Manager, Medical Informatics

Molina Healthcare Inc., is among the most experienced managed healthcare companies serving patients who have traditionally faced barriers to quality healthcare—including individuals covered under Medicaid, the Healthy Families Program, the State Children’s Health Insurance Program (SCHIP) and other government-sponsored health insurance programs. Molina has health plans in California, Indiana, Michigan, New Mexico, Utah and Washington as well as 21 primary care clinics located in Northern and Southern California with future plans in Ohio and Texas. The company’s corporate headquarters are in Long Beach, California.

Job Overview

This position provides analytic support to the Corporate Medical Informatics department goal of developing standardized, detailed, and targeted clinical cost and utilization reports and analysis including profiling of providers. Provides clinical expertise in the analysis of care management program outcomes and vendor performance evaluation. Helps determine the direction and strategy for the development of actionable, clinical analyses and reports as well as supporting the general information requirements of line medical managers. Collaborates with state plans’ leadership to determine reporting requirements to effectively monitor and improve medical management performance.

Provides analysis of the network providers and contracted facilities giving insights into their performance to implement Pay for Performance paradigms. Develops clinical outcomes measurement and analysis in terms of measuring the effectiveness not only of commonly applied acute and chronic medical care interventions, but also through innovative approaches to medical care delivery, such as Care Management programs and Disease Management programs.

The person in this role will lead a team of analysts and will interact with other functions in the company such as Medical Management, Provider Contracting, Business Development, Actuarial, and Finance. Interpreting data and making sound recommendations are key functions of this job.

Job Requirements


Education: Masters degree required. Prefer degree and expertise in health care related field – clinical or research, e.g., Health Information Management, Health Care Management, Econometrics, or Nursing Informatics. Training in clinical information systems, administrative/decision support systems preferred.

Experience: Five+ years relevant experience in a health care environment. Clinical background preferred. Managed care or health plan experience is highly desirable, especially Medicaid and Medicare. Strong technical background in clinical information systems and data management. Experience manipulating very large medical claims and other health care related data bases.
Must have a solid experience in heath care economics, cost and utilization evaluations, provider profiling, and business analytics. Experience identifying aberrant medical cost patterns and outliers using unit cost and utilization metric analytics of auth-based and claims-based data. Similar experience with pharmacy benefit management is helpful.
Experience in Health/Quality/Disease Management programs data analysis including HEDIS, CAHPS survey data analysis, and disease management outcomes analysis. Management experience desired.

Additional Skills and Knowledge: Solid computer programming skills using SQL or SAS. Additional programming skills a plus. Skill and/or knowledge of MedInsight preferred. Familiarity with QCIS, QMACS, QNXT applications a plus. Proven skill at transforming numerical data into executive management displays and summaries that answer the business questions. Skill at problem-solving business and technical issues required. Ability to work cross-functionally with other health care related functions. Excellent oral and written communication skills a must. Effective interpersonally with ability to lead and manage others. Has current knowledge of and ability to analyze vendors of health data management, predictive modeling, and provider profiling software in the market place.

Molina Healthcare offers competitive benefits and compensation package.

Molina Healthcare is an Equal Opportunity Employer (EOE).