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

Lensa; Atlanta (GA); Remote; USD 77,000 - 156,000; Full time

Job summary

A leading company is seeking a Senior Analyst for Quality Analytics and Performance Improvement. This remote role involves designing reporting solutions for HEDIS audits, analyzing complex datasets, and collaborating with various departments to improve healthcare quality metrics. Ideal candidates will have extensive experience in data analysis, SQL, and healthcare metrics.

Qualifications

• 5+ years in data mapping, scrubbing, and cleaning.
• Experience with SQL queries and data design.
• 3+ years analyzing HEDIS rates and healthcare quality data.

Responsibilities

• Support Molina's Quality Analytics team with reporting solutions.
• Work cross-functionally to capture and document requirements.
• Analyze managed care data for HEDIS audits and interventions.

Skills

Data mapping

Data scrubbing

Data cleaning

SQL queries

Statistical analysis

Trend forecasting

Education

Bachelor's Degree in Computer Science, Finance, Math, 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

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

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Job Description

Job Summary

The Analyst, Quality Analytics and Performance Improvement role will support Molina's Quality Analytics team. This includes designing and developing reporting solutions to assist with HEDIS audits, rate tracking, identifying targeted interventions, and tracking outcomes. The role also involves 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 interventions.
3. Support retrospective HEDIS rate tracking and supplemental data impact reporting.
4. Develop reports for Medical Record Review projects to track progress and team productivity.
5. Develop and QA 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 across markets and lines of business.
9. Work in an agile environment to analyze complex large datasets, perform 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, predicting future trends in cost, utilization, and performance.
12. Support research and development of special projects for internal departments or external agencies.
13. Manage changes in the Datawarehouse platform and update analytic reporting modules to ensure seamless operation.
14. Conduct impact analyses for logic and source code changes, maintaining data integrity.
15. Develop expertise as a HEDIS subject matter expert to improve health plan performance on underperforming measures.

Job Qualifications

Education

Bachelor's Degree in Computer Science, Finance, Math, Economics, or equivalent.

Experience

• 5+ years in data mapping, scrubbing, and cleaning.
• 5+ years in a managed care organization role involving complex SQL queries, functions, procedures, and data design.
• Experience 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 with healthcare quality data.
• 3+ years analyzing HEDIS rates, Medical Record Review, 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.

Physical and Work Environment

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

Additional Information

If you are a current Molina employee interested in this role, please apply through the intranet. Molina offers competitive benefits. Equal Opportunity Employer. Pay Range: $77,969 - $155,508 annually. Actual compensation varies based on location, experience, education, and skills.