Role Description The Case Analyst supports expert-led projects by managing case workflows, coordinating resources, and maintaining accurate documentation throughout the case lifecycle. This role ensures smooth operations from case intake through case completion and serves as a key liaison between internal teams, external partners, and clients. In This Role, You Will: - Assist experts in maintaining project workflow from case intake to completion by: - Determining case eligibility and project scope - Planning for case needs - Creating and monitoring project schedules to manage deadlines - Coordinating and monitoring the receipt of records - Coordinating and monitoring the provision of services - Initiating records requests and searches - Disseminating information between the experts and the clients - Tracking case progress - Maintain project records by documenting events and completion status - Work with experts to handle project issues as they arise - Interact with parties inside and outside the organization - Provide case status and case information in response to requests verbally and in writing - Improve workflow by analyzing outcomes; monitoring variances; identifying trends; recommending actions to management - Enhance the organization's reputation by providing high quality services to clients - Perform additional duties as assigned Qualifications - 2+ years of experience in a professional work environment - High school diploma or equivalent required; some college coursework or an associate degree preferred - Strong organizational and time management skills with the ability to manage multiple tasks and deadlines - Excellent verbal and written communication skills - Proficiency in Microsoft Office and administrative documentation systems - Self-motivated with attention to detail and accuracy Benefits - Employee-focused culture - Strong commitment to work-life balance - Remote work - Flexible vacation & Paid holidays - Paid family care/sick leave - Parental leave - Medical, Dental, Vision + more - 401k w/match - Career growth - Competitive salaries Disclosures As part of our recruitment process, we may use AI-assisted tools to support candidate screening and evaluation. These tools are designed to assist—rather than replace—human decision-making, and all employment decisions are made by our recruiting team in accordance with applicable laws and our commitment to equal employment opportunity. Where required by law, we will provide additional information about the use of these tools, including their purpose, and offer alternative processes or accommodations upon request.

• The Testing & Validation Analyst II is responsible for ensuring the quality, accuracy, and reliability of systems, applications, and business processes through structured testing and validation. • This role designs and executes test strategies, develops test cases, and analyzes results to identify defects, risks, and gaps against defined requirements and regulatory standards. • Working cross-functionally with business stakeholders, developers, and project teams, the analyst validates that solutions meet both functional and non-functional requirements. • Supports defect resolution, ensures readiness for deployment, maintains detailed documentation, tracks testing progress, and contributes to continuous improvement of testing methodologies, tools, and overall quality assurance practices. • Leverage Configuration Services best practices to validate design objectives, processes, and procedures, including development of data sets, test scenarios, expected results, and acceptance criteria. • Design, standardize, and maintain testing scenarios, use cases, and expected outcomes to improve testing efficiency, consistency, and repeatability. • Collaborate with business partners and cross-functional teams to validate configuration accuracy for ongoing maintenance, new client implementations, and special projects. • Ensure high levels of customer satisfaction by confirming that business requirements—particularly benefit change requests—are clearly understood, accurately documented, thoroughly tested, and effectively communicated. • Execute testing scenarios and analyze claims adjudication outcomes to identify discrepancies, inaccuracies, anomalies, and unintended impacts; provide recommendations and implement solutions to improve configuration accuracy and performance. • Support and mentor team members by assisting in the development and analysis of complex test plans, design validations, and execution strategies. • Contribute to continuous quality improvement by adhering to departmental standards and proactively identifying opportunities to enhance processes, tools, and overall testing efficiency. • Validate adjudication configurations and support the promotion of approved changes from test environments to production in accordance with established governance and best practices.

Role Description Provides support for member advocacy activities. Responsible for resolution of member issues including investigating and resolving member grievances, identifying systemic challenges affecting the member experience, and advocating for member rights. - Plays a pivotal role in ensuring the well-being and satisfaction of members by addressing their concerns with a commitment to impartiality and independence. - Listens to member concerns and ensures members understand their rights and responsibilities. - Investigates member issues and works to find appropriate and fair resolutions; this includes addressing systemic issues impacting member ability to access health care services, provision of timely support from care management staff or other personnel, billing and communication support, and any other support needs related to the member experience. - Ensures that member rights are upheld and respected throughout their health care journey. This includes protecting member confidentiality, promoting informed consent, and ensuring cultural sensitivity and diversity; collaborates with relevant stakeholders to improve the overall quality of services provided to members under covered programs. - Provides information about available resources to members and assists with navigating the health care system. - Represents members on internal issues - investigates complaints thoroughly and impartially, gathering relevant information, interviewing involved parties, and reviewing medical records, policies and procedures. - Documents all interactions, complaints, investigations, and resolutions in a timely and accurate manner. - Prepares reports and statistical analyses to identify trends and areas for improvement. - Collaborates with health care professionals, administrators, and staff to address member concerns, develop strategies for quality improvement, and promote a member-centered approach to care. - Conducts educational sessions for members, member families, and health care staff on member rights, and effective communication strategies; travels and participates in all Molina member advisory boards for covered programs statewide. - Remains knowledgeable about relevant laws, regulations, and policies about member rights and health care quality; applies this knowledge to ensure compliance and advocates for necessary change when required. - Collaborates with other applicable departments and committees within the organization to implement initiatives that enhance member satisfaction, improve processes, and promote a culture of member-centered care. - Presents and reports findings/recommendations to the appropriate channels and health plan leadership. Qualifications - At least 3 years of experience in a managed care environment, preferably in a Medicaid environment, or equivalent combination of relevant education and experience. - Knowledge of state Medicaid policies and programs. - Customer service and interpersonal skills; ability to empathize, remain calm under pressure, and build rapport with a diverse range of individuals. - Problem-solving and conflict resolution skills to address and resolve complex member/patient complaints and conflicts. - Ability to maintain strict confidentiality and handle sensitive information with integrity. - Sound judgment and decision-making abilities to assess situations, evaluate evidence, and recommend appropriate actions. - Proficiency in record-keeping and data management to accurately maintain and analyze complaint records and statistics. - Knowledge of health care systems, patient/member rights, and relevant laws and regulations. - Ability to work independently and make impartial decisions while adhering to professional ethics and standards. - Proficient in use of computer systems, software, and databases for documentation and data analysis. - Ability to navigate a large and complex matrixed organization. - Organizational and time-management skills, and ability to manage simultaneous projects and tasks to meet internal deadlines. - Effective verbal and written communication skills, including ability to communicate with internal and external stakeholders, members, families, and health care providers. - Microsoft Office suite and applicable software programs proficiency. - Specific health plans may require state residency. Preferred Qualifications - Member advocacy or complaint resolution experience in a health care setting. - Developed understanding of relevant state and federal regulations and accreditation standards, such as Health Insurance Portability and Accountability Act (HIPAA), and Centers for Medicare and Medicaid (CMS) guidelines. - Developed understanding of member rights, medical ethics, and health care quality improvement initiatives. - Developed understanding of health care processes, medical terminology, and the health care delivery system. - Certification in conflict resolution or ombudsman service. - Certification in patient/member advocacy or related field. Benefits Molina Healthcare offers a competitive benefits and compensation package. Company Description Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

• Designing, building, and troubleshooting API-driven integrations between Workday and enterprise platforms • Deep knowledge of Workday APIs, data structures, and business process behavior • Strong understanding of integration architecture and engineering principles that apply across any system or platform