Senior Analyst, Utilization Management

Molina Healthcare; Spokane (WA); On-site; USD 77,000 - 156,000; Full time

Job summary

A national healthcare organization is seeking a Senior Analyst, Utilization Management to support clinical and operational initiatives. This role involves translating healthcare business needs into technical solutions, requiring strong skills in SQL, Power BI, and healthcare data analytics. Candidates should have 3-5 years of experience and a Bachelor's degree in a relevant field. The position offers a competitive compensation package and opportunities for professional growth.

Benefits

Competitive benefits and compensation package

Qualifications

• 3–5 years of experience with healthcare data in analytics or data engineering roles.
• Advanced proficiency in SQL for analyzing healthcare claims data.
• Experience using Power BI for data visualizations.

Responsibilities

• Translate healthcare business needs into actionable technical solutions.
• Write SQL queries to analyze healthcare data.
• Build and maintain ETL pipelines for reporting and analytics.

Skills

SQL

Power BI

ETL development

Databricks

Snowflake

Data analytics

Healthcare data types

Education

Bachelor’s or Associate’s degree in Data Science, Computer Science, Analytics, Information Systems, Engineering

Tools

Databricks

Snowflake

Power BI

Job description

Job Summary

The Senior Analyst, Utilization Management plays a critical role in supporting clinical and operational initiatives by translating healthcare business needs into technical solutions. This role works closely with clinicians, utilization management teams, and business stakeholders to gather requirements and deliver actionable insights through data analytics. The ideal candidate brings a strong foundation in SQL, Power BI, Databricks, Snowflake, and ETL development, along with a collaborative approach to building scalable, healthcare-focused data solutions supporting utilization management initiatives and conducting trend analyses to identify the underlying drivers of medical cost patterns

Knowledge/Skills/Abilities

• Partner with clinical, operational, and business teams to understand data needs and translate requirements into actionable technical solutions.
• Write advanced SQL queries to extract, validate, and analyze healthcare data, including claims, authorization, pharmacy, and lab datasets.
• Build and maintain efficient ETL pipelines to support ongoing reporting and analytics workflows.
• Utilize Databricks and Snowflake to develop scalable data pipelines and analytical datasets.
• Create and maintain Power BI dashboards to deliver insights on utilization, outcomes, and cost drivers across the organization.
• Ensure data quality, governance, and documentation standards are met in all analytics work.
• Support ad hoc data requests and collaborate cross-functionally to drive data-informed decisions in clinical and business operations.
• Maintain fluency in healthcare data types (e.g., ICD/CPT codes, HEDIS measures, member eligibility) to guide technical decisions.

Job Qualifications

Required Education

Bachelor’s or Associate’s degree in Data Science, Computer Science, Analytics, Information Systems, Engineering, or other technology-related fields

Required Experience

• 3–5 years of experience working with healthcare data in analytics or data engineering roles, supporting utilization management initiatives and conducting trend analyses to identify the underlying drivers of medical cost patterns

• Advanced proficiency in SQL for large dataset analysis and transformation, specifically in processing healthcare claims data and supporting managed care reporting needs

• Experience using Power BI for developing interactive dashboards and data visualizations

• Hands-on experience with Databricks, Snowflake, or enterprise cloud data platforms

• Solid understanding of ETL concepts and experience building pipelines for healthcare analytics

• Strong communication and collaboration skills to work with clinical and business stakeholders

Preferred Experience

• 4+ years in a healthcare analytics role supporting utilization management, population health, or quality improvement within a Managed Care Organization (MCO)

• Experience working directly with clinicians, nurses, or case management teams

• Familiarity with risk adjustment, value-based care models, or healthcare performance metrics

• Understanding of regulatory and compliance considerations (e.g., HIPAA) in data handling

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: $77,969 - $155,508 / ANNUAL

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