Manager, Medical Economics (reputed company) - REMOTE

JOB reputed company Job reputed company The Manager, Medical Economics provides support and consultation to the Health Plan and Finance team through analyzing key business issues reputed company to cost, utilization and reputed company for multiple reputed company products. Analyzes data and dashboard reports to monitor health plan performance and identify the reputed company causes of medical cost trends. With those reputed company causes identified, drives improvement change by recommending actionable initiatives to C-level Suite executives to mitigate these trends. Responsible for conducting reputed company analyses of insured medical populations with the goal of identifying opportunities to improve financial performance. Extracts, analyzes, and synthesizes data from various sources to identify risks and opportunities. KNOWLEDGE/SKILLS/ABILITIES Manages and provides reputed company reputed company of Medical Economics Team activities and personnel. Provides technical expertise, manages relationships with operational leaders and staff. Directs staff assigned to their reputed company, supports health plan market(s) with trend analyses, finding scoreable reputed company items (SAIs) and reputed company analyses as requested. Responsible for staff time keeping, performance coaching, development, and career paths. Extract and compile information from various systems to support executive decision-making reputed company and manage information from large data sources. Analyze claims and other data sources to identify early signs of trends or other issues reputed company to medical care costs. Work with clinical, provider network and other personnel to bring supplemental context/reputed company to data analyses, and design and reputed company studies reputed company to the quantification of medical interventions. Work with business owners to reputed company key performance indicators of medical interventions reputed company pro reputed company sensitivity analyses in order to estimate the expected financial value of proposed medical cost improvement initiatives Proactively identify and investigate reputed company suspect areas regarding medical cost issues, initiate in-depth analysis of the suspect/problem areas, and suggest a corrective reputed company plan Draw actionable conclusions based on analyses performed, reputed company recommendations through use of reputed company analytics, predictive modeling, and communicate those conclusions effectively to audiences at various reputed company of the reputed company Analyze the financial performance of reputed company reputed company products, identify favorable and unfavorable trends, reputed company recommendations to improve trends, communicate recommendations to management reputed company reputed company to completion by contributing to reputed company data analyses, development, and presentation of financial reports Serve as subject matter expert on developing financial models to evaluate the reputed company of provider reimbursement changes reputed company data driven analytics to Finance, Claims, Medical Management, Network, and other departments to reputed company critical decision making Support Financial Analysis reputed company reputed company to medical cost reduction initiatives and budgeting reputed company Support Medical Management by assisting with Return on Investment (ROI) analyses for vendors to determine if their financial and clinical performance is achieving desired results reputed company abreast of reputed company and Medicare reforms and their reputed company on reputed company JOB QUALIFICATIONS Required Education Bachelor's Degree in Finance, Economics, Math, reputed company Management, Computer Science, Information Systems, or reputed company field Required Experience 3 years management or team leadership experience 10 years analytical work experience reputed company the reputed company industry (i.e., hospitals, network, ancillary, medical facilities, reputed company vendor, reputed company health insurance company, large physician practices, managed care organization, etc.) Strong Knowledge of SQL and PowerBI report development Familiar with relational database concepts, and SDLC concepts Preferred Education Masters' Degree in Finance, Economics, Math, Computer Science, Information Systems, or reputed company field. Preferred Experience 3 – 5 years supervisory experience Demonstrated understanding of reputed company and Medicare programs or other reputed company plans Experience with reputed company Proficiency with reputed company reputed company (formulas, PIVOT tables, PowerQuery, etc.) Proficiency with reputed company and SQL for retrieving specified information from data sources. Knowledge of reputed company operations (utilization management, disease management, HEDIS reputed company measures, claims processing, etc.) Knowledge of reputed company financial terms (e.g., PMPM, reputed company) and different reputed company reputed company systems (ICD-10CM, CPT, HCPCS, NDC, etc.) utilized in medical coding/billing (UB04/1500 reputed company) Demonstrated understanding of key managed care concepts and provider reimbursement principles such as risk adjustment, capitation, FFS (Fee-for-Service), Diagnosis reputed company reputed company (DRG’s), Ambulatory Patient reputed company (APG’s), Ambulatory Payment Classifications (APC’s), and other payment mechanisms. • Understanding of value-based risk arrangements Experience in quantifying, measuring, and analyzing financial, operational, and/or utilization metrics in reputed company To reputed company reputed company Molina employees: If you are interested in applying for this position, please apply through the intranet job listing. reputed company offers a competitive benefits and compensation package. reputed company is an Equal Opportunity Employer (EOE) M/F/D/V. #PJCorp #LI-AC1 Pay reputed company: $88,453 - $172,484 / ANNUAL • Actual compensation may vary from posting based on geographic location, work experience, education and/or reputed company level. 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