[Hiring] Senior Analyst, Data & Analytics @Molina Healthcare

Role Description

The Senior Analyst, OON Dispute Analytics and Reporting, supports the out-of-network (OON) provider liability operating model by developing the analytics, reporting, and market intelligence needed to inform the negotiation strategy, arbitration positioning, QPA payment accuracy, and overall IDR performance. The role reports to the Director, Provider Dispute Strategy, and serves as the primary analytics partner for:

• Pre-IDR negotiation
• Federal NSA IDR
• State-based dispute processes
• Provider-level OON liability management

The Senior Analyst is responsible for:

• Integrating data from multiple internal and external sources
• Building reporting dashboards
• Producing actionable insights
• Translating financial and operational data into recommendations that support improved dispute outcomes

This role requires strong:

• Data management
• Healthcare finance
• Reimbursement
• Reporting capabilities

The role partners with stakeholders to:

• Define requirements
• Develop scalable reporting and data processes
• Apply advanced analytical techniques to identify trends, forecast outcomes, and drive business performance

Qualifications

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

Requirements

• Experience with No Surprises Act IDR, state-based provider dispute processes, OON claims, or provider payment disputes
• Knowledge of QPA methodology, provider reimbursement, Medicare-based pricing, commercial benchmarks, or payer claims adjudication
• Experience combining internal data with external market data sources
• Advanced SQL, Python R, or Alteryx skills
• Experience with financial reporting, medical cost reporting, or healthcare P&L analysis
• Experience supporting provider contracting, network strategy, medical economics, or payment integrity teams

Benefits

• Molina Healthcare offers a competitive benefits and compensation package