Sr Analyst, Medical Economics (Medicaid) - REMOTE

Lensa; City of Yonkers (NY); 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 team. This role focuses on analyzing healthcare costs, utilization, and revenue trends, offering insights that drive financial improvement. You will extract and synthesize data to identify opportunities and risks, collaborate with various departments, and lead projects that enhance the organization's financial performance. If you're passionate about healthcare analytics and want to make a significant impact in a dynamic environment, this is the perfect opportunity for you.

Qualifications

• 5+ years of healthcare-related experience required.
• Understanding of Medicaid and Medicare programs essential.
• Experience with healthcare analytics and large data sources.

Responsibilities

• Analyze claims data to identify trends in medical costs.
• Collaborate with teams to support decision-making with data.
• Lead projects and present financial reports to management.

Skills

Healthcare Analytics

SQL

Excel

Power BI

Tableau

Data Analysis

Financial Modeling

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. Creates tools to monitor trend drivers and provides recommendations to senior leaders for cost management opportunities.

Responsible for conducting complex analyses of insured medical populations to identify opportunities for financial improvement. 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 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.
• Work with business owners to track key performance indicators of medical interventions.
• Perform pro forma sensitivity analyses to estimate financial impacts of medical cost reduction initiatives.
• Identify and investigate complex areas of medical cost issues, initiate in-depth analysis, and suggest corrective actions.
• Draw actionable conclusions, make recommendations using healthcare analytics and predictive modeling, and communicate findings effectively across the organization.
• Analyze financial performance of Molina Healthcare products, identify trends, develop improvement recommendations, and communicate these to management.
• Lead projects by contributing to ad-hoc data analyses, developing, and presenting financial reports.
• Serve as subject matter expert on financial models evaluating provider reimbursement changes.
• Provide data-driven analytics to various departments to support decision-making.
• Support medical cost reduction projects and ROI analyses for vendors.
• Stay informed on Medicaid and Medicare reforms and their impacts 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 (formulas, pivot tables, PowerQuery) and SQL.
• Experience building dashboards in Excel, Power BI, and/or Tableau.
• Knowledge of healthcare operations, financial terms, coding systems, and managed care concepts.
• Ability to analyze large data sources and quantify financial, operational, and utilization 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 job listing.

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

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

Additional Details

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