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Analyst, Network Strategy, Pricing & Analytics

Long Beach, CA
Molina Healthcare


Analyst, Network Strategy, Pricing & AnalyticsLong Beach, California
Job ID 2002201
Job Description
Job Summary
Responsible for supporting and validating Provider Network contracting and unit cost management activities through financial and network pricing modeling, analysis, and reporting. Perform financial modeling to support well-informed negotiations, anticipating issues resulting in the ability to reach contract terms with good faith with sustainability.
• Develop 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 basis; develop reports on a regular basis using SQL, Excel, and other reporting software.
• Research, develop, analyze and recommend cost savings opportunities in alignment to support enterprise strategies
• Track, monitor, and report cost savings initiatives (hospitals, physicians, ancillary) trend analyses, and its performance on a monthly basis.
• Conduct financial modeling and analysis (including trend analysis) by utilizing NetworX Modeler and ETL systems to support negotiating strategies, modeling current and future contract rate proposals.
• Research, analyze, and consult Medicaid and Medicare reimbursement methodologies, evaluate the impact of reimbursement changes, educate/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 contracts (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)
Job Qualifications
Required Education
• Bachelor's Degree in Business, Finance, Mathematics, Economics, Data Science or Actuarial Sciences or equivalent experience
Required Experience
• 2+ years of analytics experience in financial analysis, healthcare pricing, network management, healthcare economics or related discipline.
• 1+ years of experience with provider payment methodologies and healthcare products.
• Ability to synthesize data into actionable steps; decision support & analysis.
• Strong verbal and written communication skills.
• Intermediate to advanced level proficiency in Microsoft Excel and/or Access/SQL.
• Proficiency in Microsoft PowerPoint.
Required License, Certification, Association
Preferred Education
Master's Degree
Preferred Experience
• Preferred experience in healthcare medical economics and/or strong financial analytics background
• Proactively identify and investigate complex suspect areas regarding medical cost issues
• Initiate in-depth analysis of the suspect/problem areas and suggest a corrective action plan
• Apply investigative skill and analytical methods to look behind the numbers, assess business impacts, and make recommendations through use of healthcare analytics, predictive modeling, etc.
• Experience with industry standard normalization/reimbursement methodologies (APR-DRG, MS-DRG, EAPG, APC)
Preferred License, Certification, Association
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.