Job Description Ohio Plan Specific: In the Ohio Plan we have organized our team so that this role will have the following Knowledge/Skills/Abilities:
Develop ad-hoc reports using SQL Programming, SQL Server Reporting Services (SSRS), Power BI, Medinsight, an dother analytic/programming tools as needed.
Analyze data sets and trends for anonmalies, outliers, trend changes and oppportunities.
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 expereince in Quantifying, Measuring and Analyzing financial utilization metrics of Healthcare.
Proactively identify and investigate complex suspect areas regarding medical cost issues
Apply investigative skill and analytical methos to look behind the numbers, assess business impacts and make recommendations through the use of healthcare analytics, predictive modeling, etc.
Summarize and present analytical findings to Leadership
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.
- 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
Qualifications Job Qualifications Required Education - Bachelor's Degree in Finance, Economics, Computer Science; or Public Health, Data Analytics, Health Information Management, or equivalent experience.
Required Experience - 5-7 years increasingly complex database and data management responsibilities, also basic knowledge of SQL
- 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
Required License, Certification, Association
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.
