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Molina Talent Acquisition

via Oraclecloud

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Manager, Medical Economics (VBC) - REMOTE

Anywhere
full-time
Posted 8/30/2025
Direct Apply
Key Skills:
Data Management
SQL
SSRS
Power BI
Team Leadership
Project Management
Business Logic
Database Development
Regulatory Reporting
Financial Analysis
Utilization Patterns
Medical Management
Mentoring
Coaching
Value-Based Programs
Risk Adjustment

Compensation

Salary Range

$Not specified

Responsibilities

The Manager of Medical Economics oversees the Medical Economics Team, ensuring accurate data analysis and reporting for management decision-making. They manage team activities, allocate project requests, and serve as a liaison between departments.

Requirements

Candidates must have a Bachelor's Degree in a relevant field and at least 10 years of experience in a claims processing or healthcare environment. Management experience of 3 years is required, along with strong SQL and reporting skills.

Full Description

JOB DESCRIPTION Job Summary Collects, validates, analyzes, and organizes data into meaningful reports for management decision making as well as designing, developing, testing, and deploying reports to other end users for operational and strategic analysis. KNOWLEDGE/SKILLS/ABILITIES Manages and provides direct oversight of Medical Economics Team activities and personnel. Provides technical expertise, manages relationships with operational leaders and staff. Directs staff assigned to their projects, maintains internal work plans as well as project work plans to meet reporting needs of the Medical Economics Team. Responsible for staff time keeping, performance coaching, development, and career paths. Daily management of Data management, Tools & Technology work stream. Allocate new report/project requests (workload distribution). Coordinates with Medical Economics team to meet data analysis and database development needs. Reviews, evaluates, and improved business logic and data sources. Resource to staff for mentoring, coaching, and analysis questions. Reviews Medical Economics analyst work products to ensure accuracy and clarity. Reviews regulatory reporting requirements and Health Plan project documentation. Maintains reporting service level benchmarks for EIM team. Represents Medical Economics department in cross-departmental and operational meetings. Serves as liaison between EIM and Medical Economics regarding reporting needs. Creates reporting for strategic analysis, profitability, financial analysis, utilization patterns and medical management. Interfaces and maintains positive interactions with Health Plan and Corporate personnel. JOB QUALIFICATIONS Required Education Bachelor's Degree in Finance, Economics, Math, Computer Science, Information Systems, or related field Required Experience 3 years management or team leadership experience 10 years’ work experience preferable in claims processing environment and/or healthcare environment Strong knowledge of SQL 2005/2008 SSRS and Power BI report development Familiar with relational database concepts, and SDLC concepts Preferred Education Masters' Degree in Finance, Economics, Math, Computer Science, Information Systems, or related field. Preferred Experience 3 – 5 years supervisory experience Demonstrated knowledge of Value-Based Programs (VBP) including shared savings, bundled payments, pay-for-performance, and capitation Experience in VBP modeling, including expected and actual revenues/volumes, past performance, proposed contract language, risk adjustment and regulatory changes To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

This job posting was last updated on 8/31/2025

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