Health Plan Risk & Quality Analytics Specialist

Molina Healthcare, Inc.; United States; Remote; USD 70,000 - 110,000; Full time

Job summary

Molina Healthcare, Inc. is seeking a Health Data Analyst to provide analyst support for health plan risk and quality reporting activities.

You will design and develop custom health plan reports to support local interventions, provider outreach, and track outcomes of initiatives related to HEDIS across Medicaid, Medicare, Marketplace and MMP. You will educate users on how to use reports related to risk and quality/HEDIS and assist with research, development and completion of quality improvement

Qualifications

• 2+ years of experience mapping, scrubbing, scrapping, and cleaning data with HEDIS/risk adjustment focus
• Analytical mindset with strong attention to detail
• Experience with SQL, Databricks SQL and Power BI; Azure/AWS/Hadoop familiarity welcomed

Responsibilities

• Captures and documents health plan quality reporting requirements, builds custom reports, and educates health plan users on how to use reports.
• Builds intervention strategy reporting for risk and quality interventions and measures gap closure.
• Creates ad hoc quality reports to track HEDIS performance and monitor supplemental data.
• Develops QA health plan reports related to Risk and Quality/HEDIS for Medicaid, Marketplace and Medicare/MMP.
• Generates reports on health plan data including medical claims, pharmacy, lab and HEDIS rates.
• Collaborates with the national risk and quality team on testing of pre-production reporting.
• Calculates and tracks gap closure and intervention outcomes for the assigned health plan.
• Performs data analysis in an agile environment to derive meaningful insights from large data sets.
• Performs root-cause analysis for data issues and logic/source changes.
• Represents as HEDIS subject matter expert to support performance improvement on underperforming measures

Skills

HEDIS analytics

Data cleaning

Data analysis

Attention to detail

Tools

Microsoft T-SQL

Databricks SQL

Power BI

Microsoft Excel

Azure

AWS

Hadoop

Job description

Molina Healthcare, Inc. is seeking a Health Data Analyst to provide analyst support for health plan risk and quality reporting activities.

You will design and develop custom health plan reports to support local interventions, provider outreach, and track outcomes of initiatives related to HEDIS across Medicaid, Medicare, Marketplace and MMP. You will educate users on how to use reports related to risk and quality/HEDIS and assist with research, development and completion of quality improvement