- Molina Healthcare (Macon, GA)
- …laws and regulations pertaining to the Health Care environment **Job Duties** The Operational / Regulatory Oversight Sr. Analyst works with health plans and ... **Job Description** **Job Summary** Establish a specifically designed Operational Regulatory Oversight program that effectively...ensure adherence to and compliance with State and Federal regulatory guidelines. The Sr. Analyst develops and… more
- Molina Healthcare (Macon, GA)
- **JOB DESCRIPTION** **JOB DESCRIPTION** **Job Summary** The ** Senior Analyst , Utilization Management** plays a critical role in supporting clinical and ... operational initiatives by translating healthcare business needs into technical...care models, or healthcare performance metrics + Understanding of regulatory and compliance considerations (eg, HIPAA) in data handling… more
- Molina Healthcare (Macon, GA)
- **Job Description** **Job Summary** The Sr Analyst , Encounters is responsible for monitoring inbound and outbound encounter processes and ensuring timely, accurate, ... causes of issues that impact encounters and identify improvements to operational performance. **Job Duties** + Monitors inbound and outbound encounters submissions… more
- Molina Healthcare (Macon, GA)
- …and technical issues. Ensures system configuration aligns with business rules, regulatory requirements, and operational needs. Supports upgrades, releases, and ... health plan implementations while validating data integrity and recommending improvements to enhance system efficiency and quality. **KNOWLEDGE/SKILLS/ABILITIES** + Serves as a subject matter expert (SME) on QNXT system capabilities, leveraging system… more