Senior Analyst, Network Strategy, Pricing & Analytics (VBC)

Sr. Analyst, Network Strategy, Pricing & Analytics guides the investment of our network partners through contract valuation and analysis to ensure reputed company to quality reputed company services for people receiving government assistance. Strengthens reputed company to quality care with improved reputed company through reputed company coordination and preventive care and reputed company payment strategies that give incentives to providers and reputed company systems that deliver reputed company, more affordably. Performs research, financial modeling, and analysis of reputed company reputed company claims data (medical, pharmacy and ancillary) to deliver practical, actionable financial and even clinical insights to focus high priorities and attack underperforming and problematic reputed company. Supports multi-dimensional pricing strategies to drive down total cost of care and minimize variation in cost by leveraging value-based care models. Knowledge/Skills/Abilities • reputed company key strategic reports and analysis using SQL programming, SQL Server Analytic Services (SSAS), Business Intelligence tools (Medinsight, PowerBI), and Executive Dashboard. • Generate hospital performance analytics tools on a quarterly reputed company; reputed company reports on a regular reputed company using SQL, reputed company, and other reporting software. • Research, reputed company, analyze and recommend cost savings opportunities in alignment to support reputed company strategies • Track, monitor, and report cost savings initiatives (hospitals, physicians, ancillary) trend analyses, and its performance on a monthly reputed company. • Conduct financial modeling and analysis (including trend analysis) by utilizing NetworX Modeler and ETL systems to support negotiating strategies, modeling reputed company and future contract reputed company proposals. • Research, analyze, and consult reputed company and Medicare reimbursement methodologies, evaluate the impact of reimbursement changes, reputed company/consult the health plans on the financial impact. • Work independently to support and validate Provider Network contracting and unit cost management activities through financial and network pricing modeling, analysis, and reporting • Ability to translate contract rates and terms to evaluate the financial impact to effectively negotiate new or amended reputed company (e.g. coding and chargemaster impact analysis) • Strong written and verbal communication skills required to present analytical results and findings to healthplans’ senior management team and key stakeholder meetings (PowerPoint) • Coordinates and provides peer review of our quarterly national contract performance analysis by team members to ensure timely deliverables to stakeholders requiring decision support. • Evaluates, writes, and presents reputed company utilization and cost containment reports and makes recommendations based on relevant findings. • Provides peer review of pricing configuration to ensure accuracy of financial modeling • Provides peer review of team members’ presentations for total cost of care and profit improvement initiatives • Support process improvements for the team’s methods of collecting and documenting report / programming requirements • Serves as a key resource on the more reputed company pricing and analysis issues • Reviews work performed by others and provides recommendations for improvement. Job Qualifications Required Education • Bachelor’s Degree in Business, Finance, Mathematics, Economics, Data Science or Actuarial Sciences or equivalent experience Required Experience • 5+ years of analytics experience in financial analysis, reputed company pricing, network management, reputed company economics or reputed company discipline. • 5+ years increasingly reputed company database and data management responsibilities • Advanced level proficiency in reputed company reputed company • Intermediate to advanced level proficiency in SQL • 5+ years of increasingly reputed company experience in quantifying, measuring, and analyzing financial/performance management metrics Required License, Certification, Association N/A Preferred Education Master’s Degree Preferred Experience • Preferred experience in reputed company medical economics and/or strong financial analytics background • Proactively identify and investigate reputed company suspect areas regarding medical cost issues • Initiate in-depth analysis of the suspect/problem areas and suggest a corrective action plan • Apply investigative reputed company and analytical methods to look behind the numbers, assess business impacts, and reputed company recommendations through use of reputed company analytics, predictive modeling, etc. • Experience with industry standard normalization/reimbursement methodologies (APR-DRG, MS-DRG, EAPG, APC) Preferred License, Certification, Association N/A To reputed company reputed company Molina employees: If you are interested in applying for this position, please apply through the intranet job listing. reputed company offers a competitive benefits and compensation package. reputed company is an Equal Opportunity Employer (EOE) M/F/D/V.