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ATTENTION JOB SEEKERS AND MOLINA APPLICANTS: FRAUD ALERT

Be aware that third parties posing as Molina Healthcare may be soliciting money from job seekers and extending offers to candidates who have not interviewed. Molina does not engage in these type of practices. If you have received an offer and have not been engaging with Molina Healthcare in an interview process, reach out to erc@molinahealthcare.com to validate the legitimacy of your offer. Please note that Molina has reported this activity to the appropriate law enforcement agencies for further investigation. If you feel you’ve been victimized, please report it to local law enforcement.

Medical Economics Consultant (Medicare) - REMOTE

Molina Healthcare Arizona; Bellevue, Washington; Madison, Wisconsin; Georgia; Iowa; Nebraska; Phoenix, Arizona; Mesa, Arizona; Orlando, Florida; St. Petersburg, Florida; Detroit, Michigan; Las Cruces, New Mexico; Santa Fe, New Mexico; Rochester, New York; Columbus, Ohio; Austin, Texas; Fort Worth, Texas; Seattle, Washington; Tacoma, Washington; Racine, Wisconsin; Florida; Idaho; Utah; Wisconsin; Atlanta, Georgia; Savannah, Georgia Job ID 2029620
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Job Description


Job Summary

Provides consultative support and medical cost-based analysis of markets and network initiatives. The Medical Economics Consultant manages conflicting priorities and multiple projects concurrently.  Responsible for extracting, analyzing, and synthesizing data from various sources to identify risks and opportunities as well as packaging and delivering the results to senior leadership.  Responsible for consulting with network and clinical management on opportunities to improve our company’s discount position and strategic cost and utilization initiatives.

Knowledge/Skills/Abilities

  • Analyze and research utilization and unit cost medical cost drivers
  • Turn data into usable information by tell the story through data visualization working with clinical, provider network and other personnel to bring supplemental context and insight to data analyses
  • Support the development of scoreable action items by identifying outlier cost issues
  • Perform drill-down analysis to identify medical cost trend drivers; advise network of contracting opportunities to mitigate future trends
  • Own, track and document all aspects of related work from beginning to end of a project
  • Extract and compile information from various systems to support executive decision-making
  • Ability to mine and manage information from large data sources
  • Working with Excel, MS-Access and Web-based query tools (data warehouse)

Job Qualifications

REQUIRED EDUCATION:

Bachelor's Degree in Finance, Mathematics, Statistics, or Economics

REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS & ABILITIES:

5 - 7 years in healthcare/managed care industry with knowledge of provider contracting, provider reimbursement, patient management, product, benefits design, or related experience.

PREFERRED EDUCATION:

Master’s Degree in Business Administration, Finance, Mathematics, Statistics, or Economics

PREFERRED EXPERIENCE:

Experience working with medical and pharmacy claims, authorization data, benefits design, medical management as well as knowledge of business functions and impact on financials (underwriting, sales, product development, network management.)

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.

#PJCorp

#LI-AC1

Pay Range: $80,412 - $188,164 / 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: 01/07/2025

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