina Healthcare has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2025 (56)
2024 (45)
2023 (43)
2022 (31)
2021 (35)
2020 (55)
Funding
Current Stage
Public CompanyTotal Funding
$2.35B2025-11-17Post Ipo Debt· $850M
2024-11-13Post Ipo Debt· $750M
2021-11-16Post Ipo Debt· $750M
Leadership Team
Dave Reynolds
Executive Vice President, Health Plans & Medicaid Chief Operating Officer
Debbie Simkins
Vice President, Office of the CIO
Recent News
Hartford Business Journal
2026-01-14
Sherwood News
2026-01-09
Company data provided by crunchbase