Senior Analyst, Provider and Claim Data & Analytics (Remote)

About this role

Molina Healthcare of Nebraska is hiring for a Senior Analyst, Provider and Claim Data & Analytics. This role is remote for those within the United States.

Highly Qualified Candidates Will Have the Following Experience-

• Medicaid and managed care
• Claims and coding experience. A coder certification is a plus but not required
• Ability to support network adequacy and provider data integrity by digging into provider claims and lead provider data clean-up efforts.
• Root cause analysis
• Strong SQL skills, including writing their own formulas or queries along with strong Excel skills
• Be a self-starter who can jump in where needed, pivot when required, all while having strong attention to detail

Essential Job Duties

• Provides senior level analyst support for data analysis and reporting activities. Responsible for organizing data from multiple sources to produce reports, dashboards, and analyses related to utilization, cost-containment, and business performance. Generates data-related insights that support strategic and operational decision-making and cost-containment. Designs and delivers reporting, analytics, and data solutions across business and healthcare domains, including claims, utilization, finance, and other business areas. Partners with stakeholders to define requirements, develop scalable reporting and data processes, and apply advanced analytical techniques to identify trends, forecast outcomes, and drive business performance. Supports projects, regulatory requests, and initiatives that improve data quality, reporting workflows, and process efficiencies.
• Analyzes complex datasets from multiple sources to identify trends, patterns, risks, and opportunities.
• Designs, develops, and maintains reports, dashboards, and data solutions using tools such as Structured Query Language (SQL), Microsoft Excel, and SQL Server Reporting Services (SSRS), that support utilization analysis, cost-containment, and operational performance.
• Translates busines...