Job Details

JOB DESCRIPTION

Job Summary

Performs analysis of complex healthcare data-including claims, authorization, pharmacy, and laboratory datasets-to evaluate network utilization patterns and identify cost containment opportunities. Develops, interprets, and presents actionable insights through reports and dashboards that inform strategic decision-making. Collaborates with cross-functional teams to recommend data-driven solutions that enhance healthcare efficiency, quality, and financial performance.

KNOWLEDGE/SKILLS/ABILITIES

• Develop ad-hoc reports using Azure Databricks SQL programming, Report Builder, PowerBI, and other analytic / programming tools as needed.

• Generate and distribute standard reports on schedule using SQL, Excel, and other reporting software.

• Collects and documents report / programming requirements from requestors to ensure appropriate creation of reports and analyses. Uses peer-to-peer review process and end-user consultation to reduce report writing errors and rework.

• Identify and complete report enhancements/fixes; modify reports in response to approved change requests; retain old and new report design for audit trail purposes.

• Analyze data sets and trends for anomalies, outliers, trend changes, and opportunities.

• Create comprehensive workflows for the production and distribution of assigned reports, document reporting processes and procedures.

• Assist with completion of special projects as requested by various internal departments, or in support of requests from regulatory agencies, contracting agencies, or other external organizations.

• Demonstrate Healthcare experience in Quantifying, Measuring and Analyzing Financial and Utilization Metrics of Healthcare.

JOB QUALIFICATIONS

Required Education

Bachelor's Degree in Finance, Economics, Math, Computer Science; or equivalent experience

Required Experience

• 2-4 years increasingly complex database and data management responsibilities

• Basic knowledge of SQL

• 2-4 years of increasingly complex experience in quantifying, measuring, and analyzing financial/performance management metrics

Preferred Education

Bachelor's Degree in Finance, Economics, Math, or Computer Science

Preferred Experience

Preferred experience in Medical Economics and Strong Knowledge of Performance Indicators:

• Proactively identify and investigate complex suspect areas regarding medical cost issues

• Initiate in-depth analysis of the suspect/problem areas and suggest a corrective action plan

• Apply investigative skill and analytical methods to look behind the numbers, assess business impacts, and make recommendations through use of healthcare analytics, predictive modeling, etc.

• Analysis and forecasting of trends in medical costs to provide analytic support for finance, pricing and actuarial functions

• Python

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: $80,168 - $107,099 / ANNUAL

*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.