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

Lensa; Des Moines (IA); Remote; USD 77,000 - 156,000; Full time

Job summary

A leading company in IT Services and Consulting is seeking a Senior Analyst for Quality Analytics and Performance Improvement. This role involves designing reporting solutions for HEDIS audits and analyzing healthcare data to improve performance. Candidates should have a Bachelor's degree and extensive experience in data roles, particularly within managed care organizations.

Qualifications

• 5+ years in data mapping, scrubbing, cleaning.
• 5+ years in managed care organization roles involving SQL, data design.
• 3+ years analyzing HEDIS rates, medical record reviews, and interventions.

Responsibilities

• Design and develop reporting solutions for HEDIS audits and outcome tracking.
• Work cross-functionally to capture requirements and educate users.
• Analyze managed care data and support retrospective HEDIS rate tracking.

Skills

Data mapping

Data cleaning

SQL

Statistical analysis

Predictive modeling

Data analysis

Education

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

Tools

Microsoft T-SQL

SSIS

SSRS

Azure

AWS

Hadoop

Python

R

Job description

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

1 day ago Be among the first 25 applicants

Get AI-powered advice on this job and more exclusive features.

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. Designs and develops reporting solutions to assist with HEDIS audits, rate tracking, targeted interventions, and outcome tracking. Assists 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 reporting 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.
• Work in an agile environment to extract meaningful insights from complex, large data sets through analysis, 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 to assess significance and relevance. Use methodologies like extrapolation and interpolation to forecast future trends.
• Support research, development, and completion of special projects requested by internal departments or external agencies.
• Manage changes in the Data Warehouse platform and perform upgrades to ensure no impact on end users.
• Conduct impact analyses for logic and source code changes, maintaining other variables constant.
• Develop expertise as a HEDIS subject matter expert to help improve 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, cleaning.
• 5+ years in managed care organization roles involving SQL, data design.
• 5+ years with Microsoft T-SQL, SSIS, 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 with predictive modeling in healthcare quality data.
• 3+ years analyzing HEDIS rates, medical record reviews, and interventions.
• 3+ years handling complex data problems related to financial and performance metrics.
• 3+ years in statistical analysis and trend forecasting in healthcare.

Physical Demands

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

Interested Molina employees should apply through the intranet. Molina offers competitive benefits. We are an EOE M/F/D/V.

Pay Range

$77,969 - $155,508 annually. Compensation varies based on location, experience, education, and skills.

Additional Details

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