Molina Healthcare

Director, Medical Economics - REMOTE

Molina Healthcare • $120K — $150K *
US-AnywhereRemote in United States
Healthcare
8 - 10 years of experience
Today
Be an Early Applicant
Job Overview by Ladders

Qualifications

  • 8+ years in health care analytics or medical economics
  • 3+ years of management or leadership experience
  • Bachelor's degree in a relevant field
  • Advanced knowledge of healthcare programs, especially Medicaid and Medicare
  • Proficient in data tools like Excel, Power BI, and Tableau
  • Strong understanding of healthcare operations and financial terms
  • Excellent problem-solving and critical-thinking skills

Responsibilities

  • Lead analytics teams for care and population health management
  • Collaborate with stakeholders to define analytical priorities and insights
  • Design evaluations of healthcare programs measuring engagement and outcomes
  • Apply advanced analytical methodologies to assess program impact
  • Develop population health analytics for high-risk members
  • Translate complex data into actionable insights for decision-makers
  • Direct strategies for program optimization and resource allocation

Benefits

  • Comprehensive health and wellness programs
  • Professional development opportunities
  • Collaborative and inclusive work environment
  • Work-life balance initiatives
  • Potential for career advancement and mentoring
Full Job Description
Job Description

JOB DESCRIPTION

Job Summary

Leads and directs Strategic and Clinical Analytics team members in Medical Economics who are responsible for healthcare analytics and program evaluation, translating complex data into actionable insights that inform clinical, operational, and strategic decision-making. Partners with clinical and enterprise stakeholders to define priorities, address critical business questions, and identify opportunities to improve health outcomes and financial performance. Provides analytical leadership and develops sound approaches to advance population health and healthcare program performance.

Essential Job Duties
  • Leads teams responsible for analytics and evaluation of care management, utilization management, and other clinical and population health programs.
  • Partners with clinical leaders and enterprise stakeholders to identify business questions, define analytical approaches, and provide insights and interpretation to support decision-making.
  • Designs and conducts evaluations of healthcare programs to assess engagement, clinical, and ROI outcomes.
  • Applies advanced methodologies, including causal inference, predictive modeling, and analysis of heterogeneous treatment effects, to evaluate program impact and identify opportunities for improvement.
  • Develops population health analytics to identify members at high risk for unfavorable outcomes and those most impactable through targeted clinical interventions.
  • Translates complex analytical results into clear, actionable recommendations for clinical, operational, and enterprise partners.
  • Leads development of analytical strategies and frameworks to support program optimization, prioritization, and resource allocation.
  • Collaborates with cross-functional partners to develop metrics, measurement approaches, and analytic tools for monitoring program performance and outcomes.
  • Provides analytical oversight and guidance for high-priority initiatives, ensuring rigorous methodology, meaningful interpretation, and alignment with business and clinical objectives.
  • Recruits, hires, onboards, mentors, develops, and manages analytics staff.
  • Leads teams in the development and delivery of analytics, reporting, and evaluation capabilities that address enterprise priorities.
  • Coordinates projects involving employees across functional and enterprise areas.
  • Stays abreast of professional developments, emerging analytical methodologies, healthcare trends, and advances in population health and clinical program evaluation

Required Qualifications
  • At least 8 years of health care analytics and/or medical economics experience, or equivalent combination of relevant education and experience.
  • At least 3 years management/leadership experience.
  • Bachelor's degree in statistics, mathematics, economics, computer science, health care management or related field.
  • Advanced understanding of Medicaid and Medicare programs or other health care plans.
  • Advanced analytical work experience within the health care industry (i.e., hospital, network, ancillary, medical facility, health care vendor, commercial health insurance, large physician practice, managed care organization, etc.)
  • Advanced proficiency with retrieving specified information from data sources.
  • Advanced experience with building dashboards in Excel, Power BI, and/or Tableau and data management.
  • Advanced knowledge of health care operations (utilization management, disease management, HEDIS quality measures, claims processing, etc.)
  • Advanced knowledge of health care financial terms (e.g., PMPM, revenue) and different standard code systems (ICD-10CM, CPT, HCPCS, NDC, etc.) utilized in medical coding/billing (UB04/1500 form).
  • Advanced understanding of key managed care concepts and provider reimbursement principles such as risk adjustment, capitation, FFS (Fee-for-Service), Diagnosis Related Groups (DRG's), Ambulatory Patient Groups (APG's), Ambulatory Payment Classifications (APC's), and other payment mechanisms.
  • Advanced understanding of value-based risk arrangements
  • Advanced experience in quantifying, measuring, and analyzing financial, operational, and/or utilization metrics in health care.
  • Advanced problem-solving skills.
  • Advanced critical-thinking and attention to detail.
  • Ability to effectively collaborate with technical and non-technical stakeholders, and engage with various levels within the organization.
  • Strong time-management skills, and ability to manage simultaneous projects and tasks to meet internal deadlines.
  • Strong verbal and written communication skills.
  • Proficient in Microsoft Office suite products, advanced skills in Excel (VLOOKUPs and pivot tables)/applicable software program(s) proficiency.

Preferred Qualifications
  • Experience in complex managed care.
  • Advanced degree in statistics, mathematics, economics, computer science, health care management or related field.


To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board.

Molina Healthcare offers a competitive benefits and compensation package.

About Molina Healthcare

Molina Healthcare focuses exclusively on government-sponsored health care programs for families and individuals who qualify for government-sponsored health care. It contracts with state governments and serves as a health plan, providing a wide range of quality health care services to families and individuals.

Molina Healthcare Careers

Join the dedicated team at Molina Healthcare, a leader in providing quality healthcare services to families and individuals who qualify for government-sponsored programs, including Medicaid and Medicare. As one of the most respected companies in the health services industry, Molina Healthcare offers unparalleled job opportunities aimed at empowering your career growth and professional development.

Work You’ll Do

At Molina Healthcare, you will engage in meaningful work that directly impacts lives across the country. Our team is committed to innovation in healthcare, ensuring that all members receive the best care possible. By joining us, you will collaborate with skilled professionals dedicated to our mission of providing accessible, high-quality healthcare.

Career Opportunities and Growth

Whether you are looking for your first job, seeking a leadership role, or aiming to specialize in healthcare professions, Molina Healthcare offers a range of career paths. Our job opportunities span across various functions, including clinical services, customer support, IT, project management, and more. We believe in fostering the growth of our employees through professional development, leadership training, and diversity initiatives.

Internship Programs

Kickstart your career with a Molina Healthcare internship. Our internships provide invaluable workplace experience, offering a glimpse into the healthcare industry through hands-on projects and mentorship. Interns at Molina Healthcare gain critical skills that prepare them for future employment, making them competitive candidates in the job market.

Culture and Benefits

Molina Healthcare is not just a company; it’s a community. We prioritize a culture of inclusivity and respect, where all team members are encouraged to bring their whole selves to work. Our employees enjoy comprehensive benefits, including health insurance, retirement plans, and wellness programs, all designed to support both their professional and personal lives.

Join Our Team

Explore the various positions available at Molina Healthcare and find where your skills and interests align with our needs. We are continuously hiring talented individuals who are passionate about making a difference in healthcare. Prepare your resume, sharpen your interview skills, and become part of a team that values hard work and creativity.

Stay Connected

Keep up to date with the latest at Molina Healthcare: - **Career Growth and Networking:** Advance your career through our professional development and networking opportunities. Learn from leaders and peers alike to build connections that propel your career forward. - **Innovation and Leadership:** Drive change and lead with confidence by participating in our leadership and innovation training programs.

Apply Now

Ready to take the next step in your healthcare career? Search open positions that match your skills and interests on the Molina Healthcare Jobs portal. We look for driven, curious, and compassionate team players ready to make an impact.

Stay Informed

Subscribe to Molina Healthcare job alerts and receive updates on new openings and company news directly to your inbox. Tailor your subscription to match your career preferences and stay ahead in the dynamic field of healthcare. Join Molina Healthcare, where your career is nurtured, your contributions are valued, and your growth is guaranteed.
Learn more about Molina Healthcare
Size
14,000 employees
Market Cap
$19.5 billion
Industry
Healthcare
Net Income
$673 million
Founded
1980
5 Year Trend
+9.3%
Revenue
$19.4 billion
NASDAQ
MOH
* Ladders Estimates

Similar Jobs

Ad banner background

Get Ready For Your
Next Interview

More Jobs at Molina Healthcare

More Healthcare Jobs

Find similar Director, Medical Economics - REMOTE jobs:

NationwideRemote