Molina Healthcare · 9 hours ago
Senior Analyst, Business
United States
Full-time
Remote
Mid, Senior Level
4+ years expMolina Healthcare is a managed care organization seeking a Senior Analyst in Business. This role provides senior level support for the intake and interpretation of regulatory requirements, ensuring alignment with coverage and reimbursement processes while coordinating with stakeholders and governance committees.
Health CareHospitalMedical
Responsibilities
Develops and maintains requirement documents related to coverage, reimbursement and other applicable system changes in areas to ensure alignment to regulatory baseline requirements and any health plan/product team developed requirements
Monitors regulatory sources to ensure all updates are aligned as well as work with operational leaders within the business to provide recommendations for process improvements and opportunities for cost savings
Leads coordinated development and ongoing management /interpretation review process, committee structure and timing with key partner organizations. Interpret customer business needs and translate them into application and operational requirements
Communicates requirement interpretations and changes to health plans/product team and various impacted corporate core functional areas for requirement interpretation alignment and approvals as well as solution traceability through regular meetings and other operational process best practices
Where applicable, codifies the requirements for system configuration alignment and interpretation
Provides support for requirement interpretation inconsistencies and complaints
Assists with the development of requirement solution standards and best practices while suggesting improvement processes to consistently apply requirements across states and products where possible
Self-organized reporting to ensure health plans/product team and other leadership are aware of work efforts and impact for any prospective or retrospective requirement changes that can impact financials
Coordinates with relevant teams for analysis, impact and implementation of changes that impact the product
Engages with operations leadership and Plan Support functions to review compliance-based issues for benefit planning purposes
Qualification
Required
At least 4 years of experience in previous roles in a managed care organization, health insurance or directly adjacent field, or equivalent combination of relevant education and experience
Policy/government legislative review knowledge
Strong analytical and problem-solving skills
Familiarity with administration systems
Robust knowledge of Office Product Suite including Word, Excel, Outlook and Teams
Previous success in a dynamic and autonomous work environment
Preferred
Project implementation experience
Knowledge and experience with federal regulatory policy resources including Centers for Medicare & Medicaid Services (CMS) and the Affordable Care Act (ACA)
Medical Coding certification
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
2026-01-17
Company data provided by crunchbase