5 Healthcare jobs in Martinez

**JOB DESCRIPTION**
**Job Summary**
This Sr. Analyst, Healthcare Analytics role will be responsible for work around Program Valuation on Molina's Risk Adjustment Actuarial team. Responsibilities include research, analysis and modeling of complex healthcare claims data, pharmacy data, lab data, and Risk Adjustment submissions data to evaluate healthcare intervention program performance. Develops and presents Risk Adjustment intervention ROI, incremental conditions captured, and other program performance reports including forecasts and makes recommendations based on relevant findings. Performs Health Plan strategic analysis and planning and coordinates across business units on Risk Adjustment Program Valuation and Strategic/Scoreable Action Items (SAIs) to meet business needs. Performs analysis across multiple states and lines of business (Medicare, Medicaid, Marketplace ACA).
**KNOWLEDGE/SKILLS/ABILITIES**
+ Compiling and organizing health care data using Databricks and Spark SQL, Notebooks, Workflows, Repositories, SQL Server Stored Procedures, SQL Server Integration Services (SSIS), and other analytic / programming tools as needed
+ Reporting includes Risk Adjustment program performance metrics, risk score and revenue impact, tracking of strategic/scorable action items, annual and quarterly forecasts, and regular deep dives to drive improvement in financial results
+ Take ownership with root cause analysis to maintain high integrity data and processes to minimize discrepancies and gaps
+ Create databases and reporting dashboards for monitoring, tracking and trending based on project specifications and applies automation as appropriate
+ Complete analysis and forecasting of risk adjustment intervention program values
+ Develop and demonstrate proficiency in running all applicable risk models including the various CMS models for Medicare Advantage members, the HHS model for Commercial ACA members, the CDPS model for Medicaid members, and others as needed
+ Must have a strong attention to detail and knowledge of data structure and programming
+ Performing financial analysis to assist in delivering optimal health care management and decision making
+ Understanding and applying data storage and data sharing best practices
+ Converting data into usable information that is easy to understand and provides insights needed to support strategic investment decisions
+ Research and develop reports and analyses for senior management and effectively and concisely communicate results and key takeaways
+ Collects and documents report / programming requirements from requestors to ensure appropriate creation of reports and analyses. Uses peer-to-peer review process and end-user consultation to reduce errors and rework
+ Practice strong judgement in carrying out work independently, consult with experts as needed and use available resources and reports to critique results
+ Manage multiple projects and consistently deliver results on time in a fast-paced environment with changing priorities
**JOB QUALIFICATIONS**
**Required Education**
Bachelor's Degree in Finance, Economics, Computer Science
**Required Experience**
+ 5-7 years increasingly complex database and data management responsibilities
+ 5-7 years of increasingly complex experience in quantifying, measuring, analyzing, and reporting financial/performance management metrics
+ Demonstrate Healthcare experience in Quantifying, Measuring and Analyzing Financial and Utilization Metrics of Healthcare
+ Advanced knowledge of SQL
+ Proficient in Excel and visualization tools such as Power BI, Tableau, or similar
**Preferred Experience**
Preferred experience in Medical Economics and Strong Knowledge of Performance Indicators:
+ Proactively identify and investigate complex suspect areas regarding risk adjustment initiatives, risk score lift, conditions captured, and program value
+ 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, predictive modeling, etc.
+ Analysis and forecasting of program value and underlying population trends in risk adjustment to provide analytic support for finance, pricing and actuarial functions
+ Healthcare Analyst I or Financial/Accounting Analyst I experience desired
+ Multiple data systems and models
+ Data modelling and BI tools
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 - $155,508 / ANNUAL
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

**JOB DESCRIPTION**
**Job Summary**
Focuses on process improvement, organizational change management, project management and other processes relative to the business. Project management includes estimating, scheduling, costing, planning, and issue/risk management.
**KNOWLEDGE/SKILLS/ABILITIES**
+ Proven depth of understanding and demonstrable results for effective management of intermediate to large-scale projects, using prescribed approach(as). Solid knowledge of methods and techniques involved in project management initiatives.
+ Work with IT and business teams to set up/ amend new/ existing healthplans and new lines of business.
+ Must have experience in merger and acquisitions
+ Familiarity with SDLC.
+ Must have strong experience in Jira and smartsheets is preferred
+ Knowledge in Medicare, Medicaid and Marketplace is highly preferred.
+ Able to develop detailed project plans, communication plans, schedules, role definition, risk management and assumptions.
+ Complete mastery of standard applications and project specific software. Able to learn new software with little to no instruction within a short timeframe and instruct others on its functionality.
+ Identifies problems and anticipates potential problems. Ability to present alternatives to manage/overcome obstacles.
+ May consultant with higher level project management staff and may refer to established procedures and/or prior experience to determine appropriate and timely action. Projects may have moderate cross functional impact and team organization.
**JOB QUALIFICATIONS**
**Required Education**
Bachelor's degree or equivalent combination of education and experience and at least 1 PM course required
**Required Experience**
2-4 years of relevant work experience in business, engineering, or a related field in lieu of degree acceptable.
**Preferred Education**
Additional formal training in PM preferred.
**Preferred License, Certification, Association**
PMP or Six Sigma Green Belt Certification desired.
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 - $115,000 / ANNUAL
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

**Job Summary**
Responsible for multiple Enrollment internal business projects and programs involving department or cross-functional teams of subject matter experts, delivering products through the design process to completion. Plans and directs schedules as well as review enhancement ROI. Candidate must have strong analytic, organizational skills and the ability to independently resolve issues and remove hurdles. This is a hybrid role that requires Program Management, System Analyst and Sr. Business Analyst skills. Responsibilities include troubleshooting, analyzing, managing assignments, assisting team members, oversight of vendor projects, reviewing team outputs, review of deployment request and post deployment monitoring.
Building and maintaining strong relationships and proactive processes are key to the success of this team. The selected candidate would act as the liaison between the business, vendors , IT, and support Program Managers and Business Analyst in a subject matter expert capacity. May engage and oversee the work of external vendors. Coordinates with business analyst, IT and business areas, provides and reviews requirements and test results.
Knowledge/Skills/Abilities
+ Independently manage and deliver Enrollment Enterprise wide project initiatives from inception through delivery
+ Subject matter expert of enrollment to Program Managers and Analyst and in functional areas (Inbound and Outbound)
+ Communicate and collaborate with Operations, Health Plans and Leadership to analyze and transform needs and goals into functional requirements
+ Develops, defines, and executes plans, schedules, and deliverables. Monitors programs from initiation through delivery
+ Identify root cause, function and process improvement opportunities that are critical to effective outcome
+ Leads programs to meet critical needs. Including but not limited to BRD reviews, logic changes, root cause analysis, etc.
+ Works with operational leaders within the business to provide recommendations on opportunities for process improvements
+ Collaborate with Other Teams within Molina to deliver End to End for any process within Enrollment Accounting Team
+ Active collaborator responsible for operation projects and programs involving enrollment and eligibility
+ Works with cross-functional teams and IT and business subject matter expert and to deliver products from design to completion
+ Subject matter expert of enrollment and provides knowledge and feedback to ensure regulatory and Addresses health plan concerns within Enrollment Operations
+ Researches, interpret, define and summarize enhancement recommendations
+ Provides health plan requirement recommendations
+ Responsible for managing deliverables, improving performance, training needs, support to other business units
+ Strong business knowledge related to Medicaid and Medicare lines of business
+ Reviews enrollment issue trends and provides long term solutions as needed
+ Manages, creates and communicates status reports
+ Ensures compliant with regulatory and company guidelines, including HIPAA compliance
+ This position primarily focuses on project/program management related to the business projects, rather than the technical application projects
+ Focuses on process improvement, organizational change management, program management and other processes relative to the business
+ Participate and lead brainstorming sessions to develop new concepts to build efficiencies
+ Ideally possess minimum of 5 years' experience with eligibility processing, including; eligibility Applications and Files
+ Extensive knowledge in health insurance
+ Knowledge of enrollment files, including extracts
+ Program Manager experience
+ Sr. Business or System Analyst experience
+ Process Improvement Experience.
**JOB QUALIFICATIONS**
**Required Education**
Bachelor's Degree or equivalent combination of education and experience
**Required Experience**
7-9 years
**Required License, Certification, Association**
PMP Certification (and/or comparable coursework)
**Preferred Education**
Graduate Degree or equivalent combination of education and experience
**Preferred Experience**
10+ years
**Preferred License, Certification, Association**
Six Sigma Black Belt Certification, ITIL Certification desired
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.

McMillan Pazdan Smith is an award-winning architecture, interior design, and advisory services firm with eight studios located in the southeast. We pride ourselves on strong client relationships and community partnerships. Our projects represent the work of a collaborative group of dedicated design professionals driven by a solitary goal: to deliver a functional solution that inspire collaboration, function, imagination, constructability, and attributes of a well-constructed environmental design

We are seeking a Project Manager to join our Healthcare team

• Actively participate in the marketing and business development processes; create and monitor marketing and business development plans
• Prepare strategic plans for practice success and establish, communicate, and execute a vision for the market practice
• Represent Firm at practice market's professional and trade organizations
• Ensure practice organization, operation, and direction aligns with Firm and practices strategic plans
• Foster an environment of learning, collaboration, innovation, professional development, and communication
• Review and advocate for individual practice team members' professional development plans
• Take responsibility for finished plans, specifications, and approval of materials and construction and for managing all aspects of multiple small to large complex projects
• Prepare design and proposal / presentation materials, estimate fees, determine scope of work
• Conduct code research and analysis and review with various agencies for approval
• Collaborate with engineers, consultants, contractors and/or clients
• Ensure that the project meets environmental, safety, structural, zoning, and aesthetic standards
• Review shop drawings, submittals, and respond to RFIs
• Coordinate all project efforts, administrative and technical, to ensure the most efficient and cost-effective execution of assigned project
• Actively manage client budgets, schedules, and programs, project communications and documentation, office administrative tasks, and project team assignments
• Supervise and/or perform site observations, such as recording and reporting of existing conditions and construction progress
• Responsible for major design decisions, involving spatial, aesthetic elements, and detailing of materials
• Document the progression of a routine project through correspondence, memos, etc.
• Follow routine projects through approvals and construction. Initiate contact with client and town officials

Requirements

Required Qualifications

• Professional degree in Architecture from an NAAB-accredited program
• Ability to provide business development for firm within practice expertise area
• 10+ years combined experience as a design professional and/or architect
• Proficiency with Microsoft Suite, Adobe Creative Suite, and Revit
• Firm grasp of building technology fundamentals
• Thorough knowledge of relevant codes, operations, processes, and trends
• Excellent time management, organizational and written and verbal communication skills

Preferred Qualifications

• Master's Degree of Architecture
• Registered as a licensed architect
• Experience with Newforma Project Center and/or Newforma Project Analyzer
• Experience with Microsoft Project, Bluebeam PDF Revu
• Additional relevant certifications indicating additional expertise such as for construction administration, interior design, LEED/Green Globes/sustainability, etc.
• Experience writing and editing specifications Write and edit specifications as assigned

Position Location - Augusta

McMillan Pazdan Smith is committed to providing employees with a team environment where we teach each other to improve and reimagine what is possible while creating a shared commitment to earning the trust of our clients and communities. McMillan Pazdan Smith is also committed to providing employees with a comprehensive benefits plan to meet their current and future needs. Benefits include medical, dental and vision coverage, a PTO plan, an employer-provided life insurance with both long- and short-term disability, health savings account with certain medical plan enrollment, dependent care flexible spending accounts, paid professional membership dues and relevant exam fee reimbursement among other benefits. Physical Demands and Workplace Environment

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. The employee is occasionally required to stand; walk; sit; use hands to grasp objects; reach with hands and arms; balance, stop, kneel, or crouch; speak or listen. The employee must occasionally lift and/or carry up to twenty-five pounds. Specific vision abilities required by the job include close vision, distance vision, color vision, peripheral vision, depth perception, and the ability to adjust focus. Work environment characteristics described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. The employee may occasionally be exposed to hazardous working conditions in conjunction with construction site visits. The noise level in the construction zone may be loud. While performing the duties of this job in the office work environment, the employee will not be exposed to hazardous working conditions. The noise level in the office work environment is usually moderate.

McMillan Pazdan Smith is an equal-opportunity employer. All qualified applicants will receive consideration for employment without regard to sex, race, religion, color, national origin, age, disability, veteran's status or any classification protected by state or local law.

If you need a reasonable accommodation to access the information provided on this web site, please contact Human Resources at: for further assistance.