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Molina Healthcare Sr Business Solutions Consultant - QNXT SME - Remote in Caldwell, Idaho

Job Description

Job Summary

Business Strategy Leader managing relationships and providing process expertise with Molina health plan leadership, corporate leadership, business subject matter experts (SMEs), business and IT operations partners, and Vendors. Manage strategic operations roadmaps and capability priorities. Leads business process improvement initiatives that result in operational efficiencies and/or an increase in customer satisfaction.

Job Duties

• Builds, manages and maintains effective Business relationships with key stakeholders in business domain across Health plans and Corporate Healthcare functions,

• Requires highest level understanding of organization's business and industry requirements.

• Focus is on process analysis and re-engineering, with a deep understanding of technical problems and solutions as they relate to the current and future business environment.

• Drives process change by integrating new processes with existing ones or introducing modernization and communicating these changes to impacted business teams.

• Uses quantitative and qualitative analysis to develop and improve internal processes across the enterprise.

• Recommends and facilitates process improvement efforts. Will lead re-engineering team and act as project manager in some cases.

• Drives efficiency: looks for and documents ways to increase the efficiency through continuous improvement goals and process maturation taking into account budget impacts.

• Maintains management/technical skills that can be utilized in the field to solve complex problems.

• Continuous improvements of established reports in production to ensure best performance and use for business value metrics.

• Demonstrates use of tools, techniques and communications soft skills to build and maintain effective business relationships.

• Works closely with Corporate leadership to deliver key business initiatives, process improvements, managing KPIs and business communication.

• Assimilates and documents business needs for project requests and benefit value documentation including high level requirements, compliance implications and cost benefit analysis.

• Responsible for business case development. Advises on project benefit calculation drivers and able to explain benefits to Senior Leadership meetings.

• Demonstrates advanced knowledge and understanding of business work pipeline, IT roadmap, business impacts and required interactions to link these efforts to portfolio management processes; facilitates with clients to ensure work is considered in pipeline.

• Organizes complex project requests or issue successfully into manageable approaches and advise on project set up/structure based on proposed scope.

• Facilitates groups for problem solving and service improvement including definition/documentation, business workflow analysis.

• Develops effective processes, forums and tracking mechanisms to continuously improve process through Business feedback, proactive handling of Business complaints and facilitation of resolution.

• Conducts bi-weekly Operations and Issue Resolution meeting.

• Develops and maintains a Service Delivery Plan for individual Health plans or Corporate functions to include Business strategies/needs with corresponding IT strategies/plans, projects, performance measurements, customer satisfaction improvement plans and other items as determined by the health plan.

•Effectively manages business escalations by ensuring appropriate accountability, sense of urgency, communication and follow through to closure.

• Knowledgeable of State Medicaid contract Service Level Agreements. Demonstrates SME knowledge of MCO contract compliance requirements that impact processes.

• Facilitates and leads processes and activities to complete deliverables impacting assigned healthplans including, but not limited to, RFP Responses, audit response/coordination, and evaluation of new contract requirements.

• Remain knowledgeable of vendor strategic roadmaps and how they align with business growth and priorities

• Arrange vendor demonstrations and manager proof of concept requirements for new capability value studies.

• Other duties, as assigned.

Job Qualifications

REQU I RED ED U C A TI O N :

Bachelor’s Degree in Business, Healthcare,

Computer Science, Information Systems or 10 years of related field or equivalent experience

REQU I RED E X PE R I E N C E/KNOWLEDGE, SKILLS & ABILITIES:

• 7-10 years business function or relations management experience

• 5-7 years IT or system delivery or related experience.

• 3 years strategic planning experience.

• Project management background.

PR E FE R RED ED U C A TI O N :

Master’s Degree in Computer Science, Information Systems or Healthcare related field

PR E FE R RED E X PE R I E N C E:

3+ years management experience.

3 – 5 years managed care experience.

PR E FE R RED L I C E N S E, C E R TI FI C A T I O N , AS S O C I A TI O N :

Six Sigma Black Belt

PMI - Project Management Professional (PMP)

Agile Product Owner

Design Thinking Certification

PHY S I C AL DEM A N D S :

Working environment is generally favorable and lighting and temperature are adequate. Work is generally performed in an office environment in which there is only minimal exposure to unpleasant and/or hazardous working conditions. Must have the ability to sit for long periods. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential function.

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: $88,453 - $206,981 / ANNUAL

*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

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