Molina Healthcare

Senior Analyst, Medical Economics - Healthcare Analytics & Trend Management (REMOTE)

Molina Healthcare • $95K — $115K *
US-AnywhereRemote in United States
Healthcare
Less than 5 years of experience
Today
Be an Early Applicant
Job Overview by Ladders

Qualifications

  • 3+ years of healthcare analytics and/or medical economics experience or equivalent education.
  • Bachelor's degree in a relevant field such as statistics or healthcare management.
  • Familiarity with Medicaid and Medicare programs.
  • Experience in the healthcare industry, including hospitals and managed care organizations.
  • Proficiency in data retrieval and dashboard building with tools like Excel, Power BI, or Tableau.
  • Knowledge of healthcare financing, coding systems, and operations.
  • Strong analytical, problem-solving, and communication skills.

Responsibilities

  • Lead analyses of medical costs and utilization trends for actionable recommendations.
  • Investigate root causes of healthcare trends using integrated data sources.
  • Develop and track Scorable Action Items (SAIs) for cost containment initiatives.
  • Monitor key cost drivers and trends to identify business opportunities early.
  • Design reports and dashboards to assess health plan performance and cost initiatives.
  • Conduct ROI analyses on proposed savings and affordability programs.
  • Translate complex analytics into strategic business recommendations.

Benefits

  • Competitive benefits package including health and wellness offerings.
  • Opportunities for professional development and career advancement.
  • Collaborative and supportive work environment.
  • Access to advanced analytical tools and resources.
Full Job Description
Job Description

JOB DESCRIPTION

Job Summary

Provides senior-level analytical support for Medical Economics initiatives through the extraction, analysis, and synthesis of complex healthcare data to identify risks, opportunities, and drivers of medical cost and utilization trends. Responsible for developing actionable insights that enhance financial performance, support strategic decision-making, and improve cost of care outcomes. Partners with cross-functional teams to identify, quantify, and monitor emerging trends, develop Scorable Action Items (SAIs) and affordability initiatives, and recommend innovative cost containment strategies. Translates analytical findings into clear, business-focused recommendations that drive operational improvements, medical cost savings, and sustainable financial results.

Essential Job Duties
  • Leads medical cost, utilization, and revenue trend analyses across Molina products, identifying emerging opportunities and risks, quantifying financial impact, and communicating actionable recommendations to leadership.
  • Identifies, investigates, and explains the root causes of medical cost and utilization trends through the integration of claims, provider, membership, authorization, and financial data.
  • Develops, sizes, tracks, and prioritizes Scorable Action Items (SAIs) and other affordability initiatives designed to reduce medical costs, improve efficiency, and enhance financial performance.
  • Proactively monitors key cost drivers and emerging healthcare trends, creating analytic frameworks and reporting tools to identify opportunities before they materially impact business performance.
  • Designs and develops reports, dashboards, and analytical tools to measure health plan performance, monitor trend drivers, and evaluate the effectiveness of cost containment initiatives.
  • Performs financial and ROI analyses to estimate the impact of proposed cost savings initiatives, affordability programs, clinical interventions, and vendor partnerships.
  • Draws actionable conclusions through advanced healthcare analytics, predictive modeling, and statistical analysis, translating complex findings into strategic business recommendations.
  • Extracts, compiles, and synthesizes data from multiple internal and external sources to support executive decision-making and strategic planning.
  • Mines, manages, and interprets large healthcare datasets to uncover patterns, anomalies, and actionable business insights.
  • Collaborates with clinical, provider network, finance, payment integrity, and operational teams to validate findings, provide business context, and develop intervention strategies.
  • Partners with business owners to establish and monitor key performance indicators (KPIs) for affordability initiatives and medical management interventions.
  • Leads analytical projects from concept through implementation, including executive presentations, strategic recommendations, and communication of findings to diverse stakeholder groups.
  • Serves as a subject matter expert in Medical Economics analytics, healthcare trend analysis, financial modeling, and opportunity identification.
  • Maintains knowledge of Medicaid, Medicare, Marketplace, and healthcare industry developments to assess potential impacts on medical costs, utilization patterns, and affordability strategies.

Required Qualifications
  • At least 3 years of health care analytics and/or medical economics experience, or equivalent combination of relevant education and experience.
  • Bachelor's degree in statistics, mathematics, economics, computer science, health care management or related field.
  • Demonstrated understanding of Medicaid and Medicare programs or other health care plans.
  • 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.)
  • Proficiency with retrieving specified information from data sources.
  • Experience with building dashboards in Excel, Power BI, and/or Tableau and data management.
  • Knowledge of health care operations (utilization management, disease management, HEDIS quality measures, claims processing, etc.)
  • 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).
  • Demonstrated 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.
  • Understanding of value-based risk arrangements
  • Experience in quantifying, measuring, and analyzing financial, operational, and/or utilization metrics in health care.
  • Ability to mine and manage information from large data sources.
  • Demonstrated problem-solving skills.
  • Strong critical-thinking and attention to detail.
  • Ability to effectively collaborate with technical and non-technical stakeholders.
  • Strong time-management skills, and ability to manage simultaneous projects and tasks to meet internal deadlines.
  • Effective verbal and written communication skills.
  • Proficient in Microsoft Office suite products, key skills in Excel (VLOOKUPs and pivot tables)/applicable software program(s) proficiency.

Preferred Qualifications
  • Proficiency with Power BI and/or Tableau for building dashboards.

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

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