Director, Healthcare Analytics (CA Health Plan) - REMOTE

Molina Healthcare•Long Beach, CA

22d•Remote

About The Position

Job Summary Performs research and analysis of complex healthcare claims data, pharmacy data, and lab data regarding network utilization and cost containment information. Evaluates, writes, and presents healthcare utilization and cost containment reports and makes recommendations based on relevant findings. Knowledge/Skills/Abilities Directs Health Plan strategic analysis and planning coordinating across business units to meet data analysis and database development needs. Includes Utilization Management data needs, facilitating care coordination.

Requirements

Bachelor's Degree in Finance, Economics, Math, Computer Science, Information Systems or related field
5 years experience leading healthcare analytics function
12 years work experience preferable in claims processing environment and/or healthcare environment
Strong knowledge of SQL 2005/2008 SSRS report development
Familiar with relational database concepts, and SDLC concepts

Nice To Haves

Masters' Degree in Finance, Economics, Math, Computer Science, Information Systems or related field.
5 – 7 years supervisory experience

Responsibilities

Mentors, coaches, and provides guidance regarding finance and analysis.
Identifies and sets departmental priorities in alignment with the operating plan, budget, and regulatory requirements.
Implements strategies to ensure service level benchmarks for report turn-around are met. Reporting includes Healthcare Analysis, Quality Analysis, Risk Adjustment, Finance and other departments. Demonstrates best practices and collaboration on projects.
Reviews high priority analyses, reports, SQL programming and other Finance projects for accuracy, completeness, return on investment, and compliance with regulatory requirements.
Functions as subject matter expert on finance and healthcare analytics topics. Able to teach financial/technical information.
Reviews regulatory contract requirements and reporting requirements applicable to the Finance Department. Implements strategies and infrastructure to ensure compliance with regulatory requirements.