Long Beach, CA, 90806, USA
19 days ago
Process Consultant - QNXT SME
**Job Summary** Leads business process improvement initiatives that result in operational efficiencies and/or an increase in customer satisfaction. Assists in development of MHI's business process improvement methodology and in the implementation of a business process improvement capability. **Knowledge/Skills/Abilities** • Facilitates groups for problem solving and service improvement including definition/documentation, business workflow analysis. • Requires high level understanding of the organization’s business and industry requirements. • Knowledgeable of State Medicaid contract Service Level Agreements. Demonstrates SME knowledge of MCO contract compliance requirements that impact processes. • Works with the business and project development teams to assess and recommend the appropriate configuration design, solutions, and methodology for new and existing business. • Focus is on process analysis and re-engineering, with an understanding of technical problems and solutions as they relate to the current and future business environment. • Creates process change by integrating new processes with existing ones and communicating these changes to impacted business teams. • Recommends and facilitates process improvement efforts. May lead re-engineering team and act as project manager in some cases. • Demonstrates use of tools, techniques and communications soft skills to build and maintain effective business relationships. • Understanding of complex payment methodologies, configuration solutions, health care benefits. • Advanced knowledge of healthcare claims and claim processing from receipt through encounter submission. • Advanced knowledge of Excel and SQL knowledge preferred • Knowledge of configuration in QNXT strongly preferred **Job Qualifications** **Required Education** Bachelor's degree required in a related field (Business Administration, Healthcare, Engineering, etc.) or 5 years of related field or equivalent experience **Required Experience** • 5 years of process improvement experience **Required License, Certification, Association** LEAN certification and/or Lean Six Sigma Green Belt **Preferred Experience** • Project management • 2 years of process improvement experience with demonstrable successes in application of Lean/Six-Sigma **Preferred License, Certification, Association** Lean Six Sigma Black Belt To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V. Pay Range: $77,969 - $155,508 / ANNUAL *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
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