Senior Analyst, OON Dispute Analytics

Molina Healthcare; United States; Remote; USD 95,000 - 125,000; Full time

Benefits offered by this job

Competitive benefits

Job summary

Molina Healthcare is seeking a Senior Analyst, OON Dispute Analytics and Reporting, to support the provider liability operating model. You will develop analytics, reporting, and market intelligence for negotiation strategy, NSA IDR processes, and overall IDR performance.

You will integrate data from multiple sources, build dashboards, and translate financial data into actionable recommendations. You will partner with IT, Finance, Medical Economics, Actuary and Operations to improve data

Qualifications

• 4+ years in data analysis, reporting, or analytics or equivalent combination of education/experience.
• Strong SQL, relational databases, and Excel proficiency.
• Experience with reporting/visualization tools (SSRS or similar).
• Experience with complex datasets: claims, provider, reimbursement, and financial data.

Responsibilities

• Analyze complex, multi-source datasets to identify trends, risks, and opportunities across pre-IDR, open negotiation, arbitration, settlement, and post-award outcomes.
• Design, develop, and maintain reports, dashboards, and data solutions using SQL, Excel, SSRS; produce standard and ad hoc reporting for stakeholders.
• Translate business needs into reporting requirements; collaborate with stakeholders to deliver insights.
• Combine data from internal and external sources (claims, QPA, IDR tracking, provider data, market benchmarks, third-party data).
• Perform healthcare data analysis including claims, utilization, and cost data; leverage external data for trends.
• Develop and maintain data extraction, transformation, and validation processes.
• Ensure data quality, integrity, and consistency; reconcile data across systems and identify gaps.
• Partner with IT, Finance, Medical Economics, Actuary and Operations to improve data availability and automate reporting.
• Produce KPIs such as pre-IDR settlement rate, negotiated vs initial rate, IDR win rate, and provider acceptance; support KPI targets by market/state.
• Develop financial views quantifying dispute exposure, settlement impact, and avoided cost; translate outputs into negotiation strategy insights.
• Create executive-ready dashboards tracking OON dispute performance and financial impact; enable drill-down to market/provider/case level.
• Present findings and recommendations to leadership.

Skills

SQL

Excel

SSRS

Tableau

Power BI

Data analysis

Stakeholder comms

Tools

SQL Server

Tableau

Power BI

Job description

Molina Healthcare is seeking a Senior Analyst, OON Dispute Analytics and Reporting, to support the provider liability operating model. You will develop analytics, reporting, and market intelligence for negotiation strategy, NSA IDR processes, and overall IDR performance.

You will integrate data from multiple sources, build dashboards, and translate financial data into actionable recommendations. You will partner with IT, Finance, Medical Economics, Actuary and Operations to improve data