| Description | Molina Healthcare Davenport Iowa San Antonio Texas Madison Wisconsin Salt Lake City Utah Idaho Utah New York Kentucky Tampa Florida Rio Rancho New Mexico Des Moines Iowa Vancouver Washington Houston Texas Bellevue Nebraska St. Petersburg Florida Layton Utah Albuquerque New Mexico Dallas Texas Warren Michigan Louisville Kentucky Rochester New York Miami Florida Orlando Florida Caldwell Idaho West Valley City Utah Racine Wisconsin Dayton Ohio Chandler Arizona Ohio Nebraska Iowa Wisconsin Mesa Arizona Fort Worth Texas Detroit Michigan Scottsdale Arizona Iowa City Iowa Jacksonville Florida Orem Utah Santa Fe New Mexico Washington Kearney Nebraska Atlanta Georgia Provo Utah Sioux City Iowa Green Bay Wisconsin Omaha Nebraska Cleveland Ohio Lexington-Fayette Kentucky Meridian Idaho Florida Cincinnati Ohio Yonkers New York Grand Island Nebraska Everett Washington Albany New York Phoenix Arizona Grand Rapids Michigan Buffalo New York Michigan Columbus Ohio Tucson Arizona Augusta Georgia Idaho Falls Idaho Bellevue Washington Boise Idaho Savannah Georgia Lincoln Nebraska Nampa Idaho Tacoma Washington Georgia New Mexico Roswell New Mexico Cedar Rapids Iowa Macon Georgia Ann Arbor Michigan Akron Ohio Bowling Green Kentucky Syracuse New York Las Cruces New Mexico Sterling Heights Michigan Texas Kenosha Wisconsin Columbus Georgia Milwaukee Wisconsin Spokane Washington Austin Texas Owensboro Kentucky Covington Kentucky Job ID 2032933 Job Description Job Summary The Senior Analyst will serve a key role on the RADV (Risk Adjustment Data Validation) team contributing to the end-to-end data strategy and execution of CMS and internal audit activities. This position is responsible for supporting RADV audit cycles by identifying synthesizing and validating source data needed to build chart retrieval chase lists for medical record collection. Success in this role requires a blend of strong technical acumen business context and analytical curiosity. While data is primarily accessed through Databricks not all required elements are neatly organized or centralized. The analyst will be expected to investigate and connect disparate data sources with the support of experienced team members and cross-functional partners. This is a collaborative role well-suited for individuals who enjoy navigating ambiguity solving complex problems and contributing to initiatives that directly support regulatory and clinical compliance. Knowledge/Skills/Abilities Support RADV audit execution by identifying appropriate data sources validating CMS audit samples and generating chart retrieval chase lists in coordination with internal teams. Analyze structured and unstructured data sets using Databricks SQL and other tools to locate and confirm data elements required for audit response. Collaborate with internal stakeholders—including IT Risk Adjustment operations clinical teams and retrieval vendors—to ensure accurate data sourcing and alignment with audit requirements. Interpret CMS audit specifications and translate them into data logic and operational requirements. Document methodology assumptions and data sourcing logic to maintain audit traceability and facilitate knowledge sharing. Assist in preparing for internal simulations and proactive readiness assessments related to RADV audits. Investigate data inconsistencies and assist in performing root cause analysis offering insight into potential data gaps or operational improvements. Work iteratively and adaptively when data is incomplete or spread across multiple systems using sound judgment to build defensible audit datasets. Present findings and progress updates to project leads and stakeholders contributing to a collaborative informed audit response process. Job Qualifications Required Education Bachelor's Degree in Computer Science Finance Math or Economics or equivalent discipline Required Experience 3-5 Years of experience with healthcare-related data (claims/encounters provider CMS/EDGE response files etc. 3-5 Years of experience with advanced SQL-based analytics (procedures window functions dyanamic SQL ETC.) 3-5 years of experience in working with Databricks for analytics and workflows. 3-5 Years of experience in health plan Risk Adjustment analytics. Core database fundamentals (Primary/Foreign Keys Relational Databases Normalization Transactions etc.) 1-3 years of programming experience in python to support automated data validation / processing at scale (functions and objects) PHYSICAL DEMANDS Working environment is generally favorable and lighting and temperature are adequate. Work is generally performed in an office environment in which there is only minimal exposure to unpleasant and/or hazardous working conditions. Must have the ability to sit for long periods. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential function. 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: $77969 - $155508 / ANNUAL Actual compensation may vary from posting based on geographic location work experience education and/or skill level. ABOUT US Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V. JOB TYPE Full Time POSTING DATE 08/01/2025 |