Analyst, Network Strategy, Pricing & Analytics - REMOTE

Company:  Molina Healthcare
Location: Covington
Closing Date: 23/10/2024
Hours: Full Time
Type: Permanent
Job Requirements / Description

JOB DESCRIPTIONJob SummaryAnalyst, Network Strategy, Pricing & Analytics guides the investment of our network partners through contract valuation and analysis to ensure access to quality healthcare services for people receiving government assistance. Strengthens access to quality care with improved outcomes through better coordination and preventive care and develop payment strategies that give incentives to providers and healthcare systems that deliver better health, more affordably.Performs research, financial modeling, and analysis of complex healthcare claims data (medical, pharmacy and ancillary) to deliver practical, actionable financial and even clinical insights to focus high priorities and attack underperforming and problematic contracts. Supports multi-dimensional pricing strategies to drive down total cost of care and minimize variation in cost by leveraging value-based care models.KNOWLEDGE/SKILLS/ABILITIESDevelop key strategic reports and analysis using SQL programming, SQL Server Analytic Services (SSAS), Business Intelligence tools (Medinsight, PowerBI), and Executive Dashboard.Generate hospital performance analytics tools on a quarterly basis; develop reports on a regular basis using SQL, Excel, and other reporting software.Research, develop, analyze and recommend cost savings opportunities in alignment to support enterprise strategiesTrack, monitor, and report cost savings initiatives (hospitals, physicians, ancillary) trend analyses, and its performance on a monthly basis.Conduct financial modeling and analysis (including trend analysis) by utilizing NetworX Modeler and ETL systems to support negotiating strategies, modeling current and future contract rate proposals.Research, analyze, and consult Medicaid and Medicare reimbursement methodologies, evaluate the impact of reimbursement changes, educate/consult the health plans on the financial impact.Work independently to support and validate Provider Network contracting and unit cost management activities through financial and network pricing modeling, analysis, and reportingAbility to translate contract rates and terms to evaluate the financial impact to effectively negotiate new or amended contracts (e.g. coding and chargemaster impact analysis)Strong written and verbal communication skills required to present analytical results and findings to healthplans' senior management team and key stakeholder meetings (PowerPoint).JOB QUALIFICATIONSRequired EducationBachelor's Degree in Business, Finance, Mathematics, Economics, Data Science or Actuarial Sciences or equivalent experienceRequired Experience3+ years of analytics experience in financial analysis, healthcare pricing, network management, healthcare economics or related discipline.3+ years increasingly complex database and data management responsibilitiesAdvanced level proficiency in Microsoft ExcelIntermediate to advanced level proficiency in SQL3+ years of increasingly complex experience in quantifying, measuring, and analyzing financial/performance management metricsPreferred EducationMaster's DegreePreferred ExperiencePreferred experience in healthcare medical economics and/or strong financial analytics backgroundProactively identify and investigate complex suspect areas regarding medical cost issuesInitiate in-depth analysis of the suspect/problem areas and suggest a corrective action planApply investigative skill and analytical methods to look behind the numbers, assess business impacts, and make recommendations through use of healthcare analytics, predictive modeling, etc.Experience with industry standard normalization/reimbursement methodologies (APR-DRG, MS-DRG, EAPG, APC)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.#PJHPO#LI-AC1Pay Range: $49,430.25 - $107,098.87 / ANNUAL*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

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