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Sr Analyst, Healthcare Analytics
3 months ago
JOB DESCRIPTION
Job Summary
This Sr. Analyst, Healthcare Analytics role will support Molina's Risk Adjustment Analytics team. The job responsibilities include developing risk score models with Databricks, organizing and managing large and varied data sets, analyzing healthcare data for decision support, and communicating findings. Qualified candidates are the diligent problem solvers who have Databricks experience with advanced skills in data analysis. Performs research and deep-dive analysis of complex healthcare claims data, CMS return files, and financial cost, revenue, and vendor data. Collaborates with actuarial and operational staff to analyze, understand, modify, and communicate models and results. Makes recommendations to management based on relevant findings.
KNOWLEDGE/SKILLS/ABILITIES
- Compile and organize health care data using Databricks and Spark SQL programming, Notebooks, Workflows, Repositories, and other analytic / programming processes as needed.
- Collect programming specifications from requestors to develop Notebooks, Workflows, and documentation using multiple data sources, crosswalks, and built-in validation checks.
- Use peer-to-peer review process and end-user consultation to reduce errors and rework.
- Assist with root cause analysis to maintain high integrity data and processes to minimize discrepancies and gaps.
- Must have a strong attention to detail and knowledge of data structure and programming.
- Understanding data storage and data sharing methods.
- Converting data into usable information that is easy to understand.
- Research and develop reports and analysis for senior management and effectively communicate results.
Required Education
Bachelor's Degree in Finance, Economics, Math or Computer Science
Required Experience
- 5-7 years increasingly complex database and data management responsibilities
- 5-7 years of increasingly complex experience in quantifying, measuring, and analyzing financial/performance management metrics
- Demonstrate Healthcare experience in Quantifying, Measuring and Analyzing Financial and Utilization Metrics of Healthcare
- Basic knowledge of Databricks
Preferred experience in Medical Economics and Strong Knowledge of Performance Indicators:
- Experience developing queries within project management tools like Azure DevOps.
- Risk Adjustment experience and knowledge of risk score models like the Medicare Advantage CMS model, the Commercial ACA HHS model, and/or the Medicaid CDPS+Rx model.
- 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.
- Analysis and forecasting of trends to provide analytic support for finance, pricing and actuarial functions.
- Healthcare Analyst I experience desired.
- Advanced knowledge of Databricks
- PowerBI, Excel, Power Pivot, VBA, Macros, Copilot
- Python, PySpark, R, SAS, or other programming language(s)
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.