Business intelligence analyst jobs in Caldwell, ID - 24 jobs

JOB DESCRIPTIONJob Summary Designs and implements processes and solutions associated with a wide variety of data sets used for data/text mining, analysis, modeling, and predicting to enable informed business decisions. Gains insight into key business problems and deliverables by applying statistical analysis techniques to examine structured and unstructured data from multiple disparate sources. Collaborates across departments and with customers to define requirements and understand business problems. Uses advanced mathematical, statistical, querying, and reporting methods to develop solutions. Develops information tools, algorithms, dashboards, and queries to monitor and improve business performance. Creates solutions from initial concept to fully tested production, and communicates results to a broad range of audiences. Effectively uses current and emerging technologies. KNOWLEDGE/SKILLS/ABILITIES * Extracts and compiles various sources of information and large data sets from various systems to identify and analyze outliers. * Sets up process for monitoring, tracking, and trending department data. * Prepares any state mandated reports and analysis. * Works with internal, external and enterprise clients as needed to research, develop, and document new standard reports or processes. * Implements and uses the analytics software and systems to support the departments goals. JOB QUALIFICATIONS Required Education Associate's Degree or equivalent combination of education and experience Required Experience 1-3 years Preferred Education Bachelor's Degree or equivalent combination of education and experience Preferred Experience 3-5 years 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: $80,168 - $116,835 / 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.

Idaho National Laboratory (INL) is hiring a Policy Business Analyst to work in our Business Management department. You will support acquisition Policy & Assurance functions, ensuring compliant contracting activities that connect resources to research. You will work under minimal supervision to enhance and maintain policy infrastructure through research of new requirements, implementation of applicable changes, revision of existing procedures, and incorporation of new policies Our team works an on-site 9x80 schedule located at our Idaho Falls, ID, EROB facility with every other Friday off! You will report to the Manager of Policy & Assurance with no direct reports. Responsibilities Include: In accordance with applicable directives, federal regulations (e.g., Federal Acquisition Regulations (FAR), Department of Energy Acquisition Regulations (DEAR), and Cost Accounting Standards (CAS)), maintain and update in-depth policies and procedures to ensure effective risk mitigation and efficient operation of contract-related activities. Evaluate potential deviations from policy and recommend solutions to mitigate risk to INL. Maintain and enhance acquisition policies, procedures, forms, and other documents. Ensure policies balance compliance to regulations, while enabling efficient operations. Act as a change agent (obtain buy-in and lead implementation of new processes). Maintain precise documentation to justify decisions, conclusions, findings, or recommendations. Assure INL's interests are protected by taking a proactive approach in identifying and assessing risks; identify, develop, and implement process improvements and identify areas where automation efforts could improve current processes. Provide recommendations for process improvement initiatives and assume leadership of special projects. Interface with acquisitions, finance, business offices, internal audit, and other relevant organizations to support internal processes and controls. Use computer systems or applications to access, create, edit, print, send, retrieve, or manipulate analytical data, files, or other information to provide required and/or ad-hoc reports as necessary. Work on problems of diverse scope where analysis of information requires evaluation of identifiable factors. Devise solutions based on limited information and precedent and adapt existing approaches to resolve issues. Use evaluation, judgment, and interpretation to select the right course of action. Identify, enhance and develop processes and procedures to maximize the efficiencies of the business to which the support is being provided. This discipline is designated for professional exempt work scope for which no other appropriate work discipline code has been established. Minimum Requirements\: Level 3\: Bachelor's Degree and 5 years of relevant experience OR a Master's Degree and 2 years of relevant experience with a degree in Business, Legal, or related field. Level 4\: Bachelor's Degree and 9 years of relevant experience OR a Master's Degree and 6 years of relevant experience with a degree in Business, Legal, or related field. Job Information\: The pay range for this position is\: Level 3-Salary grade 430 ($66,504 -$136,356) / Level 4-Salary grade 440 ($79,344 - $162,732). At Idaho National Laboratory compensation decisions are determined using factors such as education, relevant experience, and other credentials. Multi-Level\: This is a multi-level posting and you will be placed at the appropriate level dependent on depth and breadth of proven experience and skills. Physical Requirements: While performing the duties of this classification, the employee is frequently required to stand, walk, sit, stoop, kneel, bend, and work in an office environment. The job requires hand/finger dexterity to keyboard or type, handle materials, manipulate tools, and reach with hands and arms. The job requires the operation of office equipment. The employee must occasionally lift and/or move up to 35 pounds. Sufficient visual acuity and hearing capacity to perform the essential functions and interact with people is required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Benefits and Relocation Medical, Dental, Vision, and Flexible Spending Accounts 401(k) with a 4.2% employer contribution and up to 4.8% match Paid time off (personal leave) Employee Education Program (tuition assistance) Comprehensive Relocation Package Benefit eligibility subject multiple factors, including employment status and position classification. INL is a science-based, applied engineering national laboratory dedicated to supporting the U.S. Department of Energy's mission in nuclear energy research, science, and national defense. With more than 5,000 scientists, researchers, and support staff, the laboratory works with national and international governments, universities and industry partners to discover new science and development technologies that underpin the nation's nuclear and renewable energy, national security, and environmental missions. INL Mission Our mission is to discover, demonstrate and secure innovative nuclear energy solutions, other clean energy options and critical infrastructure. INL Vision Our vision is to change the world's energy future and secure our nation's critical infrastructure. Selective Service Requirements To be eligible for employment at INL males born after December 31, 1959 must have registered with the Selective Service System (SSS). For more information see ************ Equal Employment Opportunity Idaho National Laboratory (INL) is an Equal Employment Opportunity (EEO) employer. It is the policy of INL to provide equal employment opportunities to all qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, protected veteran or disabled status, or genetic information. Reasonable Accommodation We will ensure that individuals with disabilities are provided reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment. Please contact us to request accommodation. Other Information When applying to positions please provide a resume and answer all questions on the following screens. Applicants, who fail to provide a resume or answer the questions, may be deemed ineligible for consideration. INL does not accept resumes from third party vendors unsolicited.

USM Business Systems Inc. is a quickly developing worldwide System Integrator, Software and Product Development, IT Outsourcing and Technology assistance supplier headquartered in Chantilly, VA with off-shore delivery centers in India. We offer world-class ability in giving most astounding quality and administrations through industry best practices planned to convey remarkable worth to our customers. Utilizing our industry knowledge, administration service offering expertise and innovation abilities, we distinguish new business and innovation slants and create answers for help customers around the globe, giving top of the line solid and practical IT benefits which are cost effective services. Established in 1999, the organization has corner qualities in building and dealing with a Business Oriented IT environment with rich involvement in technology innovation, ERP and CRM counselling, Product Engineering, Business Intelligence, Data Management, SOA, BPM, Data Warehousing, SharePoint Consulting and IT Infrastructure. Our other offerings include modified solutions and administrations in ERP, CRM, Enterprise architecture, offshore advisory services ,e-commerce, Social , Mobile, Cloud, Analytics (SMAC) and DevOps. USM, a US ensured Minority Business Enterprise (MBE) is perceived as one of the fastest developing IT Systems Integrator in the Washington, DC zone. Most as of late, USM was positioned #9 on the rundown of the Top administrations organizations in the DC Metro Area - Washington Business Journal (2011). We are a project-driven firm that reliably meets the IT needs of our State and Government customers through development and business keenness. Job Description Role Description: • Participate in a team of individuals in the Automation Integration Bureau functioning as a Business Analyst supporting customer focused testing of several large automated systems within the Division of Welfare • Works as a customer advocate on a business testing team supporting validation of software developed incrementally by several product development teams • Support the testing team in documenting test plans: objectives, scope, approach, assumptions, dependencies, risks and schedule for a particular release • Works closely with engineers developing automated tests to ensure alignment with customer needs, process flows and system requirements • Works closely with business testers developing manual User Acceptance Tests to ensure alignment with customer needs, process flows and system requirements. • Reviews, analyzes, and evaluates business systems and user needs • Facilitates the discovery of as-is and to-be business processes • Documents business processes in a manner that facilitates long term maintenance, business process automation, and process improvement Skills and knowledge in the following areas: • Supporting agile teams by collaborating with business managers, subject matter experts and specialists in policy and operations to ensure automated functionality meets business requirements, implementation parameters, readiness plan components, and timelines • Coordinating and facilitating the gathering of business and system requirements in support of incremental and iterative system development • Developing key deliverables within the agile development process; user stories, acceptance criteria, business-focused test scenarios, solution models, as-is and to-be process models, user story maps, user personas, light-weight functional and non-functional requirements and product roadmaps • Working with customer business units to understand their business processes • Performing workflow design and process improvement • Understanding and reviewing test models for product test and release control (plans, data, and scripts) • Understanding and reviewing test plans, test scripts, test cases and links that connect to requirements and done criteria • Performing testing on software applications and/or websites • Writing and executing SQL statements to analyze data in support of business analysis and testing • Demonstrating strong organizational and communication skills and attention to detail • Creating and maintaining high-quality documentation of all relevant specifications, systems, and procedures Preferred Skills/Experience (Any of these is a plus) • Experience with automated testing tools • Working knowledge of a modern welfare eligibility case management system • Experience working with government agencies Additional Information If you are interested in above position, please share your updated resume to ************************** or can directly call me on ************.

Our client, a leading organization in the industry, is seeking a Sr Business Analyst to join their team. As a Sr Business Analyst, you will be part of the Business Analysis supporting agile delivery teams. The ideal candidate will have excellent communication skills, strong analytical thinking, and a proactive approach, which will align successfully in the organization. **Job Title:** Sr Business Analyst **Location:** Remote (U.S.-based/onshore required) **Pay Range:** $55 **What's the Job?** + Drive requirements gathering, backlog readiness, and stakeholder alignment within agile teams + Write clear, high-quality user stories and tasks to support project delivery + Partner with Product Managers and Project Managers to ensure timely delivery of work + Support discovery sessions, UAT activities, and collaborate on data analytics initiatives + Lead requirement and refinement sessions, ensuring the team has prioritized work ready in the backlog **What's Needed?** + 5+ years of experience as a Business Analyst, preferably in agile environments + Strong experience writing user stories and managing backlogs using tools like Azure DevOps or Jira + Proven ability to lead requirement sessions with cross-functional teams + Experience supporting data analytics structures and methodologies + Excellent organizational, communication, and stakeholder management skills **What's in it for me?** + Opportunity to work remotely with a dynamic team + Engagement in impactful enterprise and data-focused initiatives + Collaborative environment supporting professional growth + Flexible work arrangements to support work-life balance + Potential for contract extensions based on performance and project needs **Upon completion of waiting period consultants are eligible for:** + Medical and Prescription Drug Plans + Dental Plan + Vision Plan + Health Savings Account + Health Flexible Spending Account + Dependent Care Flexible Spending Account + Supplemental Life Insurance + Short Term and Long Term Disability Insurance + Business Travel Insurance + 401(k), Plus Match + Weekly Pay If this is a role that interests you and you'd like to learn more, click apply now and a recruiter will be in touch with you to discuss this great opportunity. We look forward to speaking with you! **About ManpowerGroup, Parent Company of: Manpower, Experis, Talent Solutions, and Jefferson Wells.** _ManpowerGroup (NYSE: MAN), the leading global workforce solutions company, helps organizations transform in a fast-changing world of work by sourcing, assessing, developing, and managing the talent that enables them to win. We develop innovative solutions for hundreds of thousands of organizations every year, providing them with skilled talent while finding meaningful, sustainable employment for millions of people across a wide range of industries and skills. Our expert family of brands -_ **_Manpower, Experis, Talent Solutions, and Jefferson Wells_** _-_ creates substantial value for candidates and clients across more than 75 countries and territories and has done so for over 70 years. We are recognized consistently for our diversity - as a best place to work for Women, Inclusion, Equality and Disability and in 2023 ManpowerGroup was named one of the World's Most Ethical Companies for the 14th year - all confirming our position as the brand of choice for in-demand talent. ManpowerGroup is committed to providing equal employment opportunities in a professional, high quality work environment. It is the policy of ManpowerGroup and all of its subsidiaries to recruit, train, promote, transfer, pay and take all employment actions without regard to an employee's race, color, national origin, ancestry, sex, sexual orientation, gender identity, genetic information, religion, age, disability, protected veteran status, or any other basis protected by applicable law.

Why join CompuNet? CompuNet values its people more than any other asset-and realizes the contributions made by each employee are a reflection of their education, experience, certifications, expertise and passions. We strive to take care of each other, do the right thing and help our customers succeed. We work to build lasting relationships and are proud that our customers across many industries see us as a trusted advisor. Putting the customer at the center of every engagement, our mission is to design, test, deploy and support the right IT solutions for every customer. We offer a generous total compensation package for our employees, including competitive wages, medical, dental, vision, PTO, company-matching retirement plans, profit-sharing and more. CompuNet is seeking a Business Analyst, Sales Operations, to support the systems, tools, and data that enable effective sales execution. This role focuses on improving the effectiveness, accuracy, and efficiency of Sales Operations through system support, analysis, reporting, and continuous improvement. The Business Analyst, Sales Operations, works closely with Sales Operations leadership and internal technology teams to support and enhance core sales platforms. This role requires a balance of detailed system configuration, data analysis, and operational insight in a fast-paced sales environment. Successful candidates will be analytical, detail-oriented, and comfortable working within enterprise platforms while helping the business better leverage existing capabilities. Essential Duties & Responsibilities The Business Analyst, Sales Operations, will work closely with Sales Operations leadership and cross-functional partners to support the following areas of responsibility. Sales Systems & Quoting Platform Support Support the day-to-day operation and configuration of sales enablement tools, including the sales quoting platform and related systems. Partner with Sales Operations team to optimize workflows, data quality, system usability, and resolve system or process issues as they arise. Perform configuration changes, minor enhancements, and light low-code solutions where appropriate. Provide training, documentation, and ongoing user support for systems and processes. Perform regular audits to ensure systems align with current products, pricing, and sales strategies. Product Catalog & Sales Data Management Maintain and update product and pricing data, ensuring accuracy and consistency across sales systems. Coordinate with vendors and suppliers to ensure timely updates to product and pricing information. Ensure alignment of product catalog data across CRM and related sales tools. Reporting & Analytics Work with Business Intelligence team to structure and maintain sales reports. Analyze sales data to identify trends, risks, and opportunities for improvement. Integrate manufacturer data, including pricing and promotions, into reporting and analysis. Support forecasting and planning efforts through historical data analysis and insights. Process Improvement & Documentation Develop a working understanding of Sales Operations roles and workflows in order to identify improvement opportunities and support system enhancements. Participate in job shadowing or short-term coverage of Sales Operations roles as needed to support operational continuity and improvement efforts. Serve as a key stakeholder in sales-related tools and systems, providing input on enhancements and changes. Develop, document, and maintain standard operating procedures (SOPs) for sales tools and workflows. Ensure Sales Operations activities align with company policies and procedures. Travel Expectations Occasional, pre-planned, travel may be required for meetings, training, or company events. Education & Experience Minimum Requirements Bachelor's degree or equivalent professional experience. Mid- to senior-level experience in business analysis, sales operations, or a related role. Hands-on experience supporting enterprise CRM, sales operations, or sales enablement platforms. Experience partnering with technology teams to support or improve business systems. Desired Experience Experience with Microsoft Dynamics 365 and the Microsoft Power Platform. Experience working with enterprise reporting, automation, or low-code tools (e.g., Power BI, Power Automate, Power Apps). 3+ years of experience managing or selling subscriptions and renewals Experience performing system configuration changes and minor enhancements in a production environment. Experience developing reporting and analysis that support operational and leadership decision-making. Skills & Abilities Analytical Thinking - able to interpret data and deliver actionable insights. Sales Systems Proficiency - comfortable configuring and supporting CRM, reporting, and low-code platforms (experience with Dynamics 365 and the Power Platform preferred). Attention to Detail - strong focus on data accuracy and system integrity. Communication & Collaboration - effective partner to Sales Operations leadership and internal technology teams. Process Improvement Mindset - proactive in identifying and recommending practical improvements. Time Management - able to prioritize competing requests in a fast-paced environment. Operational Curiosity - willingness to learn, understand, and support adjacent Sales Operations roles to drive continuous improvement. Who we are CompuNet, Inc. is an engineering-led IT solution provider that offers consulting, design, and professional services. Our strength lies in our team of outcome-driven and relationship-focused professionals with a long history of designing IT solutions. Our team of highly skilled engineers take the lead in designing, developing, and implementing solutions that address complex business challenges. This team takes ownership for the entire project lifecycle, from discovery and design through deployment, training, and handoff. We are an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, national origin, disability status, protected veteran status or any other characteristic protected by law.

At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues - caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day. **Position Summary** The Rebate Engagement team is an exciting and dynamic new team being formed to address a current knowledge gap between the client and rebate/financial and reporting operations. This team is a client facing group of individuals who work with internal Account Team and rebate/financial/reporting operations team partners to manage client contractual obligations. Team members are responsible for the management and oversight of all client contracted rebate reporting, payment, and reconciliation deliverables (client invoicing, service warranty) as well as client financial projects, initiatives and other financial matters related to the client contract. The role requires someone who can drive issues to resolution while effectively collaborating with key internal and external stakeholders to deliver high quality and predictable outcomes. You will be a facilitator, not an operator, so project/issue management skills will be key to your success in this role. **GENERAL RESPONSIBILITIES** + Partner with internal cross-functional areas such as Sales, Finance, Trade and Reporting to ensure all client requirements are met and supported + Review and analysis of reporting to identify trends and opportunities, plus quality inspection prior to client delivery + Solve for opportunities identified through trend analysis - process improvement / strategic projects + Independently manage client issues and projects with little involvement from leadership + Triage of Finance specific Aunt Team requests + Support multiple complex client escalations and projects- requiring "outside of the box" solutions and ideas + Conduct "lessons learned" and feedback meetings post resolution of issues to improve processes for the future, including FOX and CSX support **PROJECT MANAGEMENT RESPONSIBILITIES** + Create and maintain issue and project tracking support tools as needed (Milestone Report/CRAID/Agendas/etc.) + Partner with cross-functional partners to align on client and project expectations + Escalate appropriately when support is needed or risk is identified, linear and/or cross-functional escalation + Send weekly meeting agenda and meeting notes 24hrs prior and after meeting takes place + Regular summary updates to Finance leadership **SOFT SKILLS NEEDED TO BE SUCCESSFUL IN ROLE** + Excellent verbal and written communication skills - transparent and trustworthy + Strong relationship building skills - approachable and consultative + Ability to flex communication approach based on client/partner style (friendly approach vs. direct approach) + Resilient and tenacious / Decisive + Attention to detail / Time management + Client centric / Curious mindset + Self-motivated and proactive (vs. reactive) + Strong critical thinking skills Your success will be measured by reduction in client escalations and Client/Account Team feedback. Client satisfaction is also paramount to your success. This position affords you the opportunity to gain visibility to senior leadership through regular updates on client initiatives and progress with the account. The contributions you will make as part of the Rebate Engagement team will position CVS Health as a leader in client satisfaction and service in the PBM marketplace. **Required Qualifications** + 2+ years of professional experience in PBM/healthcare operational and/or financial role(s) + 2+ years of experience performing in-depth research, investigation, analysis, and/or ad-hoc reporting + Experience in Microsoft Office, particularly Excel (must know how to do VLOOKUPS and pivot tables) **Preferred Qualifications** + Prior experience in client-facing role + Demonstrated project management experience + Advanced Microsoft Excel skillset including pivot-tables, advanced formulas, and maneuvering data sets + Prior Salesforce use **Education** + Bachelor's Degree or Equivalent Experience Required **Anticipated Weekly Hours** 40 **Time Type** Full time **Pay Range** The typical pay range for this role is: $46,988.00 - $122,400.00 This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong. **Great benefits for great people** We take pride in our comprehensive and competitive mix of pay and benefits - investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include: + **Affordable medical plan options,** a **401(k) plan** (including matching company contributions), and an **employee stock purchase plan** . + **No-cost programs for all colleagues** including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching. + **Benefit solutions that address the different needs and preferences of our colleagues** including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility. For more information, visit ***************************************** We anticipate the application window for this opening will close on: 01/24/2026 Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws. We are an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex/gender, sexual orientation, gender identity or expression, religion, age, disability, protected veteran status, or any other characteristic protected by applicable federal, state, or local law.

Under limited supervision, the Business Systems Analyst Senior provides strategic business analysis services to the business partners. This position works closely with the business to gain a comprehensive understanding of the business strategy, operational roadmap, processes, and services. **Duties/Responsibilties:** -Partner with business and IT leadership to align EDI capabilities with organizational strategy, growth initiatives, and operational priorities -Translate business objectives into scalable EDI solutions that support automation, efficiency, and cost reduction -Monitor daily EDI transaction flows to ensure successful transmission, receipt, and processing of documents (850,855,856,810) -Identify, analyze, and resolve EDI errors, rejections, and data discrepancies in a timely manner -Onboard, test, and maintain EDI connections with external trading partners, vendors, distributors, and customers -Act as a primary point of contact for EDI related partner issues/changes -Validate data accuracy between EDI, ERP, and downstream systems -Participate in system enhancements, migrations, and version upgrades -Define and track KPIs related to EDI performance, reliability, and business impact **Minimum Qualifications:** + Education: Bachelors degree or experience in lieu of degree + Experience: 5 years relevant experience + Licenses/Certifications: None **What's in it for you** At St. Luke's, caring for people in the communities we serve is our mission - and this includes our own SLHS team. We offer a robust benefits package to support our teams both professionally and personally. In addition to a competitive salary and retirement plans, we ensure our team feels supported in their benefits beyond the typical medical, dental, and vision offerings. We care about you and have fantastic financial and physical wellness options, such as: on-site massages, on-site counseling via our Employee Assistance Program, access to the Personify Health Wellness tool, as well as other formal training and career development offerings to ensure you are meeting your career goals. St. Luke's is an equal opportunity employer and does not discriminate against any person on the basis of race, religion, color, gender, gender identity, sexual orientation, age, national origin, disability, veteran status, or any other status or condition protected by law. *Please note: this posting is not reflective of all job duties and responsibilities and is intended to provide an overview to job seekers. **Default: Location : City** _Meridian_ **Category** _Supply Chain_ **Work Unit** _Supply Chain Management System Office_ **Position Type** _Full-Time_ **Work Schedule** _DAY_ **Requisition ID** _2025-107365_ **Default: Location : Location** _US-ID-Meridian_ **Work Location : Name** _3330 E Louise Dr 5th Floor, Meridian, Portico North Building_

**JOB DESCRIPTION** **Job Summary** Designs and implements processes and solutions associated with a wide variety of data sets used for data/text mining, analysis, modeling, and predicting to enable informed business decisions. Gains insight into key business problems and deliverables by applying statistical analysis techniques to examine structured and unstructured data from multiple disparate sources. Collaborates across departments and with customers to define requirements and understand business problems. Uses advanced mathematical, statistical, querying, and reporting methods to develop solutions. Develops information tools, algorithms, dashboards, and queries to monitor and improve business performance. Creates solutions from initial concept to fully tested production, and communicates results to a broad range of audiences. Effectively uses current and emerging technologies. **KNOWLEDGE/SKILLS/ABILITIES** + Extracts and compiles various sources of information and large data sets from various systems to identify and analyze outliers. + Sets up process for monitoring, tracking, and trending department data. + Prepares any state mandated reports and analysis. + Works with internal, external and enterprise clients as needed to research, develop, and document new standard reports or processes. + Implements and uses the analytics software and systems to support the departments goals. **JOB QUALIFICATIONS** **Required Education** Associate's Degree or equivalent combination of education and experience **Required Experience** 1-3 years **Preferred Education** Bachelor's Degree or equivalent combination of education and experience **Preferred Experience** 3-5 years 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: $80,168 - $116,835 / ANNUAL *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

Our client, a leading organization in the technology and data solutions sector, is seeking a Sr Business Analyst to join their team. As a Sr Business Analyst, you will be part of the Business Analysis and Data Support teams supporting enterprise initiatives. The ideal candidate will have strong communication skills, proactive problem-solving abilities, and a collaborative mindset, which will align successfully in the organization. **Job Title:** Sr Business Analyst **Location:** Remote (U.S.-based/onshore required) **What's the Job?** + Drive requirements gathering, backlog readiness, and stakeholder alignment for agile delivery teams + Write clear, high-quality user stories and tasks to support project delivery + Partner with Product Managers and Project Managers to ensure timely delivery of prioritized work + Support discovery sessions, UAT activities, and collaborate on data analytics initiatives + Lead requirement and refinement sessions, facilitating effective communication across teams **What's Needed?** + 5+ years of experience as a Business Analyst, preferably in agile environments + Proficiency with agile tools such as Azure DevOps, Jira, or similar platforms + Experience supporting data analytics structures and methodologies + Excellent organizational, communication, and stakeholder management skills + Ability to work independently in a remote setting and be available for occasional travel to Kennewick, WA **What's in it for me?** + Opportunity to work remotely with a dynamic and innovative team + Engagement in enterprise and data-focused initiatives that make a meaningful impact + Potential for contract extensions based on performance and project needs + Collaborative environment that values diverse perspectives and continuous learning + Supportive leadership committed to your professional growth **Upon completion of waiting period consultants are eligible for:** + Medical and Prescription Drug Plans + Dental Plan + Vision Plan + Health Savings Account + Health Flexible Spending Account + Dependent Care Flexible Spending Account + Supplemental Life Insurance + Short Term and Long Term Disability Insurance + Business Travel Insurance + 401(k), Plus Match + Weekly Pay If this is a role that interests you and you'd like to learn more, click apply now and a recruiter will be in touch with you to discuss this great opportunity. We look forward to speaking with you! **About ManpowerGroup, Parent Company of: Manpower, Experis, Talent Solutions, and Jefferson Wells.** _ManpowerGroup (NYSE: MAN), the leading global workforce solutions company, helps organizations transform in a fast-changing world of work by sourcing, assessing, developing, and managing the talent that enables them to win. We develop innovative solutions for hundreds of thousands of organizations every year, providing them with skilled talent while finding meaningful, sustainable employment for millions of people across a wide range of industries and skills. Our expert family of brands -_ **_Manpower, Experis, Talent Solutions, and Jefferson Wells_** _-_ creates substantial value for candidates and clients across more than 75 countries and territories and has done so for over 70 years. We are recognized consistently for our diversity - as a best place to work for Women, Inclusion, Equality and Disability and in 2023 ManpowerGroup was named one of the World's Most Ethical Companies for the 14th year - all confirming our position as the brand of choice for in-demand talent. ManpowerGroup is committed to providing equal employment opportunities in a professional, high quality work environment. It is the policy of ManpowerGroup and all of its subsidiaries to recruit, train, promote, transfer, pay and take all employment actions without regard to an employee's race, color, national origin, ancestry, sex, sexual orientation, gender identity, genetic information, religion, age, disability, protected veteran status, or any other basis protected by applicable law.

Under limited supervision, the Business Systems Analyst Senior provides strategic business analysis services to the business partners. This position works closely with the business to gain a comprehensive understanding of the business strategy, operational roadmap, processes, and services. Duties/Responsibilties: -Partner with business and IT leadership to align EDI capabilities with organizational strategy, growth initiatives, and operational priorities -Translate business objectives into scalable EDI solutions that support automation, efficiency, and cost reduction -Monitor daily EDI transaction flows to ensure successful transmission, receipt, and processing of documents (850,855,856,810) -Identify, analyze, and resolve EDI errors, rejections, and data discrepancies in a timely manner -Onboard, test, and maintain EDI connections with external trading partners, vendors, distributors, and customers -Act as a primary point of contact for EDI related partner issues/changes -Validate data accuracy between EDI, ERP, and downstream systems -Participate in system enhancements, migrations, and version upgrades -Define and track KPIs related to EDI performance, reliability, and business impact Minimum Qualifications: Education: Bachelors degree or experience in lieu of degree Experience: 5 years relevant experience Licenses/Certifications: None What's in it for you At St. Luke's, caring for people in the communities we serve is our mission - and this includes our own SLHS team. We offer a robust benefits package to support our teams both professionally and personally. In addition to a competitive salary and retirement plans, we ensure our team feels supported in their benefits beyond the typical medical, dental, and vision offerings. We care about you and have fantastic financial and physical wellness options, such as: on-site massages, on-site counseling via our Employee Assistance Program, access to the Personify Health Wellness tool, as well as other formal training and career development offerings to ensure you are meeting your career goals. St. Luke's is an equal opportunity employer and does not discriminate against any person on the basis of race, religion, color, gender, gender identity, sexual orientation, age, national origin, disability, veteran status, or any other status or condition protected by law. *Please note: this posting is not reflective of all job duties and responsibilities and is intended to provide an overview to job seekers.

At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues - caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day. **Position Summary** As part of the Epic team, you will be expected to be proficient in all critical functions of the application development and will champion methodologies with a deep understanding of best practices to ensure that quality standards are met. We believe for success you should have flexibility, possess a positive outlook, discernment, and inspire change within a fast-growing environment. This team directly impacts the lives of our healthcare delivery patients by creating systems that allow for efficient, quality, and safe healthcare delivery. You can work knowing you are helping many people each day. As a Sr. Software Development Engineer, your tasks will include, but are not limited to: - Build and maintenance of Epic environments - Lead Discovery calls and provide Level of Effort - Facilitate design sessions with business leaders and analysts - Create and fulfill EHR use cases, identify business and functional requirements and working closely with IT resources to translate requirements and workflows to technical specifications - Lead documentation efforts for discovery and implementation - Ensure requirements and future state workflows are clearly defined - Work with Project Managers to identify tasks and associated estimates. -Support execution of vendor upgrades, system changes and environment maintenance procedures. This role requires you to work with matrix style teams including providers, project managers, technical resources, Subject Matter Experts (SME), business stakeholders, and vendor representatives to document the business and functional requirements, system specifications, and testing attributes & results. This will result in you to also - Participate in the analysis of current state processes and collaborate with clinical business and reporting users to create future state processes - Identify and document process and data gap You will also participate in the creation and completion of project related deliverables including: − Use Cases − Business requirements − Technical specifications − Scope documents − Gap analysis − Impact assessment To be successful you should have: - Strong experience configuring, designing, and supporting an Epic solution - Previous application configuration experience - Knowledge of Cadence/Prelude workflows - Experience in test planning & execution, test case development, and meeting project quality requirements - Experience working on large projects Strong knowledge of clinical applications and understanding of the healthcare IT industry - Understanding of configurable applications and monitoring practices - Analytical, problem resolution and interpersonal skills - Ability to bridge communication among technical and nontechnical project staff and customers **Required Qualifications** + **Experience** : Minimum of five (5) years of related experience is required. + **Certification(s):** Two or more of the following Epic Certifications: + Prelude, Cadence, RTE, Referrals, MyChart, Rover, Haiku, EpicCare Link, **Anticipated Weekly Hours** 40 **Time Type** Full time **Pay Range** The typical pay range for this role is: $83,430.00 - $222,480.00 This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong. **Great benefits for great people** We take pride in our comprehensive and competitive mix of pay and benefits - investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include: + **Affordable medical plan options,** a **401(k) plan** (including matching company contributions), and an **employee stock purchase plan** . + **No-cost programs for all colleagues** including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching. + **Benefit solutions that address the different needs and preferences of our colleagues** including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility. For more information, visit ***************************************** We anticipate the application window for this opening will close on: 02/23/2026 Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws. We are an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex/gender, sexual orientation, gender identity or expression, religion, age, disability, protected veteran status, or any other characteristic protected by applicable federal, state, or local law.

**JOB DESCRIPTION** **Job Summary** Designs and implements processes and solutions associated with a wide variety of data sets used for data/text mining, analysis, modeling, and predicting to enable informed business decisions. Gains insight into key business problems and deliverables by applying statistical analysis techniques to examine structured and unstructured data from multiple disparate sources. Collaborates across departments and with customers to define requirements and understand business problems. Uses advanced mathematical, statistical, querying, and reporting methods to develop solutions. Develops information tools, algorithms, dashboards, and queries to monitor and improve business performance. Creates solutions from initial concept to fully tested production, and communicates results to a broad range of audiences. Effectively uses current and emerging technologies. **KNOWLEDGE/SKILLS/ABILITIES** + Extracts and compiles various sources of information and large data sets from various systems to identify and analyze outliers. + Sets up process for monitoring, tracking, and trending department data. + Prepares any state mandated reports and analysis. + Works with internal, external and enterprise clients as needed to research, develop, and document new standard reports or processes. + Implements and uses the analytics software and systems to support the departments goals. **JOB QUALIFICATIONS** **Required Education** Associate's Degree or equivalent combination of education and experience **Required Experience** 1-3 years **Preferred Education** Bachelor's Degree or equivalent combination of education and experience **Preferred Experience** 3-5 years 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: $80,168 - $116,835 / ANNUAL *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues - caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day. **A Brief Overview** Controls all aspects of customer benefits plan implementation. Communicates with stakeholders internally and externally to proactively identify and address critical implementation issues ensuring customer expectations are consistently satisfied or exceeded. **Job description** + Responsible for directing all aspects of customer benefit plan implementation. + Partners with all key stakeholders (i.e., sales/service staff, consultants, plan sponsors, and other internal business units) to proactively identify and address critical implementation issues ensuring customer expectations are consistently satisfied or exceeded. + Leads process improvement efforts to promote on-going enhancements to program installation. + Mediates and coordinates resolution of all project deliverables and implementation related issues. + Develops and executes implementation strategy consistent with customer expectations; + Ensures strategy is administered in accordance with all performance guarantee arrangements. + Effectively manages implementation team dynamics and provides direction/coaching to fellow team members ensuring success of the overall implementation process; + Collaborates on review, analysis and development of recommendations for the design of complex account and benefit structures based on customers' objectives and Aetna's systems, administration and reporting requirements. + Solicits and assesses internal and external customer feedback to enhance continuous quality improvement on the implementation process (i.e., systems, resources, tools, etc.). + Identifies gaps and recommends enhancements related to new and/or existing products, services and workflows based on a broad view of the organization; + Provides consultative support to customers to identify administrative and operational efficiencies resulting in potential financial savings for both Aetna and clients. + Leads critical initiatives that contribute to the development of new or updated implementation tools, resources and materials. + Participates in the development and introduction of new products, and identifies the potential impact to workflows and the overall implementation process; + May be responsible for defining, developing and implementing new or redesigned process workflows in support of new products. + Furnishes essential feedback on the effect new products lend to the implementation process. + May assist with the selection of implementation staff and the development of training activities; Mentors and coaches new/junior staff members. **Required Qualifications** + 5 years in depth knowledge of healthcare industry experience + Project management and leadership experience. + Experience preparing and delivering presentations. + Experience interacting with various levels of the organization to effectively influence others and achieve optimal results. + Proficient in Microsoft (pivot tools, excel, PP presentations). **Preferred Qualifications** + 7 years of in depth knowledge of healthcare, PBM, Account Management + Medicare experience + Knowledge of Claims and Benefits Testing/Processing + Automation, AI tools **Anticipated Weekly Hours** 40 **Time Type** Full time **Pay Range** The typical pay range for this role is: $46,988.00 - $122,400.00 This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong. **Great benefits for great people** We take pride in our comprehensive and competitive mix of pay and benefits - investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include: + **Affordable medical plan options,** a **401(k) plan** (including matching company contributions), and an **employee stock purchase plan** . + **No-cost programs for all colleagues** including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching. + **Benefit solutions that address the different needs and preferences of our colleagues** including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility. For more information, visit ***************************************** We anticipate the application window for this opening will close on: 02/24/2026 Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws. We are an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex/gender, sexual orientation, gender identity or expression, religion, age, disability, protected veteran status, or any other characteristic protected by applicable federal, state, or local law.

JOB DESCRIPTIONJob Summary Designs and implements processes and solutions associated with a wide variety of data sets used for data/text mining, analysis, modeling, and predicting to enable informed business decisions. Gains insight into key business problems and deliverables by applying statistical analysis techniques to examine structured and unstructured data from multiple disparate sources. Collaborates across departments and with customers to define requirements and understand business problems. Uses advanced mathematical, statistical, querying, and reporting methods to develop solutions. Develops information tools, algorithms, dashboards, and queries to monitor and improve business performance. Creates solutions from initial concept to fully tested production, and communicates results to a broad range of audiences. Effectively uses current and emerging technologies. KNOWLEDGE/SKILLS/ABILITIES * Extracts and compiles various sources of information and large data sets from various systems to identify and analyze outliers. * Sets up process for monitoring, tracking, and trending department data. * Prepares any state mandated reports and analysis. * Works with internal, external and enterprise clients as needed to research, develop, and document new standard reports or processes. * Implements and uses the analytics software and systems to support the departments goals. JOB QUALIFICATIONS Required Education Associate's Degree or equivalent combination of education and experience Required Experience 1-3 years Preferred Education Bachelor's Degree or equivalent combination of education and experience Preferred Experience 3-5 years 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: $80,168 - $116,835 / 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 DESCRIPTION** **Job Summary** Designs and implements processes and solutions associated with a wide variety of data sets used for data/text mining, analysis, modeling, and predicting to enable informed business decisions. Gains insight into key business problems and deliverables by applying statistical analysis techniques to examine structured and unstructured data from multiple disparate sources. Collaborates across departments and with customers to define requirements and understand business problems. Uses advanced mathematical, statistical, querying, and reporting methods to develop solutions. Develops information tools, algorithms, dashboards, and queries to monitor and improve business performance. Creates solutions from initial concept to fully tested production, and communicates results to a broad range of audiences. Effectively uses current and emerging technologies. **KNOWLEDGE/SKILLS/ABILITIES** + Extracts and compiles various sources of information and large data sets from various systems to identify and analyze outliers. + Sets up process for monitoring, tracking, and trending department data. + Prepares any state mandated reports and analysis. + Works with internal, external and enterprise clients as needed to research, develop, and document new standard reports or processes. + Implements and uses the analytics software and systems to support the departments goals. **JOB QUALIFICATIONS** **Required Education** Associate's Degree or equivalent combination of education and experience **Required Experience** 1-3 years **Preferred Education** Bachelor's Degree or equivalent combination of education and experience **Preferred Experience** 3-5 years 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: $80,168 - $116,835 / ANNUAL *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

Provides senior level support for accurate and timely intake and interpretation of regulatory and/or functional requirements related to but not limited to coverage, reimbursement, and processing functions to support systems solutions development and maintenance. This role includes coordination with stakeholders and subject matter experts on partnering teams and supporting governance committees where applicable. JOB DUTIES * 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. KNOWLEDGE/SKILLS/ABILITIES * Maintains relationships with Health Plans/Product Team and Corporate Operations to ensure all end-to-end business requirements have been documented and interpretation are agreed on and clear for solutioning. * Ability to meet aggressive timelines and balance multiple lines of business, states, and requirement areas. * Strong interpersonal and (oral and written) communication skills and ability to communicate with those in all positions of the company. * Ability to concisely synthesize large and complex requirements. * Ability to organize and maintain regulatory data including real-time policy changes. * Self-motivated and ability to take initiative, identify, communicate, and resolve potential problems. * Ability to work independently in a remote environment. * Ability to work with those in other time zones than your own. JOB QUALIFICATIONS Required Qualifications * 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 Qualifications * 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. To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V. Pay Range: $80,168 - $128,519 / 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.

Provides senior level support for accurate and timely intake and interpretation of regulatory and/or functional requirements related to but not limited to coverage, reimbursement, and processing functions to support systems solutions development and maintenance. This role includes coordination with stakeholders and subject matter experts on partnering teams and supporting governance committees where applicable. **JOB DUTIES** + 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. **KNOWLEDGE/SKILLS/ABILITIES** + Maintains relationships with Health Plans/Product Team and Corporate Operations to ensure all end-to-end business requirements have been documented and interpretation are agreed on and clear for solutioning. + Ability to meet aggressive timelines and balance multiple lines of business, states, and requirement areas. + Strong interpersonal and (oral and written) communication skills and ability to communicate with those in all positions of the company. + Ability to concisely synthesize large and complex requirements. + Ability to organize and maintain regulatory data including real-time policy changes. + Self-motivated and ability to take initiative, identify, communicate, and resolve potential problems. + Ability to work independently in a remote environment. + Ability to work with those in other time zones than your own. **JOB QUALIFICATIONS** **Required Qualifications** + 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 Qualifications** + 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. To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V. Pay Range: $80,168 - $128,519 / ANNUAL *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

Provides senior level support for accurate and timely intake and interpretation of regulatory and/or functional requirements related to but not limited to coverage, reimbursement, and processing functions to support systems solutions development and maintenance. This role includes coordination with stakeholders and subject matter experts on partnering teams and supporting governance committees where applicable. JOB DUTIES * 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. Recoveries & Disputes * Review and validate provider complaints and payment disputes, ensuring accurate and timely resolution in line with policy and contractual guidelines. * Partner with provider relations, Health plans and appeals teams to address recurring dispute trends and recommend systemic solutions. * Evaluate root cause for the disputes and recommend improvements to reduce claim errors and prevent improper payments. * Provide actionable insights and recommendations to leadership to drive continuous improvement. Skills & Competencies * Proven experience handling provider disputes, appeals, and overpayment recoveries in a managed care or payer environment. * In-depth knowledge of medical and hospital claims processing, including CPT/HCPCS, ICD, and modifier usage. * Strong understanding of claim system configurations, payment policies, and audit processes. * Exceptional analytical, problem-solving, and documentation skills. * Ability to translate complex business problems into clear system requirements and process improvements. * Proficiency in Excel * Knowledge in QNXT preferred * Strong communication and stakeholder management skills with ability to influence across teams. KNOWLEDGE/SKILLS/ABILITIES * Maintains relationships with Health Plans/Product Team and Corporate Operations to ensure all end-to-end business requirements have been documented and interpretation are agreed on and clear for solutioning. * Ability to meet aggressive timelines and balance multiple lines of business, states, and requirement areas. * Strong interpersonal and (oral and written) communication skills and ability to communicate with those in all positions of the company. * Ability to concisely synthesize large and complex requirements. * Ability to organize and maintain regulatory data including real-time policy changes. * Self-motivated and ability to take initiative, identify, communicate, and resolve potential problems. * Ability to work independently in a remote environment. * Ability to work with those in other time zones than your own. JOB QUALIFICATIONS Required Qualifications * 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 Qualifications * 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. To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V. Pay Range: $80,168 - $128,519 / 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.

Provides senior level support for accurate and timely intake and interpretation of regulatory and/or functional requirements related to but not limited to coverage, reimbursement, and processing functions to support systems solutions development and maintenance. This role includes coordination with stakeholders and subject matter experts on partnering teams and supporting governance committees where applicable. **JOB DUTIES** + 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. **Recoveries & Disputes** + Review and validate provider complaints and payment disputes, ensuring accurate and timely resolution in line with policy and contractual guidelines. + Partner with provider relations, Health plans and appeals teams to address recurring dispute trends and recommend systemic solutions. + Evaluate root cause for the disputes and recommend improvements to reduce claim errors and prevent improper payments. + Provide actionable insights and recommendations to leadership to drive continuous improvement. **Skills & Competencies** + Proven experience handling provider disputes, appeals, and overpayment recoveries in a managed care or payer environment. + In-depth knowledge of medical and hospital claims processing, including CPT/HCPCS, ICD, and modifier usage. + Strong understanding of claim system configurations, payment policies, and audit processes. + Exceptional analytical, problem-solving, and documentation skills. + Ability to translate complex business problems into clear system requirements and process improvements. + Proficiency in Excel + Knowledge in QNXT preferred + Strong communication and stakeholder management skills with ability to influence across teams. **KNOWLEDGE/SKILLS/ABILITIES** + Maintains relationships with Health Plans/Product Team and Corporate Operations to ensure all end-to-end business requirements have been documented and interpretation are agreed on and clear for solutioning. + Ability to meet aggressive timelines and balance multiple lines of business, states, and requirement areas. + Strong interpersonal and (oral and written) communication skills and ability to communicate with those in all positions of the company. + Ability to concisely synthesize large and complex requirements. + Ability to organize and maintain regulatory data including real-time policy changes. + Self-motivated and ability to take initiative, identify, communicate, and resolve potential problems. + Ability to work independently in a remote environment. + Ability to work with those in other time zones than your own. **JOB QUALIFICATIONS** **Required Qualifications** + 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 Qualifications** + 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. To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V. Pay Range: $80,168 - $128,519 / ANNUAL *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.