Organizes healthcare claims, utilization, provider, and enrollment data to create recurring and ad hoc reports, dashboards, reconciliations, and analytical summaries. Identifies data-quality and process gaps, supports regulatory inquiries and cross-functional projects, tracks reporting deliverables, and translates complex healthcare data into actionable insights for business performance, cost containment, utilization, and compliance improvements.
JOB DESCRIPTION
Job Summary
Responsible for organizing data from multiple sources to produce reports, dashboards, and analyses related to utilization, cost-containment, and business performance. Supports projects, regulatory requests, and initiatives that improve data quality, reporting workflows, and process efficiencies. Performs research and analysis of complex healthcare data, such claims, and encounters, provider rosters, provider enrollment etc. Evaluates, writes, and presents healthcare data reports, provides actionable insights to support data improvements, and regulatory compliance fillings. Collaborates with various internal department units and makes recommendations based on relevant findings.
Essential Job Duties
- Prepares recurring and ad hoc reports, basic dashboards and analytical summaries for stakeholders.
- Maintains reconciliation, production, and monthly status reports.
- Assists in organizing, developing, and maintaining datasets related to healthcare claims, utilization, and other areas.
- Establishes and tracks timelines for reporting deliverables and project milestones.
- Identifies process gaps and recommends improvements to enhance data accuracy and reporting efficiency.
- Supports projects, regulatory inquiries, and cross-departmental data needs.
- Strong analytical and problem-solving skills.
- Ability to work independently and in a team.
- Strong attention to detail and organizational skills.
- Ability to translate complex data into actionable insights.
Required Qualifications
- At least 1 year of experience in data analysis, reporting, or healthcare analytics, or equivalent combination of relevant education and experience.
- Analytical problem-solving skills, including ability to interpret datasets, identify patterns, and share meaningful insights.
- Technical proficiency with Excel, and reporting/analytics tools, and ability to learn new technologies.
- Attention to detail, accuracy in data validation, report development, and documentation.
- Ability to work cross-functionally across a highly matrixed organization.
- Effective verbal, written, and interpersonal communication skills, and ability to collaborate with cross-functional teams to clarify requirements and present data-related findings and solutions.
- Microsoft Office suite and applicable software programs proficiency.
Preferred Qualifications
- Experience with Structured Query Language (SQL), SQL Server Reporting Services (SSRS), Crystal Reports, MedInsight, Power BI, relational databases or similar tools.
- Experience with customer relationship management (CRM) systems (e.g., Salesforce).
- Experience with Extract, Transform, Load (ETL) tools such as SQL Server Integration Services (SSIS) and data warehousing concepts.
- Familiarity with cloud data platforms (e.g., Azure data lakes) and business intelligence (BI) tools.
- Experience supporting regulatory reporting and healthcare payer systems (e.g., QNXT or similar platforms).
- Knowledge of healthcare utilization metrics, medical cost analysis, and performance indicators.
- Experience working with healthcare claims, pharmacy, or utilization data.
- Project management experience.
- Microsoft certification or similar technical credentials.
To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V
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