Director, Healthcare Analytics (CA Health Plan) - REMOTE at Molina Healthcare

Long Beach, California, United States -

Full Time

Start Date

Immediate

Expiry Date

07 May, 26

Salary

0.0

Posted On

06 Feb, 26

Experience

10 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Healthcare Analytics, SQL, Data Analysis, Cost Containment, Utilization Management, Mentoring, Coaching, Regulatory Compliance, Reporting, Finance, Database Development, Care Coordination, Risk Adjustment, Quality Analysis, Subject Matter Expert, Project Collaboration

Industry

Hospitals and Health Care

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 Directs Health Plan strategic analysis and planning coordinating across business units to meet data analysis and database development needs. Includes Utilization Management data needs, facilitating care coordination. • Mentors, coaches, and provides guidance regarding finance and analysis. • Identifies and sets departmental priorities in alignment with the operating plan, budget, and regulatory requirements. • Implements strategies to ensure service level benchmarks for report turn-around are met. Reporting includes Healthcare Analysis, Quality Analysis, Risk Adjustment, Finance and other departments. Demonstrates best practices and collaboration on projects. • Reviews high priority analyses, reports, SQL programming and other Finance projects for accuracy, completeness, return on investment, and compliance with regulatory requirements. • Functions as subject matter expert on finance and healthcare analytics topics. Able to teach financial/technical information. • Reviews regulatory contract requirements and reporting requirements applicable to the Finance Department. Implements strategies and infrastructure to ensure compliance with regulatory requirements.. Job Qualifications Required Education • Bachelor's Degree in Finance, Economics, Math, Computer Science, Information Systems or related field Required Experience • 5 years experience leading healthcare analytics function • 12 years work experience preferable in claims processing environment and/or healthcare environment • Strong knowledge of SQL 2005/2008 SSRS report development • Familiar with relational database concepts, and SDLC concepts Preferred Education • Masters' Degree in Finance, Economics, Math, Computer Science, Information Systems or related field. Preferred Experience 5 – 7 years supervisory experience 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.

Responsibilities

The Director performs research and analysis of complex healthcare claims, pharmacy, and lab data to evaluate network utilization and cost containment. They also mentor staff, set departmental priorities, and ensure compliance with regulatory requirements.