Senior Analyst, Network Strategy, Pricing & Analytics - REMOTE

Job Summary

Sr. Analyst, Network Strategy, Pricing & Analytics guides the investment of our network partners through contract valuation and analysis to ensure access to quality healthcare services for people receiving government assistance. Strengthens access to quality care with improved outcomes through better coordination and preventive care and develop payment strategies that give incentives to providers and healthcare systems that deliver better health, more affordably.

Performs research, financial modeling, and analysis of complex healthcare claims data (medical, pharmacy and ancillary) to deliver practical, actionable financial and even clinical insights to focus high priorities and attack underperforming and problematic contracts. Supports multi-dimensional pricing strategies to drive down total cost of care and minimize variation in cost by leveraging value-based care models. Applies advanced dashboarding and data engineering techniques (e.g., SQL/PostgreSQL, Python, Tableau/Power BI) to automate recurring analytics and executive-level reporting.

Knowledge/Skills/Abilities

• Develop key strategic reports and analysis using SQL (including PostgreSQL), SQL Server Analytic Services (SSAS), Business Intelligence tools (Tableau and Power BI), MedInsight, and Executive Dashboards. Leverage Python and Power Query to support data preparation, transformation, and repeatable ETL.• Generate VBC performance analytics tools; develop reports on a regular basis using SQL/Excel, Tableau/Power BI and other reporting software; automate routine refreshes to improve timeliness and quality.• Research, develop, analyze and recommend cost savings opportunities in alignment to support enterprise strategies; visualize opportunities with interactive dashboards to support decision-making by senior leaders.• Track, monitor, and report cost savings initiatives (hospitals, physicians, ancillary) trend analyses, and its performance on a monthly basis; present concise, executive‑ready summaries and briefings.• Conduct financial modeling and analysis (including trend analysis) to support negotiating strategies, modeling current and future contract rate proposals; supplement with Python-based analysis and Tableau/Power BI scenarios where appropriate.• Work independently to support and validate Provider Network contracting and unit cost management activities through financial and network pricing modeling, analysis, and reporting; ensure data lineage and quality through documented prep/transform steps (e.g., Power Query/ETL).• Ability to translate contract rates and terms to evaluate the financial impact to effectively negotiate new or amended VBC contracts; create stakeholder-ready visuals and narratives to explain drivers and options.• Strong written and verbal communication skills required to present analytical results and findings to Health Plans senior management team and key stakeholder meetings ((PowerPoint supported by Tableau/Power BI visuals).• Coordinate and provide peer review of quarterly VBC contract performance analysis to ensure timely decision support deliverables; establish standardized dashboard QA and metric validation.
• Evaluates, writes, and presents VBC performance reports and makes recommendations based on relevant findings.• Provides peer review of team members' presentations for total cost of care and profit improvement initiatives; coach on data visualization best practices.• Support process improvements for the team's methods of collecting and documenting report / programming requirements; use light automation (e.g., scripts/UiPath) to reduce manual effort where feasible.• Serves as a key resource on the more complex statistical analyses for VBC program evaluation. • 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, healthcare economics, statistics, or related discipline.
• 5+ years increasingly complex database and data management responsibilities.
• Advanced level proficiency in Microsoft Excel.
• Intermediate to advanced level proficiency in SQL.
• 5+ years of increasingly complex experience in quantifying, measuring, and analyzing financial/performance management metrics using modern BI tools (Tableau and/or Power BI) and Python where appropriate.

Preferred Educationmaster'S Degree.

Preferred Experience
• Preferred experience in healthcare medical economics and/or strong financial analytics or statistics 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, advanced dashboards, statistical techniques, and automation. 
• Experience navigating and analyzing large, complex operational datasets.
• Experience with industry standard normalization/reimbursement methodologies (APR-DRG, MS-DRG, EAPG, APC).

• 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.