Sr Analyst, Medical Economics (Medicaid) - REMOTE

Lensa; Buffalo (NY); Remote; USD 77,000 - 130,000; Full time

Job summary

An established industry player is seeking a Senior Analyst in Medical Economics to drive innovation through data analysis and reporting. This role involves analyzing healthcare costs, identifying trends, and providing actionable insights to senior leaders. The ideal candidate will have a strong background in healthcare analytics, proficiency in SQL and Excel, and experience with tools like Power BI and Tableau. Join a dynamic team dedicated to improving financial performance and making a significant impact in the healthcare sector. If you're passionate about data-driven decision-making and want to contribute to meaningful financial initiatives, this opportunity is for you.

Qualifications

• 5+ years of healthcare experience with strong analytical skills.
• Proficiency in SQL and Microsoft Excel for data analysis.

Responsibilities

• Conduct complex analyses to identify financial performance opportunities.
• Extract and analyze data to support executive decision-making.

Skills

Healthcare Analytics

Data Analysis

SQL

Microsoft Excel

Power BI

Tableau

Financial Modeling

Managed Care Concepts

Education

Bachelor's Degree in Mathematics

Bachelor's Degree in Economics

Bachelor's Degree in Computer Science

Bachelor's Degree in Healthcare Management

Tools

Power BI

Tableau

Databricks

TOAD Data Point

Job description

Sr Analyst, Medical Economics (Medicaid) - REMOTE

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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. With those root causes identified, drives innovation by creating tools to monitor trend drivers and provide recommendations to senior leaders for affordability opportunities.

Responsible for conducting complex analyses of insured medical populations with the goal of identifying 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 other issues related to medical care costs.
• Work with clinical, provider network, and other personnel to bring supplemental context/insight to data analyses, and design and perform studies related to the quantification of medical interventions.
• Work with business owners to track key performance indicators of medical interventions.
• Perform pro forma sensitivity analyses to estimate the expected financial value of proposed medical cost improvement initiatives.
• 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.
• Draw actionable conclusions based on analyses performed, make recommendations using healthcare analytics and predictive modeling, and communicate those conclusions effectively to various audiences.
• Analyze the financial performance of all Molina Healthcare products, identify trends, develop recommendations, and communicate findings to management.
• Lead projects by contributing to ad-hoc data analyses, developing, and presenting financial reports.
• Serve as subject matter expert on developing financial models to evaluate the impact of provider reimbursement changes.
• Provide data-driven analytics to departments to enable critical decision-making.
• Support financial analysis projects related to medical cost reduction initiatives.
• Assist with ROI analyses for vendors to determine if their performance achieves desired results.
• Stay informed about 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 related healthcare experience.
• Understanding of Medicaid and Medicare programs or other healthcare plans.
• Analytical work experience within healthcare settings.
• Proficiency with Microsoft Excel (formulas, pivot tables, PowerQuery, etc.).
• Experience with SQL for data retrieval.
• Experience building dashboards in Excel, Power BI, and/or Tableau.
• Knowledge of healthcare operations and financial terms.
• Understanding of managed care concepts and provider reimbursement principles.
• Ability to analyze large data sources.

Preferred Qualifications

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

To all current Molina employees: Apply through the intranet job listing.

Molina Healthcare offers a competitive benefits package. We are an Equal Opportunity Employer (EOE) M/F/D/V.

Additional Details

• Pay Range: $77,969 - $130,000 / annual.

Seniority level

• Mid-Senior level

Employment type

• Full-time

Job function

• Health Care Provider

Industries

• IT Services and IT Consulting