• Play a critical role in supporting, enhancing, and optimising our Workday HCM landscape. • Work across Core HCM modules and Integrations, partner closely with People Team, Payroll and IT stakeholders. • Ensure our Workday environment remains accurate, compliant, and scalable. • Translate business needs into robust Workday solutions while driving a seamless and intuitive user experience. • Maintain and troubleshoot existing Workday integrations, ensuring accuracy, stability, and timely issue resolution. • Support the design, testing, and deployment of new integrations. • Lead the design, configuration, and maintenance of Core HCM foundation elements. • Build and optimize complex Business Processes (BPs). • Serve as the primary owner for Tier 1 and Tier 2 support tickets. • Manage mass data updates in Workday via EIBs. • Conduct regular system health checks, audits, and root-cause analysis. • Act as the primary administrator and subject matter expert for the Workday Absence module. • Manage absence plans and configurations.

Role Description Provides lead level analyst support for health plan payment integrity activities. Partners with leaders and functional representatives to drive health plan financial performance through evaluation and execution of operational initiatives tied to payment integrity (PI) and provider claims accuracy. Makes recommendations that inform decisions which contribute to health plan strategy, and acts as a trusted voice in assessing and assisting resolution of complex business challenges that impact cost-containment and regulatory compliance. Qualifications - At least 4 years of business analyst experience in a managed care organization (MCO), and at least 2 years of experience in Medicaid and/or Medicare programs, or equivalent combination of relevant education and experience. - Proven experience owning operational projects from concept to execution, especially in the areas of provider reimbursement and claims payment integrity. - Strong working knowledge of managed care claims coding (Current Procedural Terminology (CPT), International Classification of Diseases (ICD), Healthcare Common Procedure Coding System (HCPCS), Revenue Codes), and federal/state Medicaid payment rules. - Strong data analysis/queries experience, and ability to analyze data to inform business decisions. - Strong business judgment, cross-functional coordination, and ownership of high-value deliverables. - Demonstrated ability to work independently and apply business judgment in a highly regulated, cross-functional environment. - Strong written and verbal communication skills, including ability to synthesize complex information. - Microsoft Office suite (including advanced Excel), and applicable software program(s) proficiency. - Claims processing background. - Experience with Medicare, Medicaid, and/or Marketplace lines of business. - Payment integrity (PI) programs. Requirements - Assists with and executes projects and tasks to ensure Centers for Medicare and Medicaid Services (CMS) and state regulatory requirements are met for pre-pay edits, post-payment datamining, and overpayment recovery. - Manages scorable action items (SAIs) related to pre-pay editing, post-pay audit, and overpayment recovery initiatives. - Leads efforts to improve claim payment accuracy and financial performance without needing extensive oversight. - Collaborates with operational teams, enterprise stakeholders, and finance partners to proactively identify issues and implement resolution strategies. - Serves as a thought partner to health plan leadership and provides well-reasoned recommendations that support short- and long-term business goals. - Partners with the network team to communicate recovery projects to ensure provider relations is informed and able to respond to provider inquiries. - Analyzes data to identify and develop new recovery opportunities. - Conducts peer reviews of recovery concepts and offers recommendations for logical improvements. - Responsible for documenting policies and procedures related to concept approvals. - Conducts trainings and prepares training documentation for teams. Benefits - Molina Healthcare offers a competitive benefits and compensation package. - Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

Role Description The Provider Management Analyst is responsible for verifying provider information and requests for documentation to audit claims including but not limited to itemized bills, medical records, UB04’s, HCFA’s, etc. Responsibilities include verifying patient information, provider contact information, and client information for accuracy to ensure proper delivery of requests. - Communicate with respective leadership on any issues or problems identified - Maintain production standards, production requirements, and quality of work - Assist coworkers, supervisor, or management to accomplish product goals; report potential issues in a proactive manner - Timely forward misdirected requests to the correct recipient - Ensure strict confidentiality of all medical records, PHI, and PII - Outbound calling may be needed - Additional duties as assigned Qualifications - Ability to work independently - Strong organization skills - Strong analytical and problem-solving skills - Excellent attention to detail - Ability to deliver results in a timely manner - MS Office including Word, Excel, and Outlook; Windows operating system - Outbound call experience Requirements - High School Diploma or equivalent required - Demonstrated knowledge of office experience Benefits - Medical (HDHP) w/Pharmacy - Dental - Vision - Long Term Disability - Health Savings Account - Flexible Spending Account Options - Life Insurance - Accident Insurance - Critical Illness Insurance - Pre-paid Legal Insurance - Parking and Transit FSA accounts - 401K - ROTH 401K - Paid time off Company Description CERIS, a division of CorVel Corporation, a certified Great Place to Work® Company, offers incremental value, experience, and a sincere dedication to our valued partners. Through our clinical expertise and cost containment solutions, we are committed to accuracy and transparency in healthcare payments. We are a stable and growing company with a strong, supportive culture along with plenty of career advancement opportunities. We embrace our core values of Accountability, Commitment, Excellence, Integrity and Teamwork (ACE-IT!).

• Team Support: Training, coaching, fleet maintenance, dispatch, and routing to maintain high performance and morale. • Operational Oversight: Managing daily line haul routing, backhaul/DBM daily route completion, Vehicle PM’s. • Inventory Management: Overseeing Fleet rental usage and utilization accuracy. • Logistics Coordination: Organizing, scheduling, and tracking carrier shipments, including optimizing routes and transit times. • Efficiency Improvement: Using data and analytics (TMS,/Jalapeno systems) to identify bottlenecks, improve productivity, and manage workflows. • Ensure that every team member complies with all DOT, OSHA and Misfits Market safety standards - at all times. • Monitor and assess team performance against established KPIs. Implement strategies to improve productivity, efficiency, and overall operational excellence. • Complete all assigned trainings and inspections with your team to ensure a safe working environment. Maintain excellent record-keeping to meet all regulatory standards. • Optimize the allocation of resources, including workloads and equipment, to meet operational demands efficiently. Collaborate with other departments to ensure smooth workflows. • Lead and mentor front-line delivery staff to foster a culture of continuous improvement, accountability, safety, and teamwork. Provide coaching and support to enhance individual and team performance. • Supports the overall distribution volume, which may include helping other drivers complete their routes or working overtime as needed. • Ensure that team members are equipped with the necessary skills for success. Identify training needs within the team and coordinate with our HR and Learning teams to implement training programs.