Sr Analyst, Network Strategy, Pricing & Analytics

Molina Healthcare; Mississippi; On-site; USD 77,000 - 156,000; Full time

Job summary

A leading healthcare organization is seeking a Senior Analyst for Network Strategy, Pricing & Analytics. The role focuses on contract valuation and analysis, enhancing access to quality care, and developing payment strategies to improve health outcomes. Candidates should possess strong analytical skills and experience in healthcare pricing and financial analysis.

Qualifications

• At least 5 years of analytics experience in financial analysis and healthcare pricing.
• Advanced proficiency in Microsoft Excel and intermediate SQL skills.

Responsibilities

• Conduct financial modeling and analysis to support negotiations.
• Develop strategic reports and analyses using SQL and Business Intelligence tools.
• Evaluate healthcare utilization and cost containment, providing actionable recommendations.

Skills

SQL

Financial Analysis

Data Analysis

Communication

Education

Bachelor's Degree in Business

Master's Degree

Tools

Microsoft Excel

PowerBI

NetworX Modeler

Job description

Job Description

Job Summary

Senior Analyst, Network Strategy, Pricing & Analytics, guides the investment of our network partners through contract valuation and analysis to ensure access to quality healthcare services for people receiving government assistance. The role involves strengthening access to quality care with improved outcomes through better coordination and preventive care, and developing payment strategies that incentivize providers and healthcare systems to deliver better health outcomes more affordably.

Responsibilities include performing research, financial modeling, and analysis of complex healthcare claims data (medical, pharmacy, and ancillary) to deliver practical, actionable financial and clinical insights. The focus is on prioritizing high-impact areas and improving underperforming contracts. The role supports multi-dimensional pricing strategies aimed at reducing total cost of care and minimizing cost variation by leveraging value-based care models.

Knowledge/Skills/Abilities

• Develop strategic reports and analyses using SQL, SQL Server Analysis Services (SSAS), Business Intelligence tools (e.g., Medinsight, PowerBI), and Executive Dashboards.
• Create hospital performance analytics tools quarterly; develop reports regularly using SQL, Excel, and other reporting software.
• Research, develop, analyze, and recommend cost-saving opportunities aligned with enterprise strategies.
• Track, monitor, and report on cost-saving initiatives across hospitals, physicians, and ancillary services, including trend analysis and performance metrics on a monthly basis.
• Conduct financial modeling and analysis using NetworX Modeler and ETL systems to support negotiations and contract rate proposals.
• Research, analyze, and advise on Medicaid and Medicare reimbursement methodologies, evaluating the impact of reimbursement changes and educating health plans on financial implications.
• Support and validate provider network contracting and unit cost management activities through financial and network pricing modeling, analysis, and reporting.
• Translate contract rates and terms to evaluate financial impacts for negotiations, including coding and chargemaster analysis.
• Communicate analytical results clearly to senior management and stakeholders, utilizing PowerPoint.
• Coordinate and review quarterly national contract performance analyses to ensure timely delivery for decision-making.
• Evaluate, write, and present healthcare utilization and cost containment reports, providing actionable recommendations.
• Peer review of pricing configurations to ensure accuracy in financial modeling.
• Review team members' presentations on total cost of care and profit improvement initiatives.
• Support process improvements in report and programming requirements documentation.
• Serve as a key resource on complex pricing and analysis issues.
• Review and improve work performed by others.

Job Qualifications

Required Education

• Bachelor's Degree in Business, Finance, Mathematics, Economics, Data Science, Actuarial Sciences, or equivalent experience.

Required Experience

• At least 5 years of analytics experience in financial analysis, healthcare pricing, network management, healthcare economics, or related fields.
• At least 5 years of progressively responsible experience managing complex databases and data systems.
• Advanced proficiency in Microsoft Excel.
• Intermediate to advanced proficiency in SQL.
• At least 5 years of experience quantifying, measuring, and analyzing financial and performance metrics.

Preferred Education

• Master's Degree preferred.

Preferred Experience

• Experience in healthcare medical economics or strong financial analytics background.
• Ability to identify and investigate complex medical cost issues.
• Experience conducting in-depth analyses and recommending corrective actions.
• Proficiency in healthcare analytics, predictive modeling, and reimbursement methodologies (e.g., APR-DRG, MS-DRG, EAPG, APC).

Current Molina employees interested in this position should apply through the intranet. Molina Healthcare offers competitive benefits and compensation. We are an Equal Opportunity Employer (EOE) M/F/D/V.

Pay Range: $77,969 - $155,508 annually. Actual compensation may vary based on location, experience, education, and skills.