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

Lensa; City of Rochester (NY); Remote; USD 59,000 - 130,000; Full time

Job summary

A leading company is seeking a Senior Analyst for Quality Analytics and Performance Improvement. This role involves designing reporting solutions for HEDIS audits and supporting various performance improvement projects. The ideal candidate will have extensive experience in data analysis, SQL, and healthcare quality metrics. Join a dynamic team focused on enhancing healthcare outcomes through data-driven insights.

Qualifications

• Minimum 5 years in data mapping, scrubbing, and cleaning.
• At least 5 years in a managed care organization with SQL, data design, and techno-functional roles.
• 5+ years with Microsoft T-SQL, SSIS, and SSRS.

Responsibilities

• Collaborate across departments to gather requirements and build reporting solutions.
• Support predictive intervention strategy analytics and track their progress.
• Analyze managed care data such as Medical Claims, Pharmacy, Lab, and HEDIS rates.

Skills

Data Analysis

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

Azure

AWS

Hadoop

Job description

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

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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, targeted interventions, and outcome tracking. The analyst will also support research, development, and completion of special performance improvement projects.

Essential Job Duties
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Collaborate across departments to gather requirements, build reporting solutions, and train users.

Support predictive intervention strategy analytics and track their progress and impact.

Assist with retrospective HEDIS rate tracking and impact reporting.

Develop reports for Medical Record Review projects to monitor progress and productivity.

Create and QA ad-hoc and automated reports related to Quality/HEDIS for Medicaid, Marketplace, and Medicare/MMP.

Analyze managed care data such as Medical Claims, Pharmacy, Lab, and HEDIS rates.

Support HEDIS measure deep dives to aid audits and revenue risk assessments.

Calculate and monitor HEDIS rates for interventions and overall markets and lines of business.

Work in an agile environment to analyze large datasets, perform data mining, verification, and root cause analysis.

Conduct root cause analysis for data issues as assigned.

Identify trends, anomalies, and opportunities using statistical tools and techniques.

Participate in research and development of special projects as needed.

Manage changes in the Data Warehouse platform and ensure smooth upgrades of reporting modules.

Perform impact analyses for logic and source code changes in analytics and reporting modules.

Develop expertise in HEDIS to improve health plan performance on underperforming measures.

Job Qualifications

Education: Bachelor's Degree in Computer Science, Finance, Math, Economics, or related field.

Experience:

• Minimum 5 years in data mapping, scrubbing, and cleaning.
• At least 5 years in a managed care organization with SQL, data design, and techno-functional roles.
• 5+ years with Microsoft T-SQL, SSIS, and SSRS.
• Knowledge of 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 and healthcare quality data analysis.
• 3+ years analyzing HEDIS rates, Medical Record Reviews, and interventions across Medicaid, Marketplace, or Medicare/MMP.
• Experience with complex data problems related to financial and performance metrics.
• Statistical analysis and trend forecasting skills for healthcare data.

Physical/Safety Demands
Work environment is generally office-based with minimal hazards. Must be able to sit for extended periods. Accommodations can be provided for disabilities.

Current Molina employees should apply through the intranet. Molina offers competitive benefits. Equal Opportunity Employer (EOE) M/F/D/V.

Pay Range: $59,810.6 - $129,589.63 annually.

• Compensation varies based on location, experience, education, and skills.

Seniority level

• Mid-Senior level

Employment type

• Full-time

Job function

• Quality Assurance

Industries

• IT Services and IT Consulting

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