Analyst, Risk & Quality Reporting (Remote in CA)

Lensa; Riverside (CA); Remote; USD 65,000 - 95,000; Full time

Job summary

A leading company in healthcare is seeking an Analyst for Risk and Quality Reporting. This remote role involves designing health plan reports, analyzing data, and supporting quality initiatives for Medicaid, Marketplace, and Medicare. Ideal candidates will have a Bachelor's degree and experience in healthcare reporting. Join a dynamic team focused on improving health outcomes through data insights.

Qualifications

• 1-3 years of experience in data mapping, profiling, scraping, and cleaning.
• Experience in a managed care organization involving SQL and data design.
• Knowledge of HEDIS and Risk data.

Responsibilities

• Design and develop custom health plan reports for interventions and outcomes.
• Analyze data sets for anomalies and trends using tools like Databricks SQL and PowerBI.
• Collaborate with the national Risk and Quality department on reporting.

Skills

Data mapping

Data profiling

Data cleaning

Data analysis

SQL

Healthcare reporting

Education

Bachelor's Degree

Master's Degree in a clinical field or Public Health

Tools

Microsoft T-SQL

Databricks SQL

PowerBI

Microsoft Azure

AWS

Hadoop

Job description

Analyst, Risk & Quality Reporting (Remote in CA)

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Lensa is the leading career site for job seekers at every stage of their career. Our client, Molina Healthcare, is seeking professionals. Apply via Lensa today!

Job Description

JOB SUMMARY: The Analyst, Risk and Quality Reporting role supports Molina’s Risk and Quality Health Plan team. This position designs and develops custom health plan reports to support local interventions, provider outreach, and tracks outcomes of the initiatives. Educates users on how to use reports related to Risk and Quality/HEDIS for Medicaid, Marketplace, and Medicare/MMP.

Essential Job Duties

• Work with assigned health plan to capture and document requirements, build custom health plan reports, and educate health plan users on how to use reports.
• Build intervention strategy reporting for the Risk and Quality interventions and measure gap closure.
• Build ad hoc reports as requested to track HEDIS performance and supplemental data monitoring.
• Develop and QA of custom health plan reports related to Risk and Quality/HEDIS for Medicaid, Marketplace, and Medicare/MMP.
• Develop custom health plan reports related to managed care data like Medical Claims, Pharmacy, Lab, and HEDIS rates.
• Assist and collaborate with the national Risk and Quality department with testing of pre-production reporting for the assigned health plan.
• Calculate and track gap closure and intervention outcome reporting for the assigned state.
• Work in an agile environment to derive meaningful insights from organizational data sets through data analysis and profiling.
• Analyze data sets and trends for anomalies, outliers, trend changes, and opportunities using tools like Databricks SQL, PowerBI, and Excel.
• Assist with research, development, and completion of special projects as requested by internal departments or external agencies.

Required Qualifications

• Bachelor's Degree or equivalent experience.
• 1-3 years of experience in data mapping, profiling, scraping, and cleaning.
• 1-3 years of experience in a managed care organization involving SQL, data design.
• Experience with Microsoft T-SQL, Databricks SQL, PowerBI.
• Familiarity with Microsoft Azure, AWS, or Hadoop.
• Experience in healthcare reporting and data analysis.
• Knowledge of HEDIS and Risk data.

Preferred Education

Master's Degree or higher in a clinical field, Public Health, or Healthcare.

Preferred Experience

• Experience with Medicare and Medicaid.
• HEDIS reporting experience.
• Developing or analyzing performance measures.
• Certifications such as CPHQ, Nursing License, CHCA.

Interested current Molina employees should apply through the intranet. Molina offers competitive benefits. Equal Opportunity Employer.