Full-Time
Manager Medical Economics
Updated on 5/26/2026
Molina Healthcare
10,001+ employees
Administers government-sponsored Medicaid, Medicare plans
Compensation Overview
$79.6k - $172.5k/yr
Remote in USA
Remote
 Data & Analytics (1) |
|---|
- At least 7 years of health care analytics and/or medical economics experience, preferably in claims processing environment and/or health care environment, or equivalent combination of relevant education and experience.
- At least 1 year of management/leadership experience.
- Bachelor’s degree in statistics, mathematics, economics, computer science, health care management or related field.
- Demonstrated understanding of Medicaid and Medicare programs or other health care plans.
- Analytical work experience within the health care industry (i.e., hospital, network, ancillary, medical facility, health care vendor, commercial health insurance, large physician practice, managed care organization, etc.).
- Strong knowledge of queries 2005/2008 SSRS and Power BI report development.
- Familiar with relational database concepts, and SDLC concepts.
- Proficiency with retrieving specified information from data sources.
- Experience with building dashboards in Excel, Power BI, and/or Tableau and data management.
- Knowledge of health care operations (utilization management, disease management, HEDIS quality measures, claims processing, etc.).
- Knowledge of health care financial terms (e.g., PMPM, revenue) and different standard code systems (ICD-10CM, CPT, HCPCS, NDC, etc.) utilized in medical coding/billing (UB04/1500 form).
- Demonstrated understanding of key managed care concepts and provider reimbursement principles such as risk adjustment, capitation, FFS (Fee-for-Service), Diagnosis Related Groups (DRG’s), Ambulatory Patient Groups (APG’s), Ambulatory Payment Classifications (APC’s), and other payment mechanisms.
- Understanding of value-based risk arrangements
- Experience in quantifying, measuring, and analyzing financial, operational, and/or utilization metrics in health care.
- Ability to mine and manage information from large data sources.
- Demonstrated problem-solving skills.
- 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.
- Strong verbal and written communication skills.
- Proficient in Microsoft Office suite products, key skills in Excel (VLOOKUPs and pivot tables)/applicable software program(s) proficiency.
- Provides oversight for medical economics team and activities - ensuring delivery of work/project plans and required reporting.
- Re cruits, hires, onboards, mentors, develops, and manages medical economics staff.
- Provides daily management of data management, tools and technology work streams.
- Facilitates workload distribution of new reports and project requests.
- Acts as a resource to team for medical economics/analysis related questions.
- Reviews medical economics analysis work products to ensure accuracy and clarity.
- Reviews regulatory reporting requirements and health plan project documentation.
- Maintains reporting service level benchmarks for enterprise information management (EIM) team.
- Represents medical economics department in cross-departmental and operational meetings.
- Serves as liaison between EIM and medical economics for reporting needs.
- Manage the delivery and presentation of monthly trend and performance review presentations
- Interfaces and maintains positive interactions with Medicaid leadership and Medical Economics personnel
Molina Healthcare provides government-sponsored health plans in the United States, primarily serving low-income individuals and families through Medicaid, Medicare, and Marketplace products. It partners with state and federal governments to administer these programs and earns revenue from member premiums and payments for program management. A key differentiator is its focus on cost management and preventive care, aided by an online provider portal that lets clinicians verify eligibility, submit claims, and access resources. Its goal is to expand access to affordable, quality health coverage while delivering sustainable administration of government-backed plans.
Company Size
10,001+
Company Stage
IPO
Headquarters
Long Beach, California
Founded
1980
Simplify's Take
What believers are saying
- Florida Medicaid could add roughly $6 billion annual premiums starting late 2026.
- Q1 2026 premium revenue reached $10.2 billion with $2.35 adjusted EPS.
- Management reaffirmed at least $5 full-year adjusted EPS despite margin pressure.
What critics are saying
- Medicaid membership declines six percent in 2026 across California, Illinois, New York, Texas.
- Medical care ratios remain elevated at 91.1 percent, squeezing underwriting margins.
- Exiting MAPD in 2027 removes revenue and creates a $1 per-share earnings drag.
What makes Molina Healthcare unique
- Molina serves low-income members through Medicaid, Medicare, and Marketplace plans.
- It operates nationwide, serving over 2.2 million members across licensed health plans.
- The MolinaCares Accord funds community pilots, reinforcing state-partner relationships.
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People at Molina Healthcare who can refer or advise you
Benefits
Health Insurance
401(k) Retirement Plan
Remote Work Options
Paid Vacation
Flexible Work Hours
Wellness Program
Mental Health Support
Conference Attendance Budget
Professional Development Budget
Phone/Internet Stipend
Home Office Stipend
Family Planning Benefits
Fertility Treatment Support
Stock Options
Company Equity
Hybrid Work Options
PTO/vacation mention not explicit beyond Paid Vacation
Paid Sick Leave
Paid Holidays
Adoption Assistance
Company News
Molina Healthcare has risen 6.2% following the Centers for Medicare & Medicaid Services' finalisation of higher 2027 Medicare Advantage payment rates. The news has improved sentiment towards government-focused health insurers ahead of Molina's first-quarter 2026 earnings release and investor day. The stock has also attracted attention after billionaire investor Seth Klarman opened a new position. His investment follows a challenging period, with management guidance pointing to lower 2026 earnings than 2025. Whilst the rate increase improves reimbursement prospects, investors remain focused on how management addresses medical cost trends and margins. Key risks include potential Medicaid funding or programme changes that could affect earnings. The company's narrative projects $50.7 billion in revenue and $1.3 billion in earnings by 2028, requiring 6.8% annual revenue growth.
Molina Healthcare is seeking shareholder approval to amend its Certificate of Incorporation, allowing shareholders to call special stockholder meetings under defined conditions. The governance proposal aims to give investors a quicker route to raise concerns about value and corporate decisions. Trading at $139.38, the stock has gained 4% over the past week but shows longer-term declines of 59.8% over one year and 42.2% over five years. The share price sits approximately 7.5% below the analyst target of $150.65. The company's profit margin has compressed to 1.1% from 3% last year, whilst its price-to-earnings ratio of 15.38 remains below the healthcare industry average of 22.02. The vote outcome could influence how governance issues reach formal consideration at the managed care company.
Molina Healthcare, a Long Beach-based managed healthcare provider valued at $7.3 billion, is expected to report fiscal first-quarter 2026 earnings on 22 April. Analysts forecast earnings of $1.68 per share, down 72.4% year-over-year from $6.08. The company has underperformed significantly, with shares down 57.1% over the past 52 weeks compared to the S&P 500's 13.4% gain. In February, Molina reported fourth-quarter losses of $2.75 per share, missing expectations of $0.43 profit, though revenue of $11.4 billion exceeded forecasts of $10.8 billion. For full-year fiscal 2026, analysts expect earnings of $5.03 per share, down 54.4% from fiscal 2025. The stock carries a consensus "Hold" rating from 18 analysts, with an average price target of $144.40.
Molina Healthcare awards $10,000 grant to combat senior loneliness in Alcona County. LINCOLN, Mich. - The Alcona County Commission on Aging received a $10,000 grant from Molina Healthcare of Michigan to launch a creative arts program designed to combat loneliness among local seniors. The Alcona Creative Connections program will provide monthly workshops for painters and photographers, quilting groups using industrial sewing machines, and woodworking projects utilizing laser cutters. Senior "ambassadors" will receive training to operate and maintain equipment, allowing them to lead activities and ensure program sustainability. Molina Healthcare of Michigan, working with The MolinaCares Accord, distributed the grant as part of $135,000 in funding to 21 organizations across the state through the Michigan Association of Senior Centers. The initiative targets social isolation among older adults through various programs including dementia support, digital literacy, arts programming and transportation services. "The Alcona Creative Connections program at the Alcona Sunrise Center will provide seniors with meaningful opportunities for social connection and creative expression - two critical factors in combating loneliness among older adults," said Wendy Bain, Alcona County Commission on Aging. "Through photographer and artist workshops, quilting bees, and woodworking projects, the program will bring seniors together to build friendships, share skills, and stay engaged." Bain emphasized the program's peer-leadership model. "By also training senior ambassadors to lead activities, the initiative empowers older adults to support one another while strengthening the health, independence, and overall well-being of Alcona County's senior community," she said. Social isolation poses significant health risks for aging adults, according to medical research. The U.S. Surgeon General has documented that loneliness increases the risk of heart disease by 29%, stroke by 32%, and dementia by 50% in older adults. Social isolation also raises the risk of premature death by more than 60%. The health impacts of social isolation rival those of cardiovascular disease, smoking, hypertension and diabetes in terms of mortality risk, according to health officials. "Good physical and mental health are critical to aging with dignity, and these MolinaCares grants support programming that addresses existing wellness gaps," said Terrisca Des Jardins, plan president of Molina Healthcare of Michigan, at a news conference announcing the 21 grants. "Our senior population continues to grow, and we are pleased to help bring these initiatives that can be scaled to meet the needs of this population." The funding addresses a growing need as Michigan's senior population expands. The grants will support various initiatives beyond creative arts, including programs focused on dementia care, technology education, and transportation services that help seniors access community engagement opportunities. The Alcona Creative Connections program represents a community-based approach to senior wellness, emphasizing both creative expression and peer leadership to create sustainable support networks among older adults in the region. Top videos.
Molina Healthcare of Illinois and Foodsmart celebrate national nutrition month with joint effort to improve nutrition among new mothers. * 1 hr ago * 0 CHICAGO, March 24, 2026 - Molina Healthcare of Illinois is continuing its partnership with Foodsmart, a national tele nutrition and food care provider, to make nutrition a core part of maternal health care for Molina members. Through this collaboration, eligible, expectant Molina mothers can access Foodsmart's maternal health program, including support from registered dietitians and medically tailored meals that improve long-term health. Since its launch in April 2025, Foodsmart's program has engaged more than 850 Molina members in Illinois, delivering over 26,000 healthy meals and connecting program participants to registered dietitians. This has led to a 52% reduction in food insecurity and a 20% decrease in hypertension among Molina members, underscoring the role proper nutrition plays in supporting overall health. "At Foodsmart, our personalized approach to nutrition helps mothers access the food they need during pregnancy while building nutrition independence and honoring cultural food preferences," said Jennifer McGuire, chief customer experience officer at Foodsmart. "Our collaboration with Molina has effectively connected pregnant mothers to registered dietitians within two weeks of enrollment in the program, supporting healthier pregnancies and new beginnings for families in Illinois." Proper nutrition during pregnancy is critical for fetal development and healthy birth outcomes. In Illinois, where the pre-term birth rate is higher than the national average, offering comprehensive support for new mothers is especially important. "Building healthier communities begins with investing in the holistic health of our mothers and babies who are the future of Illinois," said Kris Classen, plan president of Molina Healthcare of Illinois. "This collaboration aligns with Molina's ongoing commitment to advancing maternal health outcomes by addressing the key factors that shape them." About Molina Healthcare of Illinois Molina Healthcare of Illinois, Inc. provides government-funded, quality health care, serving members through Medicaid, Medicare, and Marketplace programs in Illinois. Through its locally operated health plans, Molina Healthcare, Inc., a Fortune 500 company, provides managed health care services under the Medicaid and Medicare programs, and through state insurance marketplaces. For more information about Molina Healthcare of Illinois, visit MolinaHealthcare.com. About Foodsmart Foodsmart is the leading foodcare platform in the U.S., built to deliver nutrition-driven healthcare at scale. Powered by a national network of Registered Dietitians and serving more than 3 million members, Foodsmart combines clinical nutrition care, behavior change tools, and food benefits to improve outcomes while lowering healthcare costs. For more information, please visit www.foodsmart.com.