Molina Healthcare Sr IRIS Ops Specialist (Must live in Wisconsin) (Fully Remote role) (No Weekends, No Holidays, No After Hours) in United States

Financial Eligibility Specialist role

Preferred Experience:

Income Maintenance/Economic Support units

The CARES System,

Forward Health, and strong knowledge of different types of Medicaid.

Job Description

Job Summary

The Sr IRIS Operations Specialist is responsible for leading and executing activities and initiatives to support IRIS program operations and field staff in the areas of referrals, enrollments, disenrollments, workload assignments, ongoing eligibility, service authorization, and other requirements of Wisconsin’s IRIS program. The position requires independent problem solving; strategic thinking and initiative; and the ability to use data to monitor contract compliance, coordination across functions, and technical competencies.

Knowledge/Skills/Abilities
• Provides skilled supports to Operations and field staff in completing data entry and tracking within WISITS, SharePoint, and Power BI.
• Responds to incoming email requests from coworkers, providers, and partner agencies.
• Manages phone queues and assists with outgoing and incoming calls.
• Analyzes data and workflow, offers suggestions for improvement and/or changes to management, and assists with the implementation of changes.
• Maintains primary responsibility, as assigned, for functions such as caseload assignments, financial eligibility support, program eligibility support, enrollment and disenrollment activities, timely welcome calls, prior authorizations, individualized service plan activities, and consultation, training, and support to field staff.
• Manages projects and engages in problem solving and overall process development and implementation within identified areas of primary responsibility and subject matter expertise.
• Ensures assigned areas of primary responsibility operate at high levels of efficiency and in accordance with IRIS program requirements.
• Serves as a liaison to other IRIS partners or providers as needed.
• Establishes and maintains positive and effective work relationships with coworkers, clients, members, providers, and customers.
• Completes other duties as assigned.
• Strong customer service skills
• Excellent written and verbal communication skills
• Excellent organizational, prioritization, and time management skills
• Strong analytical and problem-solving skills
• Ability to adhere to HIPAA rules and maintain strictest confidentiality
• Ability to focus on multiple priorities simultaneously
• Ability to be resourceful, proactive, and detail-oriented, and learn and incorporate new tasks quickly
• Ability to work both collaboratively and independently
• Ability to analyze data, draw appropriate conclusions and recommend solutions
• Ability to seek out opportunities to learn and grow—embrace challenges and learn from them
• Flexibility in the work environment and willingness and ability to adapt to changing organizational needs
• Demonstrated computer and software skills required; proficiency with Microsoft Office Suite and other software; database operation/maintenance skills and data entry experience

Job Qualifications

Required Education:
• Bachelor’s degree in a related field or commensurate experience

Required Experience:
• Two or more years of previous applicable experience

Required Licensure or Certification:

Must possess a valid driver’s license, maintain adequate auto insurance for job-related travel, and ability to travel within Wisconsin and other states as necessary

PHYSICAL DEMANDS:

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: $18.04 – $35.17 / HOURLY
• Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

Apply Job!