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Knowledge/Skills/Abilities

Performs research and analysis of complex healthcare claims data, pharmacy data, and lab data regarding network utilization and cost containment information. Evaluates, writes, and presents healthcare utilization and cost containment reports and makes recommendations based on relevant findings.

• Oversees development, organization, and ongoing maintenance of data representing a wide range of healthcare information.

• Develops and directs a process to clean and integrate complex healthcare datasets in order to create the data foundation for further analytics and the development of key insights.

• Supervises completion of special projects as requested, by various internal departments, or in support of requests from regulatory agencies, contracting agencies, or other external organizations.

• Oversees, establishes, and maintains timelines for reports and projects.

• Ensures quality of output by submitting work product for quality checks and reviews and performing similar functions for other staff..

Job Qualifications

Required Education

Associate's Degree or equivalent combination of education and experience

Required Experience

3-5 years

Preferred Education

Bachelor's Degree in Finance, Economics, Computer Science

Preferred Experience

• 5-7 years increasingly complex database and data management responsibilities

• 5-7 years of increasingly complex experience in quantifying, measuring, and analyzing financial/performance management metrics

• Demonstrate Healthcare experience in Quantifying, Measuring and Analyzing Financial and Utilization Metrics of Healthcare

• Basic knowledge of SQL

• Preferred Education

• Bachelor's Degree in Finance, Economics, Math, or Computer Science

Preferred experience in Medical Economics and Strong Knowledge of Performance Indicators:

• Proactively identify and investigate complex suspect areas regarding medical cost issues

• Initiate in-depth analysis of the suspect/problem areas and suggest a corrective action plan

• Apply investigative skill and analytical methods to look behind the numbers, assess business impacts, and make recommendations through use of healthcare analytics, predictive modeling, etc.

• Analysis and forecasting of trends in medical costs to provide analytic support for finance, pricing and actuarial functions

• Healthcare Analyst I or Financial/Accounting Analyst I experience desired

• Multiple data systems and models

• BI tools

To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.

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

Pay Range: $67,725 - $128,519 / ANNUAL

*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.