Job Description
**Job Description**
**Job Summary**
Provides consultative support and medical cost-based analysis of markets and network initiatives. The Medical Economics Consultant manages conflicting priorities and multiple projects concurrently. Responsible for extracting, analyzing, and synthesizing data from various sources to identify risks and opportunities as well as packaging and delivering the results to senior leadership. Responsible for consulting with network and clinical management on opportunities to improve our company's discount position and strategic cost and utilization initiatives.
**Knowledge/Skills/Abilities**
+ Analyze and research utilization and unit cost medical cost drivers
+ Turn data into usable information by tell the story through data visualization working with clinical, provider network and other personnel to bring supplemental context and insight to data analyses
+ Support the development of scoreable action items by identifying outlier cost issues
+ Perform drill-down analysis to identify medical cost trend drivers; advise network of contracting opportunities to mitigate future trends
+ Own, track and document all aspects of related work from beginning to end of a project
+ Extract and compile information from various systems to support executive decision-making
+ Ability to mine and manage information from large data sources
+ Working with Excel, MS-Access and Web-based query tools (data warehouse)
**Job Qualifications**
**REQUIRED EDUCATION:**
Bachelor's Degree in Finance, Mathematics, Statistics, or Economics
**REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS & ABILITIES:**
5 - 7 years in healthcare/managed care industry with knowledge of provider contracting, provider reimbursement, patient management, product, benefits design, or related experience.
**PREFERRED EDUCATION:**
Master's Degree in Business Administration, Finance, Mathematics, Statistics, or Economics
**PREFERRED EXPERIENCE:**
Experience working with medical and pharmacy claims, authorization data, benefits design, medical management as well as knowledge of business functions and impact on financials (underwriting, sales, product development, network management.)
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: $80,412 - $188,164 / ANNUAL
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
Job Tags
Work experience placement,
Similar Jobs
Robert Half
Description Top Am Law Firm Seeks Trial Paralegal for High-Profile Litigation Team: MOSTLY REMOTEAbout Firm & Position: An Am Law 100 firm with a strong national reputation seeks a Trial Paralegal to join its Century City office. This is a rare opportunity to work with...
Children's Council of San Francisco
...Preferred) Department/Unit: Child Care Family Services Reports To: Community Outreach... ...assistance to pay for it. We provide home-based childcare businesses with the training and... ...professionally with all visitors and callers. Answers agency multi-phone lines and operates...
Jobright.ai
...Summary: iurApp is seeking a detail-oriented and analytical Data Analyst to join their team. The role involves transforming raw data into... ...Qualifications: Required: 2+ years of experience in data analysis Proficiency in SQL, Python, or R Experience...
Get It - Finance
**Jr. Asset Underwriter** **Job Overview:** We are seeking a detail-oriented and motivated **Jr. Asset Underwriter** to join our team. This role operates within the express swim lane process and requires a strong understanding of risk management beyond just applying...
Two95 International Inc.
...Title: Business System Analyst Location: Ewing, NJ Duration: Contract 6+ months Rate: $Open Requirements Business System Analyst with Jira confluence and agile with testing background (manual and some automation). Note: If interested please...