What are the responsibilities and job description for the Sr Analyst, Medical Economics (NY Medicaid Market) - REMOTE position at Molina Healthcare?
JOB DESCRIPTION
Job Summary
The Senior Analyst, Medical Economics provides support and consultation to the Health Plan and Finance team through analyzing key business issues related to cost, utilization and revenue for multiple Molina Healthcare products. Designs and develops reports to monitor health plan performance and identify the root causes of medical cost trends. With those root causes identified, drives innovation by creating tools to monitor trend drivers and provide recommendations to senior leaders for affordability opportunities.
Responsible for conducting complex analyses of insured medical populations with the goal of identifying opportunities to improve financial performance. Extracts, analyzes, and synthesizes data from various sources to identify risks and opportunities.
This position will primarily support the New York Medicaid market.
Job Duties
- Extract and compile information from various systems to support executive decision-making
- Mine and manage information from large data sources.
- Analyze claims and other data sources (e.g. authorization) to identify early signs of trends or other issues related to medical care costs
- Solve complex analytical problems while using the most appropriate combination of analytical tools (SQL, Power BI, Excel, Python, R, etc.) to answer a given problem
- Lead monthly trend presentations to plan leadership and other stakeholders
- Work with clinical, provider network and other personnel to bring supplemental context / insight to data analyses, and design and perform studies related to the quantification of medical interventions.
- Work with business owners to track key performance indicators of medical interventions
- Perform pro forma sensitivity analyses in order to estimate the expected financial value of proposed medical cost improvement initiatives
- 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
- Draw actionable conclusions based on analyses performed, make recommendations through use of healthcare analytics, predictive modeling, and communicate those conclusions effectively to audiences at various levels of the enterprise
- Analyze the financial performance of all Molina Healthcare products, identify favorable and unfavorable trends, develop recommendations to improve trends, communicate recommendations to management
- Lead projects to completion by contributing to ad-hoc data analyses, development, and presentation of financial reports
- Serve as subject matter expert on developing financial models to evaluate the impact of provider reimbursement changes
- Provide data driven analytics to Finance, Claims, Medical Management, Network, and other departments to enable critical decision making
- Support Financial Analysis projects related to medical cost reduction initiatives
- Support Medical Management by assisting with Return on Investment (ROI) analyses for vendors to determine if their financial and clinical performance is achieving desired results
- Keep abreast of Medicaid and Medicare reforms and their impact on Molina Healthcare
Job Qualifications
Required Education :
Bachelor's Degree in Mathematics, Economics, Computer Science, Healthcare Management, or related field.
Required Experience, Knowledge, Skills, and Abilities :
Preferred Qualifications :
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 : $67,725 - $129,590 / ANNUAL
Salary : $67,725 - $129,590
