Sr Analyst, Medical Economics (Medicaid) - REMOTE

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

Job summary

A leading healthcare organization is seeking a Senior Analyst in Medical Economics to support the Health Plan and Finance team. This role involves analyzing key business issues, developing reports, and providing actionable insights to improve financial performance. The ideal candidate will have extensive experience in healthcare data analysis and a strong understanding of Medicaid and Medicare programs. Join a dynamic team focused on driving affordability opportunities and enhancing healthcare outcomes.

Qualifications

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

Responsibilities

• Conduct complex analyses of insured medical populations.
• Extract and compile information to support decision-making.
• Analyze claims to identify trends related to medical care costs.

Skills

Healthcare Data Analysis

Quantitative Analysis

Communication

Education

Bachelor's Degree in Mathematics

Bachelor's Degree in Economics

Bachelor's Degree in Computer Science

Bachelor's Degree in Healthcare Management

Tools

Excel

SQL

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 affordability 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 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.
• Track key performance indicators of medical interventions with business owners.
• Perform sensitivity analyses to estimate financial impacts of cost reduction initiatives.
• Identify and investigate complex medical cost issues, initiate in-depth analyses, and suggest corrective actions.
• Draw actionable conclusions, make recommendations using healthcare analytics and predictive modeling, and communicate findings effectively.
• Analyze financial performance of Molina Healthcare products, identify trends, and develop improvement strategies.
• Lead projects, contribute to ad-hoc analyses, and develop financial reports.
• Serve as SME for financial models evaluating provider reimbursement impacts.
• Provide data-driven analytics to various departments to support decision-making.
• Support medical cost reduction projects and ROI analyses for vendors.
• Stay updated on Medicaid and Medicare reforms and their impacts.

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 healthcare-related experience.
• Understanding of Medicaid and Medicare programs.
• Experience with healthcare data analysis, including Excel and SQL.
• 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 operational metrics.

Preferred Qualifications

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

Interested Molina employees should apply through the intranet. Molina offers competitive benefits. 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 Consulting.