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

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

Job summary

A leading company in healthcare analytics is seeking a Senior Analyst to join their Quality Analytics team. The successful candidate will support HEDIS audits and develop reporting solutions while collaborating with various departments. This role offers the chance to derive insights from large datasets and contribute to performance improvement projects in a dynamic environment.

Benefits

Competitive benefits

Qualifications

• 5+ years in data mapping, scrubbing, scraping, and cleaning.
• 5+ years in a managed care organization role involving SQL, data design.
• 3+ years analyzing HEDIS rates and interventions.

Responsibilities

• Design and develop reporting solutions for HEDIS audits and rate tracking.
• Work cross-functionally to build reporting solutions and educate users.
• Analyze managed care data and support quality improvement projects.

Skills

Data Analysis

Statistical Analysis

Data Mapping

Predictive Modeling

SQL

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

The Analyst, Quality Analytics and Performance Improvement role will support Molina's Quality Analytics team. You will design and develop reporting solutions to assist with HEDIS audits, rate tracking, targeted interventions, and outcome tracking. You will also assist with 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 report usage.
• Assist Quality Data Analytics Leaders in predictive intervention strategy analytics, including tracking progress and impact.
• Support retrospective HEDIS rate tracking and supplemental data impact reporting.
• Develop Medical Record Review project reports to monitor progress and team productivity.
• Develop and QA 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 intervention outcomes across markets and lines of business.
• Derive meaningful insights from large datasets through data analysis, mining, verification, scrubbing, and root cause analysis in an agile environment.
• Perform root cause analysis for business data issues as assigned.
• Analyze data trends for anomalies, outliers, and opportunities using statistical tools to determine significance and relevance; use methodologies like extrapolation and interpolation to predict future trends.
• Support research, development, and completion of special projects as requested by internal or external stakeholders.
• Manage changes in the Data Warehouse platform and perform transparent upgrades to ensure no impact on end users.
• Conduct impact analyses for logic and source code changes in analytics and reporting modules.
• 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 related field.

Experience:

• 5+ years in data mapping, scrubbing, scraping, and cleaning.
• 5+ years in a managed care organization role involving SQL, 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 Azure, AWS, or Hadoop.
• 3+ years in predictive modeling in healthcare quality data.
• 3+ years analyzing HEDIS rates, Medical Record Review, and interventions in Medicaid, Marketplace, or Medicare/MMP.
• 3+ years handling complex data problems related to financial and performance metrics.
• 3+ years in statistical analysis and trend forecasting in healthcare data.

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

Pay Range: $59,810.60 - $129,589.63 annually. Actual compensation may vary 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