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

Lensa; Augusta (GA); Remote; USD 59,000 - 130,000; Full time

Job summary

A leading healthcare organization is seeking a Senior Analyst for Quality Analytics. This role involves developing reporting solutions for HEDIS audits and analyzing healthcare data to improve performance metrics. The ideal candidate will have extensive experience in data management and healthcare analytics.

Qualifications

• 5+ years in data mapping, scrubbing, and cleaning.
• 5+ years in managed care organizations with SQL.
• 3+ years analyzing HEDIS rates and medical record reviews.

Responsibilities

• Design and develop reporting solutions for HEDIS audits.
• Analyze managed care data and report on trends.
• Support retrospective HEDIS rate tracking.

Skills

Data Mapping

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

SQL

Microsoft T-SQL

SSIS

SSRS

Python

R

Azure

AWS

Hadoop

Job description

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

Be among the first 25 applicants. 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. This position involves designing and developing reporting solutions to assist with HEDIS audits, rate tracking, identifying targeted interventions, and tracking outcomes. The role also includes research, development, and completion of special performance improvement projects.

Essential Job Duties

• Work cross-functionally with various departments to capture and document requirements, build reporting solutions, and educate users on how to use reports.
• Assist Quality Data Analytics Leaders in predictive intervention strategy analytics, along with tracking the progress and impact of interventions.
• Support retrospective HEDIS rate tracking and supplemental data impact reporting.
• Develop medical record review project reporting to track progress and team productivity.
• Develop and QA of ad-hoc and automated analytical and reporting modules related to Quality/HEDIS for Medicaid, Marketplace, and Medicare/MMP.
• Analyze and report on managed care data such as medical claims, pharmacy, lab, and HEDIS rates.
• Assist the quality department with HEDIS measure deep dives to support audits and revenue at risk reporting.
• Calculate and track HEDIS rates for interventions and overall markets and lines of business.
• Operate in an agile environment to analyze complex organizational data sets, perform data mining, verification, scrubbing, and root cause analysis.
• Conduct root cause analysis for business data issues as assigned.
• Analyze data trends for anomalies, outliers, and opportunities using statistical tools, extrapolation, interpolation, and other methodologies to predict future trends.
• Support research, development, and completion of special projects for internal departments or external agencies.
• Manage changes in the Datawarehouse platform and perform upgrades to analytic reporting modules with minimal impact.
• Conduct impact analyses for logic and source code changes in analytics and reporting modules.
• Develop expertise as a HEDIS subject matter expert to improve 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, scrapping, and cleaning.
• 5+ years in managed care organizations with SQL, functions, procedures, and data design.
• 5+ years with Microsoft T-SQL, SSIS, and SSRS.
• Familiarity with data science techniques and languages like Python and R is advantageous.
• 3+ years with cloud platforms like Azure, AWS, or Hadoop.
• 3+ years in predictive modeling in healthcare quality data.
• 3+ years analyzing HEDIS rates, medical record reviews, and intervention tracking.
• 3+ years working with complex data problems related to financial and performance metrics.
• 3+ years in statistical analysis and trend forecasting in healthcare.

Physical Demands

The working 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 role, apply through the intranet. Molina offers competitive benefits and is an Equal Opportunity Employer. Pay range: $59,810.60 - $129,589.63 annually. Actual compensation varies based on location, experience, education, and skills.

Additional Details

• Seniority level: Mid-Senior level
• Employment type: Full-time
• Job function: Quality Assurance
• Industries: IT Services and IT Consulting