Manager, Medical Economics - REMOTE
location_onPacific Avenue, Long Beach, Los Angeles County, California, 90802, United States
Job Description
About the Role
The Manager, Medical Economics leads a specialized team responsible for medical economics analysis activities. This role is pivotal in extracting, analyzing, and synthesizing data from various sources to identify risks and opportunities, ultimately driving improved financial performance. The position serves as a strategic liaison between the Enterprise Information Management (EIM) team and medical economics personnel, ensuring that reporting needs are met with accuracy and clarity.
Team Context and Mission
This role operates within the Medicaid line of business, where the team collaborates closely with health plans to identify and track savings opportunities. The manager coordinates and leads trend review meetings related to clinical programs and initiatives, acting as a key resource for the team on medical economics and analysis-related questions. By maintaining rigorous reporting service level benchmarks and overseeing the delivery of monthly trend and performance review presentations, the team ensures that leadership has the insights needed to make informed decisions.
Culture and Values
Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V. We are committed to fostering an inclusive environment where diverse perspectives are valued. Our culture emphasizes collaboration, critical thinking, and attention to detail, encouraging team members to effectively engage with both technical and non-technical stakeholders to solve complex healthcare challenges.
Work location
Work model: Remote
Pacific Avenue, Long Beach, Los Angeles County, California, 90802, United States
Long Beach, California
Key Responsibilities
- check_circleCollaborate with health plans to track savings opportunities
- check_circleLead trend review meetings for Medicaid clinical programs
- check_circleReview regulatory reporting and project documentation
- check_circlePresent monthly trend and performance reviews
- check_circleServe as liaison between EIM and medical economics
- check_circleManage medical economics team and oversee project delivery
- check_circleAnalyze data to identify risks and financial opportunities
- check_circleRecruit, hire, and develop medical economics staff
Requirements
- verifiedAt least 7 years of healthcare analytics and/or medical economics experience
- verifiedAt least 1 year of management/leadership experience
- verifiedBachelor’s degree in statistics, mathematics, economics, computer science, healthcare management, or related field
- verifiedStrong knowledge of SSRS 2005/2008 and Power BI report development
- verifiedExperience building dashboards in Excel, Power BI, and/or Tableau
- verifiedProficient in Microsoft Office suite, specifically Excel (VLOOKUPs and pivot tables)
- verifiedFamiliar with relational database concepts and SDLC concepts
- verifiedKnowledge of healthcare operations (utilization management, disease management, HEDIS, claims processing)
- verifiedKnowledge of healthcare financial terms and standard code systems (ICD-10CM, CPT, HCPCS, NDC)
- verifiedUnderstanding of key managed care concepts and provider reimbursement principles
- verifiedUnderstanding of value-based risk arrangements
Skills, education and keywords
Skills: ssrs 2005, ssrs 2008, power bi, tableau, excel, vlookup, pivot tables, microsoft office, relational database, sdlc.
Education: Bachelor’s degree in statistics, mathematics, economics, computer science, healthcare management, or related field.