Dir, Medical Economics

Job Description 
 

Job Summary

Responsible for leading the Medical Economics team to develop SAI tracking tools in conjunction with SAI leads to support of Health Plans data management needs. Collaborates with senior leadership to identify opportunities to improve the Health Plan's performance and data management.

Knowledge/Skills/Abilities

• Participates or leads standard trend management review with Health Plans 
• Leads ad hoc analysis to support Health Plans and Shared Service Partners. 
• Coordinate with Shared Services functions (Payment Integrity, National Contracting, Health Services) to conduct annual deep dive trend review of each Health Plan. 
• Coordinates trend mitigation strategies with Health Plans, Shared Services and SAI process. 
• Performs consistent follow up on issues and opportunities identified. 
• Leads staff to utilize tracking tool for trend mitigation items being worked between Health Plan and Shared Services (Tools and Technology). 
• Coordinates analytical views of data for oversight of initiatives and impact on trend. 
• Leads team to develop SAI tracking tools in conjunction with SAI leads. 
• Leads team to develop intake tool for MedEcon Request 
• Coordinates Data management advocacy structure and set organizational standards. 
• Primary point of contact between MedEcon and EIM Team. 
• Coordinate projects involving employees across functional areas. 
• Stay abreast of professional developments and industry trends.

Job Qualifications

Required Education

Bachelor's Degree

Required Experience

6+ Years

Preferred Experience

7 Years and experience in complex managed care or other health care organizations.
 

 

 

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.