Molina Healthcare · 3 hours ago
Senior Analyst, Network Strategy, Pricing & Analytics (VBC) - REMOTE
United States
Full-time
Remote
Senior Level
$78K/yr - $130K/yr
5+ years expMolina Healthcare is a company focused on improving access to quality healthcare services. The Senior Analyst, Network Strategy, Pricing & Analytics role involves guiding network partner investments through contract valuation and analysis, performing financial modeling, and developing pricing strategies to enhance cost efficiency and care quality.
Health CareHospitalMedical
Responsibilities
Guide the investment of our network partners through contract valuation and analysis to ensure access to quality healthcare services for people receiving government assistance
Perform research, financial modeling, and analysis of complex healthcare claims data (medical, pharmacy and ancillary) to deliver practical, actionable financial and even clinical insights to focus high priorities and attack underperforming and problematic contracts
Support multi-dimensional pricing strategies to drive down total cost of care and minimize variation in cost by leveraging value-based care models
Develop key strategic reports and analysis using SQL programming, SQL Server Analytic Services (SSAS), Business Intelligence tools (Medinsight, PowerBI), and Executive Dashboard
Generate hospital performance analytics tools on a quarterly basis; develop reports on a regular basis using SQL, Excel, and other reporting software
Research, develop, analyze and recommend cost savings opportunities in alignment to support enterprise strategies
Track, monitor, and report cost savings initiatives (hospitals, physicians, ancillary) trend analyses, and its performance on a monthly basis
Conduct financial modeling and analysis (including trend analysis) by utilizing NetworX Modeler and ETL systems to support negotiating strategies, modeling current and future contract rate proposals
Research, analyze, and consult Medicaid and Medicare reimbursement methodologies, evaluate the impact of reimbursement changes, educate/consult the health plans on the financial impact
Work independently to support and validate Provider Network contracting and unit cost management activities through financial and network pricing modeling, analysis, and reporting
Translate contract rates and terms to evaluate the financial impact to effectively negotiate new or amended contracts (e.g. coding and chargemaster impact analysis)
Present analytical results and findings to healthplans' senior management team and key stakeholder meetings (PowerPoint)
Coordinate and provide peer review of our quarterly national contract performance analysis by team members to ensure timely deliverables to stakeholders requiring decision support
Evaluate, write, and present healthcare utilization and cost containment reports and make recommendations based on relevant findings
Provide peer review of pricing configuration to ensure accuracy of financial modeling
Provide peer review of team members' presentations for total cost of care and profit improvement initiatives
Support process improvements for the team's methods of collecting and documenting report/programming requirements
Serve as a key resource on the more complex pricing and analysis issues
Review work performed by others and provide recommendations for improvement
Qualification
Required
Bachelor's Degree in Business, Finance, Mathematics, Economics, Data Science or Actuarial Sciences or equivalent experience
5+ years of analytics experience in financial analysis, healthcare pricing, network management, healthcare economics or related discipline
5+ years increasingly complex database and data management responsibilities
Advanced level proficiency in Microsoft Excel
Intermediate to advanced level proficiency in SQL
5+ years of increasingly complex experience in quantifying, measuring, and analyzing financial/performance management metrics
Preferred
Master's Degree
Preferred experience in healthcare medical economics and/or strong financial analytics background
Proactively identify and investigate complex suspect areas regarding medical cost issues
Initiate in-depth analysis of the suspect/problem areas and suggest a corrective action plan
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
Experience with industry standard normalization/reimbursement methodologies (APR-DRG, MS-DRG, EAPG, APC)
Benefits
Competitive benefits and compensation package
Company
Molina Healthcare
Molina Healthcare is a healthcare company that specializes in government-sponsored healthcare programs for families and individuals.
10001+ employees
H1B Sponsorship
Molina Healthcare has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2025 (56)
2024 (45)
2023 (43)
2022 (31)
2021 (35)
2020 (55)
Funding
Current Stage
Public CompanyTotal Funding
$2.35B2025-11-17Post Ipo Debt· $850M
2024-11-13Post Ipo Debt· $750M
2021-11-16Post Ipo Debt· $750M
Leadership Team
Dave Reynolds
Executive Vice President, Health Plans & Medicaid Chief Operating Officer
Debbie Simkins
Vice President, Office of the CIO
Recent News
2025-12-30
The Motley Fool
2025-12-30
Company data provided by crunchbase