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
Similar Jobs
Cloud • Information Technology • Security • Software • Cybersecurity
Conduct advanced threat research across endpoint and cloud environments, dissecting and replicating adversary techniques to improve detection. Engineer attack automation, test code, and proof-of-concept detections; collaborate with detection engineers, analysts, and threat hunters; document findings; influence product strategy and vendor telemetry; and mentor junior researchers.
Top Skills:
Ai/MlAWSCC++Endpoint Detection And Response (Edr)GitGitGoLinuxmacOSMicrosoft 365OktaPowershellPythonRustWindows
Cloud • Information Technology • Security • Software • Cybersecurity
Conducts advanced threat research across endpoint, cloud, and identity environments. Analyzes and replicates cyberattacks, engineers automated attack and test code, develops detection proofs of concept, and provides scalable detection recommendations. Collaborates with detection engineers, intelligence analysts, and threat hunters, documents findings, presents research, contributes to product strategy, and mentors colleagues.
Top Skills:
Ai/MlAWSAzureCC++Cloud SecurityEndpoint Detection And Response (Edr)GCPGitGitGoLinuxmacOSMicrosoft 365OktaPowershellPythonWindows
Artificial Intelligence • Professional Services • Business Intelligence • Consulting • Cybersecurity • Generative AI
Executes procurement workstreams, manages purchase requests and orders, evaluates supplier proposals and contracts, supports sourcing strategies, and coordinates supplier relationships. Analyzes procurement data and market trends to identify cost savings and process improvements, assists with contract lifecycle activities, monitors vendor risk and performance, and maintains procurement records and reports. Guides junior team members and builds relationships with internal stakeholders.
What you need to know about the Los Angeles Tech Scene
Los Angeles is a global leader in entertainment, so it’s no surprise that many of the biggest players in streaming, digital media and game development call the city home. But the city boasts plenty of non-entertainment innovation as well, with tech companies spanning verticals like AI, fintech, e-commerce and biotech. With major universities like Caltech, UCLA, USC and the nearby UC Irvine, the city has a steady supply of top-flight tech and engineering talent — not counting the graduates flocking to Los Angeles from across the world to enjoy its beaches, culture and year-round temperate climate.
Key Facts About Los Angeles Tech
- Number of Tech Workers: 375,800; 5.5% of overall workforce (2024 CompTIA survey)
- Major Tech Employers: Snap, Netflix, SpaceX, Disney, Google
- Key Industries: Artificial intelligence, adtech, media, software, game development
- Funding Landscape: $11.6 billion in venture capital funding in 2024 (Pitchbook)
- Notable Investors: Strong Ventures, Fifth Wall, Upfront Ventures, Mucker Capital, Kittyhawk Ventures
- Research Centers and Universities: California Institute of Technology, UCLA, University of Southern California, UC Irvine, Pepperdine, California Institute for Immunology and Immunotherapy, Center for Quantum Science and Engineering
