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

Lensa; Grand Island (NE); Remote; USD 59,000 - 130,000; Full time

Job summary

A leading healthcare organization is seeking a Senior Analyst for Quality Analytics and Performance Improvement. This remote role involves designing reporting solutions, analyzing healthcare data, and supporting HEDIS audits. Ideal candidates will have extensive experience with SQL, data analysis, and a strong background in managed care.

Qualifications

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

Responsibilities

• Design and develop reporting solutions for HEDIS audits and rate tracking.
• Work cross-functionally to capture requirements and educate users.
• Analyze data trends for anomalies and opportunities using statistical tools.

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

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Job Description

Job Summary

The Analyst, Quality Analytics and Performance Improvement role will support Molina's Quality Analytics team. Responsibilities include designing and developing reporting solutions to assist with HEDIS audits, rate tracking, identifying targeted interventions, and tracking outcomes. The role also involves 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 and track progress and impact of interventions.
• 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 and overall markets and lines of business.
• Work in an agile environment to derive meaningful insights from large datasets through data analysis, mining, verification, scrubbing, and root cause analysis.
• Perform root cause analysis for business 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 as needed.
• Manage changes in the Data Warehouse platform and perform upgrades to ensure no impact to 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

Required Education:

Bachelor's Degree in Computer Science, Finance, Math, Economics, or equivalent.

Required Experience:

• 5+ years in data mapping, scrubbing, and cleaning.
• 5+ years in a managed care organization role involving SQL, data design.
• 5+ years with Microsoft T-SQL, SSIS, SSRS.
• Familiarity with Data Science techniques and languages like Python and R is advantageous.
• 3+ years with cloud platforms like Azure, AWS, or Hadoop.
• 3+ years with predictive modeling in healthcare quality data.
• 3+ years analyzing HEDIS rate tracking, Medical Record Review, and interventions.
• 3+ years working with 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 are available for individuals with disabilities.

Interested Molina employees should apply via the intranet.

Molina Healthcare 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 varies based on location, experience, education, and skills.

Additional Information

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