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

Lensa; Idaho Falls (ID); 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, analyzing healthcare data, and collaborating with various departments to enhance performance metrics. The ideal candidate will have extensive experience in SQL and data analysis, contributing to improved healthcare outcomes through data-driven insights.

Qualifications

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

Responsibilities

• Design and develop reporting solutions for HEDIS audits.
• Collaborate with departments to gather requirements.
• Analyze large datasets and conduct root cause analysis.

Skills

Data Mapping

Data Scrubbing

Data Cleaning

SQL

Statistical Analysis

Predictive Modeling

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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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. 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

• Collaborate with various departments to gather requirements, build reporting solutions, and educate users on report usage.
• Support predictive intervention strategy analytics and track progress and impact of interventions.
• Assist with retrospective HEDIS rate tracking and supplemental data impact reporting.
• Develop reports for Medical Record Review projects 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.
• Support HEDIS measure deep dives to assist audits and revenue risk reporting.
• Calculate and track HEDIS rates for interventions, markets, and lines of business.
• Work in an agile environment to analyze large datasets, perform data mining, verification, and root cause analysis.
• Conduct root cause analysis for data issues.
• Analyze data trends for anomalies, outliers, and opportunities, using statistical tools to predict future trends.
• Participate in research and development of special projects, including compliance and external reporting.
• Manage changes in the Datawarehouse platform and ensure smooth upgrades of reporting modules.
• Perform impact analyses for logic and source code changes in analytics 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:

• 5+ years in data mapping, scrubbing, and cleaning.
• 5+ years in managed care with complex SQL queries, data design.
• 5+ years with Microsoft T-SQL, SSIS, and SSRS.
• Knowledge of 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.
• 3+ years handling complex data problems related to healthcare metrics.
• 3+ years in statistical analysis and trend forecasting in healthcare data.

Physical and Work Environment

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

Current Molina employees should apply through the intranet.

Molina Healthcare offers competitive benefits and is an Equal Opportunity Employer.

Compensation

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