Jobs
>
Long Beach

    Sr Analyst, Healthcare Analytics - Long Beach, United States - Molina Healthcare

    Default job background
    Description

    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, $129,589.63 / ANNUAL

    *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.


  • Molina Healthcare Long Beach, United States

    Job Summary · Manages the activities of the Data Analytics and Operations team. 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 reports an ...


  • Molina Healthcare Long Beach, United States

    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 recommendation ...


  • Molina Healthcare Long Beach, United States

    **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 report ...


  • Molina Healthcare Long Beach, United States

    **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 report ...


  • Molina Healthcare Long Beach, United States

    Job Description · 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 contai ...


  • Molina Healthcare Long Beach, United States Full time

    Job Description · 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 containm ...


  • Molina Healthcare Long Beach, United States Full time

    Job Description · 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 containm ...


  • Molina Healthcare Long Beach, United States Full time

    Job Description · JOB DESCRIPTION · Job Summary · 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 ...


  • Memorial Health University Medical Center Carson, United States

    Title: Sr. Healthcare Analytics Developer · Location: Fountain Valley, CA / Remote · Department: IS Healthcare Intelligence · Status: Full Time · Shift: Days · Pay Range*: $106, $155,001.60 · At MemorialCare Health System, we believe in providing extraordinary healthc ...


  • Molina Healthcare Long Beach, United States

    Job Description · JOB DESCRIPTION · Job Summary · Manages the activities of the Data Analytics and Operations team. Performs research and analysis of complex healthcare claims data, pharmacy data, and lab data regarding network utilization and cost containment information. Eva ...


  • MemorialCare Fountain Valley, United States

    · Title: Sr. Healthcare Analytics Developer · Location: Fountain Valley, CA / Remote · Department: IS Healthcare Intelligence · Status: Full Time · Shift: Days · Pay Range*: $106, $155,001.60 · At MemorialCare Health System, we believe in providing extraordinary healt ...


  • MemorialCare Health Services Fountain Valley, United States Full time

    Description · Title: Sr. Healthcare Analytics Developer · Location: Fountain Valley, CA / Remote · Department: IS Healthcare Intelligence · Status: Full Time · Shift: Days · Pay Range*: $106, $155,001.60 · At MemorialCare Health System, we believe in providing extraordinary hea ...


  • Molina Healthcare Long Beach, United States

    Job Summary · Analyst, 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 i ...


  • Molina Healthcare Long Beach, United States

    Job Summary · The position will oversee and manage the Vendor Management team responsible of managing and coordinating the vendor activities between contracted entities and Molina Healthcare to support enrollment, claims, contact center, appeals and grievances, risk adjustment, m ...

  • Molina Healthcare

    Vp, Member

    2 weeks ago


    Molina Healthcare Long Beach, United States

    Job Duties · - Responsible for all Member and Provider Services, including Workforce Management, Reporting, Data & Analytics, Quality Assurance, Business Solutions, Vendor Performance and Telephony across Medicaid, Medicare and Marketplace. · - Develops and drives strategic initi ...

  • Molina Healthcare

    Director, Quality

    3 weeks ago


    Molina Healthcare Long Beach, United States

    Job Description · Job Summary · Job Duties · Serves as the primary contact to State agencies for all Risk and Quality matters. · Leads the local Quality committees. · Prepares, in collaboration and support with MHI Quality, required documentation for state Performance Improvement ...


  • Molina Healthcare Long Beach, United States

    Job Description · Job Summary · Job Duties · Identifies innovative Quality interventions that meet state and federal intervention rules and are aligned with effective practices as identified in the healthcare quality improvement literature and within Molina plans. · Develops targ ...


  • Molina Healthcare Long Beach, United States

    Care Review Clinician, Inpatient Review · - Behavioral Health · For this position we are seeking a LPC or LCSW who lives in and must be licensed for the state they reside. Strong inpatient medical and analytical experience is needed. Excellent computer multi-tasking skills and go ...


  • Molina Healthcare Long Beach, United States

    **Remote and must live in the United States** · **Job Description**: · Job Summary · This role will require a comprehensive knowledge of computer information systems along with the skills necessary for effective decision making in a business environment that is diverse and highly ...

  • Molina Healthcare

    Lead, Hcs

    3 weeks ago


    Molina Healthcare Long Beach, United States

    Job Summary · Molina Healthcare Services (HCS) Department works with members, providers and multidisciplinary team members to assess, facilitate, plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long-term care, for members w ...