JOB DESCRIPTION

Job Summary

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.

KNOWLEDGE/SKILLS/ABILITIES

• Generate and distribute standard reports on schedule using SQL, Excel, and other reporting software.
• Maintain and manager team SharePoint sites, state regulatory site
• Must be able to work on Workzone to maintain, create and manage documents.
• Must be able to use advanced Excel for data analysis and reporting.
• Create Business requirement documents and collect data from various reporting dashboards 
• Collects and documents report / programming requirements from requestors to ensure appropriate creation of reports and analyses. Uses peer-to-peer review process and end-user consultation to reduce report writing errors and rework.
• Identify and complete report enhancements/fixes; modify reports in response to approved change requests; retain old and new report design for audit trail purposes.
• Analyze data sets and trends for anomalies, outliers, trend changes, and opportunities.
• Create comprehensive workflows for the production and distribution of assigned reports, document reporting processes and procedures.
• Assist with completion of special projects as requested by various internal departments, or in support of requests from regulatory agencies, contracting agencies, or other external organizations.
• Demonstrate Healthcare experience in Quantifying, Measuring and Analyzing Financial and Utilization Metrics of Healthcare.

JOB QUALIFICATIONS

Required Education

Bachelor's Degree in Finance, Economics, Math, Computer Science or equivalent; or equivalent experience       

Required Experience

• Must have experience in Sharepoint, Excel, Workzone (PM tool)
• 2-4 years of increasingly complex experience in quantifying, measuring, and analyzing financial/performance management metrics  

Preferred Education

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

Preferred Experience

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
• Excel, Visio, Access, PowerBI

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: $52,176 - $107,098.87 / 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.