Role Summary

HIGHLIGHTS

Senior health pricing and analytics role focused on Medicaid and Medicare provider network contract valuation and financial modeling. You will analyze medical, pharmacy and ancillary claims to drive payment strategies, cost containment, and support negotiations. Senior Analyst level (5+ years) and remote, supporting Molina Healthcare’s Network Strategy, Pricing & Analytics.

JOB DESCRIPTION SUMMARY

Value and model provider contracts for Medicaid and Medicare networks
Analyze complex claims data (medical, pharmacy, ancillary) to find cost savings
Build reports and dashboards using SQL, SSAS, PowerBI and Excel
Support negotiating strategies using NetworX Modeler and ETL systems
Senior individual contributor with 5+ years healthcare pricing/analytics experience

DOMAIN EXPERTISE

healthcare pricing and network contract valuation
analysis of medical, pharmacy, and ancillary claims data
Medicaid and Medicare reimbursement methodologies
financial modeling for provider contracting
experience with NetworX Modeler or ETL-based contract modeling

KEY REQUIREMENTS

5+ years analytics experience in healthcare pricing, network management, or healthcare economics
5+ years database and data management responsibilities
Intermediate to advanced SQL proficiency
Advanced Microsoft Excel skills
Bachelor’s degree in Business, Finance, Mathematics, Data Science, Actuarial Science or equivalent