What Jobs are available for Healthcare Professionals in Spokane?

Showing 9 Healthcare Professionals jobs in Spokane

Data Analyst (Healthcare Preferred) - Remote

99207 Spokane, Washington Molina Healthcare

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Job Description

**Job Summary**
Designs and implements processes and solutions associated with a wide variety of data sets used for data/text mining, analysis, modeling, and predicting to enable informed business decisions. Gains insight into key business problems and deliverables by applying statistical analysis techniques to examine structured and unstructured data from multiple disparate sources. Identifies and interprets trends and patterns in datasets to locate influences and provides recommendations and strategic/tactical plans based on findings. Collaborates within Care Connections and across departments to define requirements and understand business problems. Uses advanced mathematical, statistical, querying, and reporting methods to develop solutions. Develops information tools, algorithms, dashboards, and queries to monitor and improve business performance. Creates specifications for reports and analysis based on business needs and required or available data elements and works with Clinical Informatics to design. Creates solutions from initial concept to fully tested production products and communicates results to a broad range of audiences.
Effectively uses current and emerging technologies.
**KNOWLEDGE/SKILLS/ABILITIES**
+ Extracts and compiles various sources of information and large data sets from various systems to identify and analyze data.
+ Sets up process for monitoring, tracking, and trending department data, including quality measures, effectiveness of communications, and process improvements.
+ Works with internal, external and enterprise stakeholders, as needed, to research, develop, and document new standard reports and/or processes.
+ Implements and uses the analytics software and systems to support department goals.
**JOB QUALIFICATIONS**
**Required Education**
Associate's Degree or equivalent combination of education and experience
**Required Experience**
1-3 years
**Preferred Education**
Bachelor's Degree or equivalent combination of education and experience
**Preferred Experience**
3-5 year
Quality and/or Medicare Stars knowledge highly preferred
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.
Pay Range: $77,969 - $116,835 / ANNUAL
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
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Accounting Internship, Healthcare Audit Fall 2026

99207 Spokane, Washington Wipfli LLP

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Job Description

Overview
At Wipfli, people count.
At Wipfli, our people are core to everything we do-the catalyst behind our ability to create exceptional impact and extraordinary results.
We believe in flexibility. We focus on relationships. We encourage each individual to follow their own path.
People truly matter and they feel it. For those looking to make a difference and find a professional home, Wipfli offers a career-defining opportunity.
This role requires an in-person work arrangement. At Wipfli, in-person work is defined as associates regularly working 5 days a week, for full-time interns, or during your working hours, for part-time interns, in a Wipfli office or at client sites. The client sites can vary locally, regionally, or nationally depending on the industry alignment. Scheduled meetings at the client and in the office require in-person attendance.
Responsibilities
Responsibilities:
Interns will be responsible for utilizing educational knowledge and experience to perform numerous accounting related responsibilities (in audit or financial accounting) such as:
+ Respond to client and firm associate requests in a timely, accurate, positive and professional manner
+ Respond to inquiries from client and work with client to gather necessary information for completion of required documents
+ Use data analysis skills to discover useful information and patterns to provide support in recommendations
+ Proactively identify improvement opportunities in processes to enhance efficiency
Healthcare Audit & Accounting Specific:
+ Perform audit, review, and compliance testing procedures in accordance with firm an professional standards and as directed by engagement leaders
+ Communicate with engagement leaders regarding open items, testing problems, or other important matters in a timely manner
+ Prepare (or review client prepared) financial statements and footnotes, management reports, and other engagement outputs
+ Develop technical competency with GAAP, especially related to assigned product line
+ Assist team with Medicare and Medicaid/Medi-cal Cost Report Reimbursement team!
What You will Gain
+ Experience the Wipfli Way first hand while working side by side with professionals from all levels of the firm
+ Develop experience and skills to become a trusted business advisor for clients and associates
+ Gain hands-on experience in tax and/or audit work, and related software applications
+ Work as an individual contributor and as part of a team to support client engagements
+ Gain exposure to a variety of clients and industries ranging from small businesses to large corporations
+ Develop administrative, professional, and interpersonal skills to the extent of being able to organize, analyze, and communicate with others in a productive and efficient manner
This position will take place starting in August-December 2 026.
Knowledge, Skills and Abilities
Qualifications:
+ Pursuing a Bachelors or Master's degree in Accounting (completion of corporate or individual taxation class is required)
+ Above average knowledge in accounting as demonstrated by college GPA; Preferred 3.0 GPA or higher
+ Working towards eligibility to sit for CPA exam upon graduation
+ Preferred coursework in Data Analytics or Big Data
+ Ability to think independently and make good decisions based on education and experience
+ Good communication and interpersonal skills to effectively communicate with clients and staff
+ Ability to prioritize work, follow through on requests, take initiative and meet deadlines
+ Must be legally authorized to work in the United States on a full-time basis upon hire. Wipfli will not consider candidates for this position who require sponsorship for employment visa status now or in the future (e.g., H-1B status)
Estella Anderson, from our recruiting team, will be guiding you through this process. Visit herLinkedIn ( page to connect!
#LI-Hybrid
#LI-EA1
Additional Details
This role requires an in-person work arrangement. At Wipfli, in-person work is defined as associates regularly working 5 days a week in a Wipfli office or at client sites. The client sites can vary locally, regionally, or nationally depending on the industry alignment. Scheduled meetings at the client and in the office require in-person attendance.
Additional Details:
Not fully prepared to apply for an internship or not sure where to start? Please join our Talent Community to explore how you can stay connected to Wipfli.
Wipfli is an equal opportunity/affirmative action employer. All candidates will receive consideration for employment without regards to race, creed, color, religion, national origin, sex, age, marital status, sexual orientation, gender identify, veteran status, disability, or any other characteristics protected by federal, state, or local laws.
Wipfli is committed to providing reasonable accommodations for people with disabilities. If you require a reasonable accommodation to complete an application, interview, or participate in our recruiting process, please send us an email at
Wipfli values fair, transparent, and competitive compensation, considering each candidate's unique skills and experiences. The estimated base pay rate for this role is $28/hour. The actual salary at the time of offer depends on business related factors like location, skills, experience, training/education, licensure, certifications, business needs, current associate pay, and relevant employment laws.
Wipfli cares about our associates and offers a variety of benefits to support their well-being. Benefit offerings include paid sick leave; access to free, confidential counseling through our Employee Assistance Program. This role requires a hybrid work arrangement. At Wipfli, hybrid is defined as associates regularly work in a Wipfli office, from home, and other meeting sites. Note that scheduled meetings in the office will require in-person attendance.
"Wipfli" is the brand name under which Wipfli LLP and Wipfli Advisory LLC and its respective subsidiary entities provide professional services. Wipfli LLP and Wipfli Advisory LLC (and its respective subsidiary entities) practice in an alternative practice structure in accordance with the AICPA Code of Professional Conduct and applicable law, regulations, and professional standards. Wipfli LLP is a licensed independent CPA firm that provides attest services to its clients, and Wipfli Advisory LLC provides tax and business consulting services to its clients. Wipfli Advisory LLC and its subsidiary entities are not licensed CPA firms.
Job LocationsUS-WA-Spokane
Job ID
Category Entry-Level/Internships
Remote No
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Healthcare Operations Intern (Reporting & Analytics) - REMOTE

99207 Spokane, Washington Molina Healthcare

Posted 12 days ago

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Job Description

**JOB DESCRIPTION**
**Job Summary**
The Molina Healthcare Internship Program shares an objective to create a steppingstone for students who aim to be professionals and future leaders in the healthcare business profession. Interns are assigned special projects and various other duties that are intended to provide them with valuable professional work experience and industry insight. The purpose of an internship is to develop talent by providing students with experiential learning, formal training and opportunities to interact with healthcare professionals and community leaders. Interns will perform meaningful work alongside talented professionals, gaining insight to Molina's culture, Mission and Values.
**KNOWLEDGE, SKILLS & ABILITIES**
**Implementation Support:** Works to support management and teams through following job duties for implementation support:
+ Provides support with analytical, problem solving, including definition and documentation, business workflow analysis, specifications, requirements definition and documentation.
+ Supports documentation and changes to existing business processes. Helps to identify new opportunities for process developments and improvements.
+ Supports team on work plans and other deliverables for assigned areas utilizing approved templates and practices to ensure consistent content and format is maintained across department.
**Data Analytics:** Reviews data extracts from multiple sources of information and large data sets from a variety of systems to identify and analyze outliers.
+ Supports the work related to monitoring, tracking, and trending department data.
+ Supports preparation of state mandated reports and analysis.
**Preferred Experience**
+ Must possess clear and professional written, verbal and interpersonal communication skills.
+ Strong work ethic, self-motivated and ability to develop relationships.
+ Good time management, organizational and interpersonal skills required
+ Computer and data analysis experience including MS Word, Excel, Outlook and PowerPoint and experience with internet research.
+ Excellent critical thinking/problem solving skills
+ Ability to handle confidential information
+ Ability to maintain confidentiality and to comply with Health Insurance Portability and Accountability Act (HIPAA)
**REQUIRED EDUCATION:**
+ Must be currently enrolled in an undergraduate or graduate program
+ Should be a freshman sophomore or junior
+ Minimum GPA of 3.0 or higher
+ Pursuing a degree in - Data Analytics, Healthcare or related field
+ Must have unrestricted authorization to work in the United States
+ Able to commit to the full-time, 10-week internship program from June 1st - August 7, 2026.
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.
Pay Range: $21.16 - $21.66 / HOURLY
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
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Healthcare Business Admin Intern (Operations) - REMOTE

99207 Spokane, Washington Molina Healthcare

Posted 12 days ago

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Job Description

**JOB DESCRIPTION**
**Job Summary**
The Molina Healthcare Internship Program shares an objective to create a steppingstone for students and alumni who aim to be professionals and future leaders in the healthcare business profession. We aim to develop talent by providing students and alumni with experiential learning, formal training, and opportunities to interact with healthcare business professionals who will act as intern managers along the way.
**KNOWLEDGE/SKILLS/ABILITIES**
· Assist in gathering and organizing operational data from various sources, including internal systems and reports.
· Conduct quantitative and qualitative analysis to identify trends, inefficiencies, and opportunities for improvement.
· Support the creation of dashboards, visualizations, and regular performance reports for leadership and operational teams.
· Collaborate with leadership and cross-functional teams to understand business processes and contribute to process optimization projects.
· Participate in meetings and present findings to team members and stakeholders.
· Help document processes, methodologies, and recommendations for future reference.
**Qualifications**
· Strong analytical and problem-solving skills, with attention to detail.
· Proficiency in Microsoft Excel; familiarity with data visualization tools (e.g., Power BI) is a plus.
· Excellent written and verbal communication skills.
· Ability to work independently and as part of a team in a fast-paced environment.
· Interest in business operations, process improvement, and data-driven decision making.
** REQUIRED EDUCATION:**
Must be currently enrolled in an undergraduate or graduate program
Should be a freshman sophomore or junior
Minimum GPA of 3.0 or higher
Pursuing a degree in Business/Information Systems, Actuarial Sciences, Industrial Engineering or a related field
Must have unrestricted authorization to work in the United States
Able to commit to the full-time, 10-week internship program from June 1 - August 7, 2026
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.
Pay Range: $21.16 - $21.66 / HOURLY
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
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Program Manager, Healthcare Services - Clinical Systems

99207 Spokane, Washington Molina Healthcare

Posted 18 days ago

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Job Description

**Job Summary**
Provides subject matter expertise and leadership to healthcare services function - providing support for project/program/process design, execution, evaluation and support, and ensuring compliance with regulatory and internal standards, practices, policies and contractual commitments. Contributes to overarching strategy to provide quality and cost-effective member care.
**Essential Job Duties**
+ Collaboratively plans and executes internal healthcare services projects and programs involving department or cross-functional teams of subject matter experts - delivering products from the design process to completion.
+ Provides ongoing communication related to program goals, evaluation and support to ensure compliance with standardized protocols and processes.
+ May engage and oversee the work of external vendors.
+ Focuses on process improvement, organizational change management, program management and other processes relative to business needs.
+ Serves as a subject matter expert and leads healthcare services programs to meet critical needs.
+ Communicates and collaborates with customers to analyze and transform needs and goals into functional requirements.
+ Conducts quality audits to assess healthcare services staff educational needs and service quality, and implements quality initiatives within the department as appropriate.
+ Creates business requirements documents (BRDs), test plans, requirements traceability matrix (RTMs), user training materials and other related business documents.
**Required Qualifications**
+ At least 5 years of health care experience, including experience in clinical operations, and at least 3 or more years in one or more of the following areas: utilization management, care management, care transitions, behavioral health, or equivalent combination of relevant education and experience.
+ Registered Nurse (RN), Licensed Vocational Nurse (LVN), Licensed Practical Nurse (LPN), Advanced Practice Social Worker (APSW), Certified Health Education Specialist (CHES), Licensed Professional Counselor (LPC), Licensed Professional Clinical Counselor (LPCC) or Licensed Marriage and Family Therapist (LMFT). Clinical licensure and/or certification required ONLY if required by state contract, regulation or state board licensing mandates. If licensed, license must be active and unrestricted in state of practice.
+ Strong analytical and problem-solving skills.
+ Strong organizational and time-management skills.
+ Ability to work in a cross-functional, professional environment.
+ Experience working within applicable state, federal, and third-party regulations.
+ Strong verbal and written communication skills.
+ Microsoft Office suite/applicable software program proficiency, and ability to navigate online portals and databases.
**Preferred Qualifications**
+ Certified Case Manager (CCM), Certified Professional in Healthcare Management (CPHM), Certified Professional in Healthcare Quality (CPHQ), or other health care or management certification.
+ Leadership experience.
+ Medicaid/Medicare population experience.
+ Six sigma certification
+ Experience with Agile Methodology
+ Experience with Epic
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
Pay Range: $77,969 - $171,058 / ANNUAL
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
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Supervisor, Healthcare Services; Care Management (Remote - GA)

99207 Spokane, Washington Molina Healthcare

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Job Description

This position will offer remote work flexibility, but the individual selected for the role must reside in Georgia.
JOB DESCRIPTION
Job Summary
Leads and supervises multidisciplinary team of healthcare services professionals in some or all of the following functions: care management, utilization management, behavioral health, care transitions, long-term services and supports (LTSS), and/or other special programs. Ensures members reach desired outcomes through integrated delivery and coordination of care across the continuum, and contributes to overarching strategy to provide quality and cost-effective member care.
Essential Job Duties
+ Assists in implementing health management, care management, utilization management, behavioral health and other program activities in accordance with regulatory, contract standards and accreditation compliance.
+ Functions as a "hands-on" supervisor, assisting with assessing and evaluation of systems, day-to-day operations and efficiency of operations/services.
+ Assists in the coordination of orienting and training staff to ensure maximum efficiency and productivity, program implementation, and service excellence.
+ Trains and supports team members to ensure high-risk, complex members are adequately supported.
+ Assists with staff performance appraisals, ongoing monitoring of performance, and application of protocols and guidelines.
+ Collaborates with and keeps healthcare services leadership apprised of operational issues, staffing, resources, system and program needs.
+ Assists with coordination and reporting of department statistics and ongoing client reports, as assigned.
+ Local travel may be required (based upon state/contractual requirements).
Required Qualifications
+ At least 5 years health care experience, and at least 2 years of managed care experienced in one or more of the following areas: utilization management, care management, care transitions, behavioral health, long-term services and supports (LTSS), or equivalent combination of relevant education and experience. r equivalent combination of relevant education and experience.
+ Registered Nurse (RN), Licensed Vocational Nurse (LVN), Licensed Practical Nurse (LPN), Licensed Clinical Social Worker (LCSW), Licensed Marriage and Family Therapist (LMFT), Licensed Professional Clinical Counselor (LPCC), or Licensed Master of Social Work (LMSW). Clinical licensure and/or certification required ONLY if required by state contract, regulation or state board licensing mandates. If licensed, license must be active and unrestricted in state of practice.
+ Ability to manage conflict and lead through change.
+ Operational and process improvement experience.
+ Strong written and verbal communication skills.
+ Working knowledge of Microsoft Office suite.
+ Ability to prioritize and manage multiple deadlines.
Excellent organizational, problem-solving and critical-thinking skills.
Preferred Qualifications
+ Registered Nurse (RN). License must be active and unrestricted in state of practice.
+ Certified Case Manager (CCM), Certified Professional in Health Care Management certification (CPHM), Certified Professional in Health Care Quality (CPHQ) or other health care or management certification.
+ Medicaid/Medicare population experience.
+ Clinical experience.
+ Supervisory/leadership experience. 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
#PJHPO3
Pay Range: $77,969 - $155,508 / ANNUAL
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
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Manager, Healthcare Analytics - Health Plan Integration - Remote

99207 Spokane, Washington Molina Healthcare

Posted 26 days ago

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Job 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 provider networks and other end users for operational and strategic analysis.
**KNOWLEDGE/SKILLS/ABILITIES**
Manages and provides direct oversight of Healthcare Analytics 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 Health Plan. Resource to HCS staff for mentoring, coaching, and analysis questions. Responsible for staff time keeping, performance coaching, development, and career paths.
+ Daily management of Healthcare Analytics team.
+ Allocate new report/project requests (workload distribution).
+ Coordinates with Health Plan departments to meet data analysis and database development needs.
+ Reviews, evaluates, and improved Company business logic and data sources.
+ Resource to Health Plan staff for mentoring, coaching, and analysis questions.
+ Reviews Health Plan analyst work products to ensure accuracy and clarity.
+ Reviews regulatory reporting requirements and Health Plan project documentation.
+ Maintains reporting service level benchmarks for Healthcare Analytics team.
+ Represents Healthcare Analytics department in cross-departmental and operational meetings.
+ Serves as liaison between Corporate IT and Health Plan 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.
+ Management Health Plan Encounter workflow process.
**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 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
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
Pay Range: $88,453 - $206,981 / ANNUAL
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
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Specialist, Config Oversight (healthcare Medical claim audits)

99207 Spokane, Washington Molina Healthcare

Posted 8 days ago

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Job Description

**Job Description**
**Work hours will be 7am-3:30pm PST M-F**
**Job Summary**
Responsible for conducting various healthcare Healthcare claim audits including, but not limited to; vendor, focal, audit the auditor. Confirm that documentation is clear and concise to ensure accuracy in auditing of critical information on claims ensuring adherence to business and system requirements of customers as it pertains to contracting (benefit and provider), network management, credentialing, prior authorizations, fee schedules, and other business requirements critical to claim accuracy. Maintain audit records, and provide counsel regarding coverage amount and benefit interpretation within the audit process. Provide clear and concise results and comments to leaders about focal audits. Contributes to completion of audits as needed to ensure audits are conducted in a timely fashion and in accordance with audit standards.
**Job Duties**
- Reviews documentation regarding updates/changes to member enrollment, provider contract, provider demographic information, and/or claim processing guidelines. Evaluates the accuracy of these updates/changes as applied to the appropriate modules within the core processing system (QNXT).
- Conducts focal healthcare Medical claim audits on samples of processed transactions impacted by these updates/changes. Determines that all outcomes are aligned to the original documentation and allow appropriate processing.
- Conducts audits of vendor audits and verifies accuracy of their published outcomes are aligned to the documentation, various sources of truth and being assessed appropriately.
- Clearly documents the focal audit results and makes recommendations as necessary.
- Researches and tracks the status of unresolved errors issued on daily transactional audits and communicates with Core Operations Functional Business Partners to ensure resolution within 30 days of error issuance.
- Evaluates the adjudication of claims using standard principles and state specific policies and regulations in order to identify incorrect coding, abuse and fraudulent billing practices, waste, overpayments, and processing errors of claims. ( _Use for claims specific positions only_ )
- Prepares, tracks and provides audit findings reports according to designated timelines
- Presents audit findings and makes recommendations to management for improvements based on audit results.
**Job Qualifications**
**REQUIRED EDUCATION:**
Associate's Degree or equivalent combination of education and experience
**REQUIRED EXPERIENCE, SKILLS & ABILIITIES:**
+ Minimum 2 years as an operational auditor for at least one core operations function
+ Previous examiner/processing experience in at least one core operations functional area
+ Strong attention to detail
+ Knowledge of using Microsoft applications to include; Excel, Word, Outlook, Powerpoint and Teams
+ Ability to effectively communicate written and verbal
+ Knowledge of verifying documentation related to updates/changes within claims processing system .
+ Experience using claims processing system (QNXT).
**PREFERRED EDUCATION:**
Bachelor's Degree or equivalent combination of education and experience
**PREFERRED EXPERIENCE:**
3+ years healthcare Medical claims auditing
**PHYSICAL DEMANDS:**
Working environment is generally favorable and lighting and temperature are adequate. Work is generally performed in an office environment in which there is only minimal exposure to unpleasant and/or hazardous working conditions. Must have the ability to sit for long periods. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential function.
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
Pay Range: $21.16 - $42.2 / HOURLY
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
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Lead Analyst, Healthcare Analytics- Managed care analytics & financial contracts

99207 Spokane, Washington Molina Healthcare

Posted 20 days ago

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Job Description

**JOB DESCRIPTION**
***Candidates must be located in California and work PST hours.***
**Job Summary**
Performs research and analysis of complex healthcare claims data, pharmacy data, and lab data regarding network utilization and cost containment information. Evaluates, writes, and presents healthcare utilization and cost containment reports and makes recommendations based on relevant findings.
**KNOWLEDGE/SKILLS/ABILITIES**
+ Develops, implements, and uses software and systems to support the department's goals.
+ Develops and generates ad-hoc and standard reports using SQL programming, excel , Databricks and other analytic / programming tools.
+ Coordinates and oversees report generation by team members and distribution schedule to ensure timely delivery to customers, ensuring the highest quality on every project/request. Responsible for error resolution, follow up and performance metrics monitoring.
+ Provides peer review of critical reports and guidance on programming / logic improvements; provides guidance to team members in their analysis of data sets and trends using statistical tools and techniques to determine significance and relevance.
+ Applies process improvements for the team's methods of collecting and documenting report / programming requirements from requestors to ensure appropriate creation of reports and analyses while reducing rework.
+ Manage the creation of comprehensive workflows for the production and distribution of assigned reports, document reporting processes and procedures.
+ Create new databases and reporting tools for monitoring, tracking, and trending based on project specifications.
+ Create comprehensive workflows for the production and distribution of assigned reports, document reporting processes and procedures.
+ Assist with research, development and completion of special projects as requested by various internal departments, or in support of requests from regulatory agencies, contracting agencies, or other external organizations.
+ Maintains SharePoint Sites as needed, including training materials and documentation archives.
+ Demonstrate Healthcare experience in contract modeling, analyzing relevant Financial and Utilization Metrics of Healthcare.
+ Must be able to act as a liaison between Finance and Network Contracting as well as other external teams.
+ Must have experience in Financial modeling, identifying Utilization mgmt. trends and monitor pair mix.
+ Experience with Medicaid contract analytics is highly preferred.
+ Experience working on Managed care analytics and healthcare reimbursement models is required.
+ Must be able to work in a cross functional team.
**JOB QUALIFICATIONS**
**Required Education**
Bachelor's Degree in Finance, Economics, Computer Science
**Required Experience**
+ 6+ years of progressive responsibilities in Data, Finance or Systems Analysis
+ Expert knowledge on SQL, PowerBI, Excel, Databricks or similar tools
**Preferred Education**
Bachelor's Degree in Finance, Economics, Math, Accounting or related fields
Preferred experience in Medical Economics and Strong Knowledge of Performance Indicators:
+ Proactively identify and investigate complex suspect areas regarding contract rate and related medical costs
+ 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, etc.
+ Analysis of trends in medical costs to provide analytic support for finance, pricing, and actuarial functions
+ Multiple data systems and models
+ BI tools (Power BI)
**Preferred License, Certification, Association**
QNXT or similar healthcare payer applications
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.
Pay Range: $77,969 - $171,058 / ANNUAL
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
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  62. wifi Telecoms
  63. psychology Therapy
  64. pets Veterinary
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