Analyst, Network Strategy, Pricing & Analytics - REMOTE

$49,430 - $107,099/Yr

Molina Healthcare

Full-time

Remote

Insurance Carriers and Related Activities

About the position

The Analyst, Network Strategy, Pricing & Analytics role at Molina Healthcare focuses on guiding the investment of network partners through contract valuation and analysis. The position aims to enhance access to quality healthcare services for individuals receiving government assistance by developing payment strategies that incentivize providers and healthcare systems to deliver better health outcomes affordably. The analyst will perform research, financial modeling, and analysis of complex healthcare claims data to provide actionable insights and support pricing strategies that minimize cost variations.

Responsibilities

• Guide the investment of network partners through contract valuation and analysis.
• Perform research, financial modeling, and analysis of complex healthcare claims data.
• Develop key strategic reports and analysis using SQL programming and Business Intelligence tools.
• Generate hospital performance analytics tools and develop regular reports using SQL and Excel.
• Research and recommend cost savings opportunities aligned with enterprise strategies.
• Track and report cost savings initiatives and their performance on a monthly basis.
• Conduct financial modeling and analysis to support negotiating strategies.
• Research and analyze Medicaid and Medicare reimbursement methodologies and their impacts.
• Support and validate Provider Network contracting and unit cost management activities.
• Translate contract rates and terms to evaluate financial impacts for negotiations.
• Present analytical results and findings to senior management and stakeholders.

Requirements

• Bachelor's Degree in Business, Finance, Mathematics, Economics, Data Science or Actuarial Sciences or equivalent experience.
• 3+ years of analytics experience in financial analysis, healthcare pricing, network management, or related discipline.
• 3+ years of database and data management responsibilities.
• Advanced proficiency in Microsoft Excel.
• Intermediate to advanced proficiency in SQL.
• 3+ years of experience in quantifying, measuring, and analyzing financial/performance management metrics.

Nice-to-haves

• Master's Degree in a relevant field.
• Experience in healthcare medical economics or strong financial analytics background.
• Ability to identify and investigate complex medical cost issues.
• Experience with healthcare analytics and predictive modeling.
• Familiarity with normalization/reimbursement methodologies (APR-DRG, MS-DRG, EAPG, APC).

Benefits

• Competitive benefits and compensation package.