Sr Analyst, Medical Economics (Medicaid) - REMOTE

Lensa; Cincinnati (OH); Remote; USD 77,000 - 130,000; Full time

Job summary

An established industry player is seeking a Senior Analyst in Medical Economics to provide critical support and consultation to their Health Plan and Finance teams. This role focuses on analyzing key business issues related to cost, utilization, and revenue for various healthcare products. You'll design reports to monitor performance, identify trends, and drive innovation through data analysis. If you have a strong background in healthcare analytics and a passion for improving financial performance, this is an exciting opportunity to make a significant impact in a forward-thinking organization.

Qualifications

• 5+ years of healthcare-related experience required.
• Strong understanding of Medicaid and Medicare programs.
• Ability to analyze large data sources effectively.

Responsibilities

• Conduct complex analyses of insured medical populations.
• Provide data-driven analytics to enable critical decision making.
• Lead projects and communicate findings to management.

Skills

Healthcare Analytics

Excel

SQL

Power BI

Tableau

Data Analysis

Financial Metrics Analysis

Medicaid Knowledge

Medicare Knowledge

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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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

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, predictive modeling, and communicate those conclusions effectively to audiences at various levels of the enterprise
• 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, development, and presentation of financial reports
• Serve as subject matter expert on developing financial models to evaluate provider reimbursement impacts
• 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 is achieving desired results
• Keep abreast of 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 analytics, including Excel, SQL, and dashboard tools like Power BI or Tableau
• Knowledge of healthcare operations, financial terms, and coding systems
• Understanding of managed care concepts and provider reimbursement principles
• Ability to analyze large data sources and quantify financial and operational metrics

Preferred Qualifications

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

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

Molina Healthcare offers a competitive benefits and compensation package. Equal Opportunity Employer (EOE) M/F/D/V.

Additional Details

• Pay Range: $77,969 - $130,000 annually
• Seniority level: Mid-Senior level
• Employment type: Full-time
• Job function: Health Care Provider
• Industries: IT Services and IT Consulting