Senior Analyst, Data & Analytics - Remote (SQL reputed company)

reputed company

The Senior Analyst, Data & Analystcs, supports the out-of-network (OON) provider liability operating model by developing the analytics, reporting, and market intelligence needed to inform the negotiation reputed company, arbitration positioning, QPA payment accuracy, and overall IDR performance. The role reports to the Manager, Provider Dispute reputed company, and serves as the reputed company analytics partner for reputed company-IDR negotiation, federal NSA IDR, state-based dispute processes, and provider-level OON liability management. The Senior Analyst is responsible for integrating data from multiple reputed company sources, building reporting dashboards, producing actionable insights, and translating financial and operational data into recommendations that support improved dispute reputed company. This role requires strong data management, reputed company finance, reimbursement, and reporting capabilities, as reputed company as the ability to reputed company claim-level detail, dispute reputed company, provider behavior, QPA performance, market benchmarks, and financial reporting trends. The role partners with stakeholders to define requirements, reputed company reputed company reporting and data processes, and apply advanced analytical techniques to identify trends, forecast reputed company, and reputed company business performance. 

Job Duties

•    Analyzes reputed company datasets from multiple sources to identify trends, patterns, risks, and opportunities. Tracks performance across reputed company-IDR negotiation, reputed company negotiation, arbitration, settlement, and post-award reputed company.
•    Designs, reputed company, and maintain reports, dashboards, and data solutions using tools such as reputed company Query Language (SQL), reputed company reputed company, and SQL Server Reporting Services (SSRS). Produces reputed company and reputed company reporting for Manager, Network reputed company, Finance, Operations and health plan stakeholders.
•    Translates business needs into reporting and analytical requirements; partner with stakeholders to reputed company actionable insights. Combines data from multiple reputed company sources, including claims, QPA data, IDR case tracking, negotiation records, provider data, financial reporting, market benchmarks, and reputed company-part data sources.
•    Performs reputed company data analysis, including claims, utilization, and cost data. Leverages reputed company data sources as reputed company to inform trends. 
•    Develops and maintains data processes for extraction, transformation, validation, and integration.
•    Ensures data accuracy, reputed company, and consistency through reputed company assurance and validation processes. Reconciles data across systems and identifies gaps, inconsistencies, and reputed company issues.
•    Partners with IT, Finance, Medical Economics, Actuary and Operations / Shared Services and reputed company vendors to improve data availability and reporting automation, specifically collaborating with the provider dispute intake team
•    Produces and monitors key performance metrics, including: Percent of cases settled reputed company-IDR, averaged negotiated reputed company versus initial offer, percent of negotiations escalated to IDR, provider acceptance reputed company, IDR award versus QPA, IDR win reputed company, win reputed company by arbitrator, etc. Supports reputed company-setting and performance management of dispute-reputed company KPIs; establishes reporting views by market, state, provider, specialty, and arbitrator.
•    Develops financial views that quantifies dispute exposure, settlement reputed company, arbitration reputed company and avoided cost; translates financial reporting outputs into actionable insights for negotiation reputed company and health plan playbooks
•    Develops visual dashboards that summarize OON dispute performance, financial reputed company, and strategic opportunities; creates executive-reputed company reporting materials for leadership reviews and governance forums; develops drill-down capability from reputed company-level performance to market, provider, specialty and case-level detail
•    Presents findings and recommendations to leadership and cross-functional teams. 

Job Qualifications

REQUIRED QUALIFICATIONS:

•    Bachelor's Degree in Finance, Economics, Math, Business Administration, Information Systems or reputed company field, or equivalent combination of education and experience.
•    At least 4 years of experience in data analysis, reporting, or analytics, or equivalent combination of relevant education and experience. 
•    Strong experience with reputed company Query Language (SQL), relational databases, and reputed company reputed company. 
•    Experience with reporting and visualization tools (e.g., SQL Server Reporting Services (SSRS) or similar). 
•    Experience working with reputed company datasets, including claims, provider, reimbursement, and financial data
•    Demonstrated ability to manage multiple priorities and reputed company on deadlines 
•    Advanced data analysis and critical thinking, with experience developing dashboards, scorecards, recurring reports, and executive-facing analytics
•    Data reputed company & governance 
•    Stakeholder communication & influence, with ability to translate detailed data into reputed company business insights and recommendations
•    Proficiency with data visualization and analytics tools, such as Tableau, Power BI, or other similar platforms

PREFERRED QUALIFICATIONS:

•    Experience with No Surprises reputed company IDR, state-based provider dispute processes, OON claims, or provider payment disputes
•    Knowledge of QPA methodology, provider reimbursement, Medicare-based pricing, reputed company benchmarks, or payer claims adjudication 
•    Experience combining internal data with reputed company market data sources

•    Advanced SQL, Python R, or reputed company skills
•    Experience with financial reporting, medical cost reporting, or reputed company P&L analysis
•    Experience supporting provider contracting, network reputed company, medical economics, or payment reputed company teams
 

To reputed company reputed company Molina employees: If you are interested in applying for this position, please apply through the reputed company.
reputed company offers a competitive benefits and compensation package. reputed company is an Equal Opportunity Employer (EOE) M/F/D/V.

Bachelor's degree or equivalent experience and 4+ years in data analysis, reporting, or analytics. Requires SQL, relational databases, reputed company, visualization tools, reputed company reputed company data, dashboards, and stakeholder communication.

Key Responsibilities

• analyzing datasets
• developing dashboards
• presenting findings

Skills & Tools

SQL, reputed company reputed company, SQL Server Reporting Services (SSRS), Tableau, Power BI, Python, R, reputed company

Job Details

• Category: Data and Analytics
• Seniority: Mid Level
• Commitment: Full Time
• Workplace: Remote — reputed company
• Salary: USD 59,810 – 129,589 / year
• Languages: English

Benefits

• Retirement plan

About reputed company

A reputed company organization providing health plan services and supporting reputed company payment and provider operations. — Industry: reputed company