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

Lensa; Bellevue (NE); Remote; USD 77,000 - 156,000; Full time

Job summary

A leading company in IT Services is seeking a Senior Analyst for Quality Analytics & Performance Improvement. This remote role involves designing reporting solutions for HEDIS audits and analyzing healthcare data to enhance performance. Ideal candidates will have extensive experience in data management and a strong background in healthcare analytics.

Qualifications

• 5+ years in data mapping, scrubbing, and cleaning.
• 5+ years in managed care with SQL and data design.
• Experience in statistical analysis and trend forecasting.

Responsibilities

• Collaborate with departments to build reporting solutions.
• Support predictive intervention strategy analytics.
• Analyze managed care data and report on HEDIS rates.

Skills

Data mapping

Data scrubbing

Data cleaning

Statistical analysis

Predictive modeling

Data analysis

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. This role involves designing and developing reporting solutions to assist with HEDIS audits, rate tracking, identifying targeted interventions, and tracking outcomes. The analyst will also assist with research, development, and completion of special performance improvement projects.

Essential Job Duties

• Collaborate with various departments to capture requirements, build reporting solutions, and educate users on report usage.
• Support predictive intervention strategy analytics and track progress and impact of interventions.
• Assist with retrospective HEDIS rate tracking and supplemental data impact reporting.
• Develop reports for Medical Record Review projects to monitor progress and team productivity.
• Create and QA 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.
• Support HEDIS measure deep dives to aid audits and revenue risk reporting.
• Calculate and track HEDIS rates for intervention outcomes across markets and lines of business.
• Extract meaningful insights from large and complex data sets through analysis, data mining, verification, scrubbing, and root cause analysis.
• Perform root cause analysis for business data issues.
• Identify data anomalies, outliers, and trends using statistical tools, and predict future trends in cost, utilization, and performance.
• Participate in research and development for special projects and external requests.
• Manage changes in the Datawarehouse platform and upgrade analytic reporting modules with minimal impact.
• Conduct impact analyses for logic and source code changes in analytics and reporting modules.
• Develop expertise in HEDIS to help 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 with SQL, data design, and techno-functional roles.
• Proficiency in 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 for healthcare quality data.
• 3+ years analyzing HEDIS rates, medical record reviews, and interventions across Medicaid, Marketplace, and Medicare/MMP.
• 3+ years handling complex data problems related to financial and performance metrics.
• Experience in statistical analysis and trend forecasting in healthcare.

Physical Demands

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.

Interested Molina employees should apply through the intranet. Molina offers competitive benefits and is an EOE. Pay range: $77,969 - $155,508 annually, varies by location and experience.

Additional Information

• Level: Mid-Senior
• Type: Full-time
• Function: Quality Assurance
• Industry: IT Services and Consulting