Sr Analyst, Medical Economics (Medicaid) - REMOTE

Lensa; Grand Rapids (MI); Remote; USD 77,000 - 130,000; Full time

Job summary

A leading healthcare company is seeking a Senior Analyst in Medical Economics to provide analytical support for financial performance. This remote position involves data analysis, trend identification, and collaboration with various teams to enhance decision-making. The ideal candidate will have extensive experience in healthcare analytics and a strong understanding of Medicaid and Medicare programs.

Qualifications

• 5+ years of healthcare-related experience.
• Understanding of Medicaid and Medicare programs.
• Experience quantifying and analyzing healthcare metrics.

Responsibilities

• Extract and compile information from various systems.
• Analyze claims and other data sources for trends.
• Lead projects and develop financial reports.

Skills

Healthcare Analytics

Data 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

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 add context/insights 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 improvement initiatives.
• Identify and investigate complex suspect areas regarding medical cost issues, and suggest corrective actions.
• Draw actionable conclusions from analyses, make data-driven recommendations, and communicate effectively across various levels of the organization.
• Analyze financial performance of Molina Healthcare products, identify trends, and recommend improvements.
• Lead projects, contribute to ad-hoc analyses, and develop financial reports.
• Serve as subject matter expert on financial models evaluating provider reimbursement changes.
• Provide analytics to departments to facilitate decision-making.
• Support medical cost reduction initiatives and ROI analyses for vendors.
• Stay informed 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 in healthcare analytics within hospitals, insurance, or managed care
• Proficiency in Excel (formulas, pivot tables, PowerQuery)
• Experience with SQL for data retrieval
• 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
• Experience quantifying and analyzing healthcare metrics

Preferred Qualifications:

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

Interested current Molina employees should apply through the intranet. Molina Healthcare offers competitive benefits. We are an Equal Opportunity Employer.

Additional Details

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

Job Details

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