Job Summary Provides senior-level financial and analytical support for Molina's Medicare line of business across multiple markets, with primary responsibility for overseeing financial performance, forecasting, reporting, and trend analysis for SC, NY, MA, TX, ID/UT, AZ, CA, and WA. Monitors medical cost performance, evaluate financial trends, support capitation and risk-based arrangements, and deliver actionable insights that support business decision-making.
Essential Job Duties
Develop and maintain forecasts, financial models, and projections related to Medicare medical costs, capitation arrangements, and value-based care programs.
Monitor and analyze medical cost and utilization trends, identifying key drivers, risks, and opportunities across Medicare markets.
Evaluate the financial performance of provider capitation and risk-based arrangements through variance analysis, trend reporting, and performance monitoring.
Support value-based care initiatives by measuring provider performance, identifying opportunities for improvement, and assessing financial impact.
Prepare recurring financial reports, forecasts, and analyses for market and executive leadership, highlighting key performance indicators and actionable insights.
Partner with operational, clinical, and market teams to analyze financial performance and develop recommendations to improve cost and quality outcomes.
Utilize large healthcare and financial datasets to perform ad hoc analyses, quantify financial impacts, and support strategic decision-making.
Present findings and recommendations to management and stakeholders while driving enhancements to reporting, forecasting, and analytical processes.
Required Qualifications
At least 3 years of finance experience, or equivalent combination of relevant education and experience.
Bachelor’s degree in finance or related field or equivalent combination of education and experience.
Strong critical-thinking and attention to detail.
Ability to effectively collaborate with technical and non-technical stakeholders.
Strong time-management skills, and ability to manage simultaneous projects and tasks to meet internal deadlines.
Effective verbal and written communication skills.
Proficient in Microsoft Office suite products, including key skills in Excel (VLOOKUPs and pivot tables), and applicable software program(s) proficiency.
Preferred Qualifications
Medicare healthcare experience, preferably within a managed care or health plan environment.
Experience supporting value-based care (VBC), capitation, or other risk-based reimbursement arrangements preferred.
Proficiency in SQL for data extraction, validation, analysis, and reporting.
Advanced Excel skills, including financial modeling, forecasting, and trend analysis.
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
Molina Healthcare is a managed care organization that provides health insurance and care management services, primarily serving Medicaid members. The company operates health plans and delivers integrated care coordination across the continuum of care, combining medical management with behavioral health, long-term services and supports (LTSS), and community resources. Molina employs advanced claims processing systems, risk adjustment methodologies, and quality performance management to ensure cost-effective, high-quality member outcomes. The company supports various health plans and regulatory requirements while managing complex operations including provider contracting, benefits configuration, and HEDIS audit compliance.
