Senior Analyst, Data & Analytics - No Surprises Act/Provider Reimbursements/SQL - Remote
Role Overview
The Senior Analyst, OON Dispute Analytics and Reporting, supports the out-of-network (OON) provider liability operating model by developing the analytics, reporting, and market intelligence needed to inform the negotiation strategy, arbitration positioning, QPA payment accuracy, and overall IDR performance.
The role reports to the Director, Provider Dispute Strategy, and serves as the primary analytics partner for pre-IDR negotiation, federal NSA IDR, state-based dispute processes, and provider-level OON liability management.
The Senior Analyst is responsible for integrating data from multiple internal and external sources, building reporting dashboards, producing actionable insights, and translating financial and operational data into recommendations that support improved dispute outcomes.
This role requires strong data management, healthcare finance, reimbursement, and reporting capabilities, as well as the ability to connect claim-level detail, dispute outcomes, provider behavior, QPA performance, market benchmarks, and financial reporting trends.
The role 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.
Key Skills for This Role
Full Job Posting
PREFERRED QUALIFICATIONS
- Experience with No Surprises Act IDR, state-based provider dispute processes, OON claims, or provider payment disputes
- Knowledge of QPA methodology, provider reimbursement, Medicare-based pricing, commercial benchmarks, or payer claims adjudication
- Experience combining internal data with external market data sources
- Advanced SQL, Python R, or Alteryx skills
- Experience with financial reporting, medical cost reporting, or healthcare P&L analysis
- Experience supporting provider contracting, network strategy, medical economics, or payment integrity teams
- 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
About Molina Healthcare
Provider of managed healthcare services for government-sponsored programs.
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