Director, Medical Economics (Remote within the US)
Molina Healthcare Arizona; Houston, Texas; Wisconsin; Savannah, Georgia; Idaho Falls, Idaho; Davenport, Iowa; Louisville, Kentucky; Austin, Texas; Fort Worth, Texas; Warren, Michigan; Rochester, New York; Iowa; Layton, Utah; Seattle, Washington; New York; Madison, Wisconsin; Macon, Georgia; Nampa, Idaho; Caldwell, Idaho; Sioux City, Iowa; Bellevue, Nebraska; Yonkers, New York; Kentucky; Cleveland, Ohio; Dallas, Texas; Mesa, Arizona; Kenosha, Wisconsin; Des Moines, Iowa; Cedar Rapids, Iowa; Bowling Green, Kentucky; Covington, Kentucky; Detroit, Michigan; Ann Arbor, Michigan; Provo, Utah; Texas; Milwaukee, Wisconsin; Miami, Florida; Orlando, Florida; Boise, Idaho; Iowa City, Iowa; Lexington-Fayette, Kentucky; Owensboro, Kentucky; Salt Lake City, Utah; New York, New York; Tacoma, Washington; Dayton, Ohio; San Antonio, Texas; Chandler, Arizona; Racine, Wisconsin; Jacksonville, Florida; Augusta, Georgia; Columbus, Georgia; Grand Rapids, Michigan; Albuquerque, New Mexico; Rio Rancho, New Mexico; Sterling Heights, Michigan; Vancouver, Washington; New Mexico; Cincinnati, Ohio; Utah; Washington; Phoenix, Arizona; Tucson, Arizona; St. Petersburg, Florida; Meridian, Idaho; Santa Fe, New Mexico; Georgia; Idaho; Kearney, Nebraska; Las Cruces, New Mexico; Roswell, New Mexico; Columbus, Ohio; Spokane, Washington; Nebraska; Ohio; Akron, Ohio; Scottsdale, Arizona; Bellevue, Washington; Green Bay, Wisconsin; Tampa, Florida; Atlanta, Georgia; West Valley City, Utah; Grand Island, Nebraska; Omaha, Nebraska; Lincoln, Nebraska; Buffalo, New York; Syracuse, New York; Florida; Orem, Utah; Michigan Job ID 2029915
Job Description
Job Summary
Responsible for leading the Medical Economics team to develop SAI tracking tools in conjunction with SAI leads to support of Health Plans data management needs. Collaborates with senior leadership to identify opportunities to improve the Health Plan's performance and data management.
Knowledge/Skills/Abilities
• Participates or leads standard trend management review with Health Plans
• Leads ad hoc analysis to support Health Plans and Shared Service Partners.
• Coordinate with Shared Services functions (Payment Integrity, National Contracting, Health Services) to conduct annual deep dive trend review of each Health Plan.
• Coordinates trend mitigation strategies with Health Plans, Shared Services and SAI process.
• Performs consistent follow up on issues and opportunities identified.
• Leads staff to utilize tracking tool for trend mitigation items being worked between Health Plan and Shared Services (Tools and Technology).
• Coordinates analytical views of data for oversight of initiatives and impact on trend.
• Leads team to develop SAI tracking tools in conjunction with SAI leads.
• Leads team to develop intake tool for MedEcon Request
• Coordinates Data management advocacy structure and set organizational standards.
• Primary point of contact between MedEcon and EIM Team.
• Coordinate projects involving employees across functional areas.
• Stay abreast of professional developments and industry trends..
Job Qualifications
Job Summary
Responsible for leading the Medical Economics team to develop SAI tracking tools in conjunction with SAI leads to support of Health Plans data management needs. Collaborates with senior leadership to identify opportunities to improve the Health Plan's performance and data management.
Knowledge/Skills/Abilities
• Participates or leads standard trend management review with Health Plans
• Leads ad hoc analysis to support Health Plans and Shared Service Partners.
• Coordinate with Shared Services functions (Payment Integrity, National Contracting, Health Services) to conduct annual deep dive trend review of each Health Plan.
• Coordinates trend mitigation strategies with Health Plans, Shared Services and SAI process.
• Performs consistent follow up on issues and opportunities identified.
• Leads staff to utilize tracking tool for trend mitigation items being worked between Health Plan and Shared Services (Tools and Technology).
• Coordinates analytical views of data for oversight of initiatives and impact on trend.
• Leads team to develop SAI tracking tools in conjunction with SAI leads.
• Leads team to develop intake tool for MedEcon Request
• Coordinates Data management advocacy structure and set organizational standards.
• Primary point of contact between MedEcon and EIM Team.
• Coordinate projects involving employees across functional areas.
• Stay abreast of professional developments and industry trends..
Job Qualifications
Required Education
Bachelor's Degree
Required Experience
6+ Years
Preferred Experience
7 Years and experience in complex managed care or other health care organizations.
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: $96,325.57 - $208,705.4 / ANNUAL
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
About Us
Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
Job Type: Full Time Posting Date: 02/04/2025ABOUT OUR LOCATION
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