Senior Analyst, Utilization Management

Job Summary The

Senior Analyst, Utilization Management

plays a critical role in supporting clinical and operational initiatives by translating healthcare business needs into technical solutions. This role works closely with clinicians, utilization management teams, and business stakeholders to gather requirements and deliver actionable insights through data analytics. The ideal candidate brings a strong foundation in SQL, Power BI, Databricks, Snowflake, and ETL development, along with a collaborative approach to building scalable, healthcare-focused data solutions supporting utilization management initiatives and conducting trend analyses to identify the underlying drivers of medical cost patterns

Knowledge/Skills/Abilities

Partner with clinical, operational, and business teams to understand data needs and translate requirements into actionable technical solutions.

Write advanced SQL queries to extract, validate, and analyze healthcare data, including claims, authorization, pharmacy, and lab datasets.

Build and maintain efficient ETL pipelines to support ongoing reporting and analytics workflows.

Utilize Databricks and Snowflake to develop scalable data pipelines and analytical datasets.

Create and maintain Power BI dashboards to deliver insights on utilization, outcomes, and cost drivers across the organization.

Ensure data quality, governance, and documentation standards are met in all analytics work.

Support ad hoc data requests and collaborate cross-functionally to drive data-informed decisions in clinical and business operations.

Maintain fluency in healthcare data types (e.g., ICD/CPT codes, HEDIS measures, member eligibility) to guide technical decisions.

Job Qualifications Required Education Bachelor’s or Associate’s degree in Data Science, Computer Science, Analytics, Information Systems, Engineering, or other technology-related fields

Required Experience

3–5 years of experience working with healthcare data in analytics or data engineering roles, supporting

utilization management

initiatives and conducting trend analyses to identify the underlying drivers of medical cost patterns

Advanced proficiency in SQL for large dataset analysis and transformation, specifically in processing healthcare claims data and supporting managed care reporting needs

Experience using

Power BI

for developing interactive dashboards and data visualizations

Hands-on experience with

Databricks ,

Snowflake , or enterprise

cloud data platforms

Solid understanding of

ETL concepts

and experience building pipelines for healthcare analytics

Strong communication and collaboration skills to work with clinical and business stakeholders

Preferred Experience

4+ years in a healthcare analytics role supporting

utilization management, population health, or quality improvement within a Managed Care Organization (MCO)

Experience working directly with

clinicians, nurses, or case management teams

Familiarity with risk adjustment, value-based care models, or healthcare performance metrics

Understanding of regulatory and compliance considerations (e.g., HIPAA) in data handling

To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.

Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

Pay Range: $77,969 - $155,508 / ANNUAL

*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

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