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

Lensa; Boise (ID); Remote; USD 59,000 - 130,000; Full time

Job summary

A leading company seeks a Senior Analyst for Quality Analytics to support HEDIS audits and performance improvement projects. The role involves data analysis, reporting solutions, and collaboration across departments to enhance healthcare quality metrics. Candidates should have extensive experience in SQL and data management, with a strong analytical background.

Benefits

Competitive benefits

Qualifications

• 5+ years in data mapping, scrubbing, and cleaning.
• 5+ years in a managed care organization role involving SQL, data design.
• 3+ years in statistical analysis and forecasting trends in healthcare data.

Responsibilities

• Design and develop reporting solutions for HEDIS audits and rate tracking.
• Analyze Managed Care data such as Medical Claims, Pharmacy, and Lab.
• Work cross-functionally to capture requirements and educate users.

Skills

Data Analysis

Predictive Modeling

Statistical Analysis

SQL

Data Mapping

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 position involves designing and developing reporting solutions to assist with HEDIS audits, rate tracking, and identifying targeted interventions and tracking outcomes. The role also includes 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 Medical Record Review project reporting 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 all intervention outcomes, markets, and lines of business.
9. Work in an agile environment to analyze complex organizational data sets through data analysis, 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 to determine significance and relevance, including predictive methodologies.
12. Assist with research and development of special projects requested by internal departments or external agencies.
13. Manage changes in the Datawarehouse platform and perform 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 performance on underperforming measures.

Job Qualifications

Required 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 SQL, data design.
• 5+ years with Microsoft T-SQL, SSIS, SSRS.
• Familiarity with Data Science techniques and languages like Python and R is a plus.
• 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 Review, and intervention tracking.
• 3+ years handling complex data problems related to financial and performance metrics.
• 3+ years in statistical analysis and forecasting trends in healthcare data.

Physical Demands

Office environment, sitting for long periods, minimal exposure to hazards. Accommodations available for disabilities.

Additional Information

Interested candidates should apply through the intranet if currently employed at Molina. The company offers competitive benefits. Equal Opportunity Employer. Pay range: $59,810.6 - $129,589.63 annually, varies by location and experience.