Sr Analyst, Medical Economics (Medicaid) - REMOTE

Lensa; Bowling Green (KY); Remote; USD 77,000 - 130,000; Full time

Job summary

A leading healthcare organization is seeking a Senior Analyst in Medical Economics to analyze costs and utilization trends. The role involves creating reports, conducting complex analyses, and providing recommendations to improve financial performance across various healthcare products. The ideal candidate will have extensive experience in healthcare data analysis and a strong understanding of Medicaid and Medicare programs.

Qualifications

• 5+ years of healthcare-related experience required.
• Proficiency with Microsoft Excel and SQL for data retrieval.

Responsibilities

• Analyze claims and data to identify trends in medical care costs.
• Collaborate with teams to design studies related to medical interventions.
• Provide data-driven analytics to various departments.

Skills

Healthcare-related experience

Data analysis

Understanding of Medicaid and Medicare

Financial metrics analysis

Education

Bachelor's Degree in Mathematics

Bachelor's Degree in Economics

Bachelor's Degree in Computer Science

Bachelor's Degree in Healthcare Management

Tools

Microsoft Excel

SQL

Power BI

Tableau

Job description

Sr Analyst, Medical Economics (Medicaid) - REMOTE

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Lensa is the leading career site for job seekers at every stage of their career. Our client, Molina Healthcare, is seeking professionals. Apply via Lensa today!

Job Description

Job Summary

The Senior Analyst, Medical Economics provides support and consultation to the Health Plan and Finance team through analyzing key business issues related to cost, utilization, and revenue for multiple Molina Healthcare products. Designs and develops reports to monitor health plan performance and identify the root causes of medical cost trends. Creates tools to monitor trend drivers and provides recommendations to senior leaders for affordability opportunities.

Responsible for conducting complex analyses of insured medical populations to identify opportunities to improve financial performance. Extracts, analyzes, and synthesizes data from various sources to identify risks and opportunities.

Job Duties

• Extract and compile information from various systems to support executive decision-making.
• Mine and manage information from large data sources.
• Analyze claims and other data sources to identify early signs of trends or issues related to medical care costs.
• Collaborate with clinical, provider network, and other personnel to add context to data analyses, and design studies related to medical interventions.
• Track key performance indicators of medical interventions with business owners.
• Perform pro forma sensitivity analyses to estimate the financial impact of medical cost reduction initiatives.
• Identify and investigate complex areas regarding medical cost issues, and suggest corrective actions.
• Draw actionable conclusions from analyses, make recommendations using healthcare analytics and predictive modeling, and communicate effectively across enterprise levels.
• Analyze financial performance of Molina Healthcare products, identify trends, and develop improvement recommendations.
• Lead projects involving ad-hoc data analyses and financial reporting.
• Serve as subject matter expert on financial models for provider reimbursement impacts.
• Provide data-driven analytics to departments such as Finance, Claims, Medical Management, and Network.
• Support medical cost reduction projects and ROI analyses for vendors.
• Stay informed on Medicaid and Medicare reforms and their impact on Molina Healthcare.

Job Qualifications

Required Education

Bachelor's Degree in Mathematics, Economics, Computer Science, Healthcare Management, or related field.

Required Experience, Knowledge, Skills, and Abilities

• 5+ years of healthcare-related experience.
• Understanding of Medicaid and Medicare programs.
• Experience with healthcare industry data analysis.
• Proficiency with Microsoft Excel (formulas, PIVOT tables, PowerQuery).
• Experience with SQL for data retrieval.
• Experience building dashboards in Excel, Power BI, or Tableau.
• Knowledge of healthcare operations and financial terms.
• Understanding of managed care concepts and provider reimbursement principles.
• Ability to analyze large data sources and quantify financial metrics.

Preferred Qualifications

• Proficiency with Power BI and Tableau dashboards.
• Experience with Databricks and TOAD Data Point.

To all current Molina employees: Please apply through the intranet.

Molina Healthcare offers competitive benefits and is an Equal Opportunity Employer.

Additional Details

Pay Range: $77,969 - $130,000 annually. Actual compensation may vary based on location, experience, education, and skills.

Job Details

• Seniority level: Mid-Senior level
• Employment type: Full-time
• Job function: Health Care Provider
• Industries: IT Services and IT Consulting