Executive Director

**JOB DESCRIPTION** **Job Summary** Provides senior-level analytical support for Medical Economics initiatives through the extraction, analysis, and synthesis of complex healthcare data to identify risks, opportunities, and drivers of medical cost and utilization trends. Responsible for developing actionable insights that enhance financial performance, support strategic decision-making, and improve cost of care outcomes. Partners with cross-functional teams to identify, quantify, and monitor emerging trends, develop scorable action items (SAIs) and affordability initiatives, and recommend innovative cost containment strategies. Translates analytical findings into clear, business-focused recommendations that drive operational improvements, medical cost savings, and sustainable financial results. Essential Job Duties Leads medical cost, utilization, and revenue trend analyses across Molina products, identifying emerging opportunities and risks, quantifying financial impact, and communicating actionable recommendations to leadership. Identifies, investigates, and explains the root causes of medical cost and utilization trends through integration of claims, provider, membership, authorization, and financial data. Develops, sizes, tracks, and prioritizes Scorable Action Items (SAIs) and affordability initiatives designed to reduce medical costs, improve efficiency, and enhance financial performance. Proactively monitors key cost drivers and emerging healthcare trends, creating analytic frameworks and reporting tools. Designs and develops reports, dashboards, and analytical tools to measure health plan performance, monitor trend drivers, and evaluate the effectiveness of cost containment initiatives. Performs financial and ROI analyses to estimate the impact of proposed cost savings initiatives, affordability programs, clinical interventions, and vendor partnerships. Draws actionable conclusions through advanced healthcare analytics, predictive modeling, and statistical analysis. Extracts, compiles, and synthesizes data from multiple internal and external sources. Mines, manages, and interprets large healthcare datasets to uncover patterns, anomalies, and actionable business insights. Collaborates with clinical, provider network, finance, payment integrity, and operational teams. Partners with business owners to establish and monitor KPIs for affordability initiatives. Leads analytical projects from concept through implementation, including executive presentations, strategic recommendations, and communication to diverse stakeholder groups. Serves as a subject matter expert in Medical Economics analytics. Maintains knowledge of Medicaid, Medicare, Marketplace, and healthcare industry developments. Required Qualifications At least 3 years of health care analytics and/or medical economics experience, or equivalent. Bachelor's degree in statistics, mathematics, economics, computer science, health care management or related field. Demonstrated understanding of Medicaid and Medicare programs. Experience with building dashboards in Excel, Power BI, and/or Tableau. Knowledge of health care operations (utilization management, disease management, HEDIS quality measures, claims processing). Knowledge of health care financial terms (e.g., PMPM, revenue) and code systems (ICD-10CM, CPT, HCPCS, NDC). Understanding of key managed care concepts and provider reimbursement principles. Experience in quantifying, measuring, and analyzing financial, operational, and/or utilization metrics. Strong critical-thinking, attention to detail, collaboration skills, time-management, and communication skills. Proficient in Microsoft Office suite, especially Excel. Preferred Qualifications Proficiency with Power BI and/or Tableau. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V. Pay Range: $59,810.6 - $129,589.63 / ANNUAL #J-18808-Ljbffr