Teams at Molina Healthcare Inc.

Own and prioritize the HEDIS Engine and clinical data ingestion products end-to-end. Define product vision, maintain backlog, write user stories, lead Agile ceremonies, accept delivered work, ensure regulatory/compliance alignment, mitigate delivery risks, and collaborate with engineering, data, QA, operations, and health plan stakeholders.

Entry-level analyst responsible for accurate loading, updating, and auditing of provider demographic and contract data across claims systems and provider databases to ensure correct claims processing, reporting, and directories.

Review, research, and resolve member and provider appeals, grievances, and claims denials in accordance with CMS, state, and Molina guidelines; communicate outcomes, prepare correspondence and summaries, request and review medical records, and identify root causes of payment errors.