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

Lensa; Dallas (TX); Remote; USD 77,000 - 156,000; Full time

Job summary

A leading company in healthcare analytics is seeking a Senior Analyst to support quality improvement initiatives. This role involves designing reporting solutions, analyzing healthcare data, and collaborating with various departments to enhance performance metrics. Candidates should have extensive experience in data management and a strong background in healthcare analytics.

Qualifications

• 5+ years in data mapping, scrubbing, and cleaning.
• 5+ years in managed care with SQL experience.
• 3+ years analyzing HEDIS rates and healthcare quality data.

Responsibilities

• Design and develop reporting solutions for HEDIS audits.
• Analyze managed care data and track outcomes.
• Support predictive intervention strategy analytics.

Skills

Data mapping

Data cleaning

SQL

Statistical analysis

Predictive modeling

Data analysis

Education

Bachelor's Degree in Computer Science, Finance, Math, Economics

Tools

Microsoft T-SQL

SSIS

SSRS

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, identifying targeted interventions, and tracking outcomes. The analyst will also support 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 how to use reports.
• Assist Quality Data Analytics Leaders in predictive intervention strategy analytics, including tracking progress and impact of interventions.
• Support retrospective HEDIS rate tracking and supplemental data impact reporting.
• Develop medical record review project reporting to track 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.
• Work in an agile environment to derive insights from large and complex data sets through analysis, data mining, verification, scrubbing, and root cause analysis.
• Perform root cause analysis for data issues as assigned.
• Analyze data trends for anomalies, outliers, and opportunities using statistical tools and techniques.
• Assist with research and development of special projects for internal departments or external agencies.
• Manage changes and upgrades in the Datawarehouse platform, ensuring no impact on end users.
• Conduct impact analyses for logic and source code changes, maintaining consistent variables.
• 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 equivalent.

Experience:

• 5+ years in data mapping, scrubbing, and cleaning.
• 5+ years in managed care, with experience in SQL, 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 Azure, AWS, or Hadoop.
• 3+ years in predictive modeling in healthcare quality data.
• 3+ years analyzing HEDIS rates, medical record reviews, and interventions for 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.

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 can be made for individuals with disabilities.

Interested Molina employees should apply via the intranet. Molina offers competitive benefits. Equal Opportunity Employer. Pay Range: $77,969 - $155,508 annually.