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

Lensa; Cincinnati (OH); Remote; USD 59,000 - 130,000; Full time

Job summary

A leading company is seeking a Senior Analyst for Quality Analytics to support HEDIS audits and performance improvement projects. The role involves developing reporting solutions, analyzing data trends, and collaborating with various departments. Ideal candidates will have extensive experience in data analytics within managed care environments, particularly with SQL and reporting tools. This position offers competitive benefits and the opportunity to make a significant impact on health plan performance.

Qualifications

• 5+ years in data mapping, scrubbing, and cleaning.
• 5+ years in a managed care organization with SQL queries.
• 3+ years analyzing HEDIS rate tracking.

Responsibilities

• Develop reporting solutions for HEDIS audits and rate tracking.
• Analyze and report on data related to Managed Care.
• Support retrospective HEDIS rate tracking.

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

Microsoft Azure

AWS

Hadoop

Job description

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

2 days ago 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. They will design and develop reporting solutions to assist with HEDIS audits, rate tracking, and 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, tracking progress and impact of 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 data related to Managed Care, including 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 interventions and overall markets and lines of business.
9. Operate in an agile environment to derive insights from complex, large organizational data sets through 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, and predict future trends in cost, utilization, and performance.
12. Support research, development, and completion of special projects for internal departments or external agencies.
13. Manage changes in the Data Warehouse platform and perform upgrades to analytic reporting modules without impacting end users.
14. Conduct impact analyses for logic and source code changes in data analytics and reporting modules.
15. Develop expertise as a HEDIS subject matter expert to help improve health plan performance on underperforming measures.

Job Qualifications

Education:

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

Experience:

• 5+ years in data mapping, scrubbing, scrapping, and cleaning.
• 5+ years in a managed care organization in a techno-functional role involving complex SQL queries, 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 a plus.
• 3+ years with cloud platforms like Microsoft Azure, AWS, or Hadoop.
• 3+ years with predictive modeling in healthcare quality data.
• 3+ years analyzing HEDIS rate tracking, Medical Record Review, and intervention tracking for Medicaid, Marketplace, or Medicare/MMP.
• 3+ years working with complex data problems related to financial/performance metrics.
• 3+ years in statistical analysis and trend forecasting in HEDIS rates.

Physical & Sensory Requirements

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.

To current Molina employees: Please apply through the intranet job listing.

Molina Healthcare offers competitive benefits and compensation. We are an EOE M/F/D/V.

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
• Industry: IT Services and IT Consulting

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