Sr Analyst, Medical Economics (Medicaid) - REMOTE

Lensa; Everett (WA); Remote; USD 77,000 - 130,000; Full time

Job summary

A leading healthcare organization is looking for a Senior Analyst in Medical Economics to provide analytical support and recommendations to improve financial performance. The role involves analyzing healthcare data, identifying cost trends, and collaborating with various teams to enhance decision-making. This position offers competitive benefits and the opportunity to impact healthcare delivery positively.

Qualifications

• 5+ years of healthcare-related experience.
• Understanding of Medicaid and Medicare programs.
• Ability to analyze large datasets and extract insights.

Responsibilities

• Extract and compile information for executive decision-making.
• Analyze claims to identify trends related to medical care costs.
• Provide data-driven analytics for decision-making.

Skills

Healthcare Data Analysis

Analytical Skills

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

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 issues related to medical care costs.
• Collaborate with clinical, provider network, and other personnel to bring context/insight 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 the financial impact of proposed medical cost 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 communicate effectively across various levels.
• Analyze financial performance of Molina Healthcare products, identify trends, develop improvement recommendations, and communicate with management.
• Lead projects involving ad-hoc data analyses and financial reporting.
• Serve as SME on financial models evaluating provider reimbursement impacts.
• Provide data-driven analytics to various departments for decision-making.
• Support medical cost reduction projects and ROI analyses for vendors.
• Stay updated 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 data analysis, including Excel (formulas, PivotTables, PowerQuery) and SQL.
• Experience in building dashboards with Excel, Power BI, or Tableau.
• Knowledge of healthcare operations and financial terms, coding systems, and reimbursement principles.
• Ability to analyze large datasets and extract insights.

Preferred Qualifications

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

Interested Molina employees should apply through the intranet. Molina Healthcare offers competitive benefits. EOE M/F/D/V.

Additional Details

• Pay Range: $77,969 - $130,000/year (may vary based on location, experience, education, skills).

Seniority level

• Mid-Senior level

Employment type

• Full-time

Job function

• Health Care Provider

Industries

• IT Services and IT Consulting