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

Lensa; Covington (KY); 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 remote role involves developing reporting solutions for HEDIS audits and collaborating with various departments to enhance healthcare quality metrics. The ideal candidate will have extensive experience in SQL, data analysis, and healthcare quality data. Competitive benefits and a supportive work environment are offered.

Qualifications

• At least 5 years in data mapping, scrubbing, and cleaning.
• At least 5 years in a managed care organization role involving complex SQL queries.
• At least 3 years experience with predictive modeling in healthcare quality data.

Responsibilities

• Design and develop reporting solutions for HEDIS audits and rate tracking.
• Analyze large organizational data sets and conduct root cause analysis.
• Support retrospective HEDIS rate tracking and develop project reports.

Skills

Data Analysis

SQL

Statistical Analysis

Predictive Modeling

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. The role involves designing and developing reporting solutions to assist with HEDIS audits, rate tracking, targeted interventions, and tracking outcomes. The position also includes 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 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.
• 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, overall markets, and lines of business.
• Operate in an agile environment to analyze large organizational data sets, perform data analysis, mining, verification, scrubbing, and root cause analysis.
• Conduct root cause analysis for business data issues as assigned.
• Identify trends, anomalies, and opportunities through statistical analysis, including extrapolation and interpolation to predict future cost, utilization, and performance trends.
• Support research, development, and completion of special projects as needed by internal departments or external agencies.
• Manage changes in the Data Warehouse platform and perform transparent upgrades to ensure no impact on end users.
• 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:

• At least 5 years in data mapping, scrubbing, and cleaning.
• At least 5 years in a managed care organization role involving complex SQL queries, data design, and functional analysis.
• At least 5 years working with Microsoft T-SQL, SSIS, and SSRS.
• Familiarity with Data Science techniques and languages like Python and R is a plus.
• At least 3 years experience with cloud platforms like Azure, AWS, or Hadoop.
• At least 3 years experience with predictive modeling in healthcare quality data.
• At least 3 years experience with HEDIS rate tracking, medical record review, and intervention tracking across Medicaid, Marketplace, or Medicare/MMP.
• At least 3 years handling complex data problems related to financial/performance metrics.
• At least 3 years in statistical analysis and trend forecasting in healthcare.

Physical Demands

Work environment is generally office-based with adequate lighting and temperature. Must be able to sit for long periods. Reasonable accommodations available for disabilities.

Interested current Molina employees should apply via the intranet. Molina offers competitive benefits. Equal Opportunity Employer. Pay range: $59,810.60 - $129,589.63 annually. Actual pay may vary based on location, experience, education, and skills.

Additional Details

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