Senior Analyst, Quality Analytics & Performance Improvement - Power BI/SQL/Hedis - Remote

Lensa; Albuquerque (NM); Remote; USD 59,000 - 130,000; Full time

Job summary

A leading healthcare organization is seeking a Senior Analyst for Quality Analytics and Performance Improvement. This remote role involves developing reporting solutions for HEDIS audits and supporting quality initiatives. The ideal candidate will have extensive experience in data analysis, SQL, and healthcare quality metrics. Join a dynamic team focused on improving healthcare outcomes through data-driven insights.

Benefits

Competitive benefits package

Qualifications

• 5+ years in data mapping, scrubbing, cleaning.
• 5+ years in managed care organization with SQL.

Responsibilities

• Design and develop reporting solutions for HEDIS audits.
• Analyze and report on managed care data including claims and HEDIS rates.

Skills

Data Mapping

Data Scrubbing

SQL

Statistical Analysis

Predictive Modeling

Education

Bachelor's Degree in Computer Science

Bachelor's Degree in Finance

Bachelor's Degree in Math

Bachelor's Degree in Economics

Tools

Microsoft T-SQL

SSIS

SSRS

Python

R

Azure

AWS

Hadoop

Job description

Senior Analyst, Quality Analytics & Performance Improvement - Power BI/SQL/Hedis - Remote

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, Quality Analytics and Performance Improvement role will support Molina's Quality Analytics team. The role involves designing and developing reporting solutions to assist with HEDIS audits, rate tracking, and identifying targeted interventions and tracking outcomes. The analyst will also assist with research, development, and completion of special performance improvement projects.

Essential Job Duties

1. Work cross-functionally with various departments to capture and document requirements, build reporting solutions, and educate users on report usage.
2. Assist Quality Data Analytics Leaders in predictive intervention strategy analytics, along with tracking the progress and impact of these interventions.
3. Support retrospective HEDIS rate tracking and supplemental data impact reporting.
4. Develop medical record review project reporting to monitor progress and team productivity.
5. Develop and QA of ad-hoc and automated analytical and reporting modules related to Quality/HEDIS for Medicaid, Marketplace, and Medicare/MMP.
6. Analyze and report on managed care data such as medical claims, pharmacy, lab, and HEDIS rates.
7. Assist the Quality department with HEDIS measure deep dives to support audits and revenue at risk reporting.
8. Calculate and track HEDIS rates for intervention outcomes and overall markets and lines of business.
9. Work in an agile environment to extract meaningful insights from large and complex data sets through analysis, data mining, verification, scrubbing, and root cause analysis.
10. Perform root cause analysis for business data issues as assigned.
11. Analyze data trends for anomalies, outliers, and opportunities using statistical tools and techniques, and predict future trends in costs, utilization, and performance.
12. Support research, development, and completion of special projects as requested by internal departments or external agencies.
13. Manage changes in the Datawarehouse platform and perform transparent upgrades to ensure no impact on end users.
14. Conduct impact analyses for logic and source code changes in analytics and reporting modules.
15. Develop expertise as a HEDIS subject matter expert to help improve health plan performance on underperforming measures.

Job Qualifications

Required Education: Bachelor's Degree in Computer Science, Finance, Math, Economics, or related field.

Required Experience:

• 5+ years in data mapping, scrubbing, cleaning, and related tasks.
• 5+ years in a managed care organization role involving SQL, data design, and techno-functional responsibilities.
• 5+ years working with Microsoft T-SQL, SSIS, and SSRS.
• Familiarity with data science techniques and languages like Python and R is a plus.
• 3+ years with cloud platforms such as Azure, AWS, or Hadoop.
• 3+ years in predictive modeling within healthcare quality data.
• 3+ years analyzing HEDIS rates, medical record reviews, and interventions for Medicaid, Marketplace, or Medicare/MMP.
• 3+ years handling complex data problems related to financial and performance metrics.
• 3+ years in statistical analysis and trend forecasting in healthcare data.

Physical Demands

The work environment is generally office-based with adequate lighting and temperature. Must be able to sit for long periods. Reasonable accommodations available for individuals with disabilities.

If you are a current Molina employee interested in this position, please apply through the intranet.

Molina Healthcare offers a competitive benefits package. We are an Equal Opportunity Employer (EOE) M/F/D/V.

Pay Range: $59,810.60 - $129,589.63 annually. Actual compensation varies based on location, experience, education, and skills.