See all roles

Sr Analyst, Healthcare Analytics (Remote)

Work from home Full-time role Hiring

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 • Develop ad-hoc reports using SQL programming, SQL Server Reporting Services (SSRS), Medinsight, RxNavigator, Crystal Reports, Executive Dashboard, and other analytic / programming tools as needed. • Generate and distribute standard reports on schedule using SQL, Excel, and other reporting software. • Create new databases and reporting tools for monitoring, tracking and trending based on project specifications. • 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. • Responsible for timely completion of projects, including timeline development and maintenance; coordinates activities and data collection with requesting internal departments or external requestors. • 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, using statistical tools and techniques to determine significance and relevance. Utilize extrapolation, interpolation, and other statistical methodologies to predict future trends in cost, utilization and performance. Provide executive summary of findings to requestors. • Create comprehensive workflows for the production and distribution of assigned reports, document reporting processes and procedures. • Assist with research, development and completion of special projects as requested by various internal departments, or in support of requests from regulatory agencies, contracting agencies, or other external organizations. • Maintains SharePoint Sites as needed. Job Qualifications Required Education Bachelor's Degree in Finance, Economics, Computer Science Required 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 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: $59,810.6 - $129,589.63 / ANNUAL • Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level Apply Job!

You might like

Demand Generation Associate, Health Plans (Hybrid or Remote)

Work from home Full-time role

Patient Representative - Remote | WFH

Work from home Full-time role

Licensed Clinical Social Worker - Remote

Work from home Full-time role

Coordinator - Hybrid Patient Monitor

Work from home Full-time role

IT Contract Analyst, (Operations and Policy Analyst 2)

Work from home Full-time role

CVS Remote Jobs (Work From Home) $25/Hour

Work from home Full-time role

Technical Printer Support Representative - Remote

Work from home Full-time role

Client Service Excellence Representative PA - Remote (Pipeline 2024)

Work from home Full-time role

CVS Remote Jobs (Work From Home) $30/Hour – Apply Now

Work from home Full-time role

Office Assistant I - Mayor's Office of Employment Development

Work from home Full-time role

Experienced Customer Service Representative – Remote Customer Support Team at arenaflex

Work from home Full-time role

Experienced Full Stack Live Chat Support Specialist – Conversational AI Development

Work from home Full-time role

Require ESSER III ELA/Math Tutor in Arizona

Work from home Full-time role

Senior Staff Machine Learning Engineer, Guest & Host

Work from home Full-time role

Urgent Care Nurse Practitioner

Work from home Full-time role

Senior Business Analyst

Work from home Full-time role

Cold Caller / Closer - Snr Vice President

Work from home Full-time role

Experienced Full Stack Remote Data Entry Specialist – No Experience Required, Competitive Pay, and Comprehensive Benefits at Blithequark

Work from home Full-time role

Experienced Data Entry Specialist – Remote Part-Time Opportunity with arenaflex

Work from home Full-time role

AI Engineer/ML Engineer - Senior Developers - AI Training - Atlanta, US

Work from home Full-time role