Lead Risk Adjustment Predictive Analytics Specialist

Molina Healthcare; United States; Remote; USD 110,000 - 160,000; Full time

Job summary

Molina Healthcare is seeking a lead-level Analyst to support enterprise risk-adjustment predictive analytics. You will design and develop tracking systems for risk scores and outcomes across markets, while building QA modules for multiple lines of business.

Successful candidates will have extensive SQL/T-SQL experience, Power BI expertise, and familiarity with cloud platforms. You will collaborate with stakeholders to ensure data requirements are met and insights drive interventions.

Qualifications

• 4+ years writing complex SQL queries and data design in health care analytics.
• Experience with T-SQL, SSIS, SSRS and Power BI in enterprise environments.
• Predictive modeling and tracking for risk adjustment across payers.
• Experience with cloud/data platforms (Azure, AWS, Hadoop).
• Ability to communicate results to non-technical stakeholders.

Responsibilities

• Support enterprise risk-adjustment analytics and interventions.
• Design and lead tracking systems for risk scores across markets.
• Develop QA reporting modules for Medicaid, Marketplace and MMP lines.
• Create automated suspect/target ranking engines for multiple lines.
• Analyze managed care data including claims, pharmacy, and costs.
• Perform data analysis, mining, verification, scrubbing, and root-cause analysis.
• Collaborate with stakeholders to define data requirements and deliverables.
• Conduct root-cause analysis for data issues and communicate findings.

Skills

SQL

T-SQL

SSIS

SSRS

Power BI

Predictive modeling

Data analysis

Data mining

Databricks SQL

Python

R

Tools

Azure

AWS

Hadoop

Databricks

Job description

Molina Healthcare is seeking a lead-level Analyst to support enterprise risk-adjustment predictive analytics. You will design and develop tracking systems for risk scores and outcomes across markets, while building QA modules for multiple lines of business.

Successful candidates will have extensive SQL/T-SQL experience, Power BI expertise, and familiarity with cloud platforms. You will collaborate with stakeholders to ensure data requirements are met and insights drive interventions.