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

Lensa; Iowa City (IA); Remote; USD 80,000 - 110,000; Full time

Job summary

A leading company in healthcare analytics is seeking a Senior Analyst to enhance quality performance through data analysis and reporting. This remote role involves collaboration with various departments to improve healthcare metrics and support HEDIS audits. Candidates should have extensive experience in SQL, data science techniques, and a strong background in managed care analytics.

Qualifications

• 5+ years of experience in data analysis and managed care.
• 3+ years with HEDIS rate tracking and healthcare metrics.
• Experience with cloud platforms and predictive modeling.

Responsibilities

• Design and develop reporting solutions for HEDIS audits.
• Support predictive intervention strategies and track their impact.
• Analyze managed care data including claims and pharmacy.

Skills

Data cleaning

Data mapping

Data scrubbing

Statistical analysis

Trend forecasting

Predictive modeling

Education

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

Job Summary

The Analyst, Quality Analytics and Performance Improvement will support Molina's Quality Analytics team by designing and developing reporting solutions for HEDIS audits, rate tracking, and targeted interventions. The role involves research, development, and execution of special performance improvement projects.

Essential Job Duties

1. Collaborate with departments to gather requirements, build reports, and train users.
2. Support predictive intervention strategies and track their impact.
3. Assist in retrospective HEDIS rate tracking and data impact reporting.
4. Create reports for Medical Record Review projects and team productivity.
5. Develop and QA analytical and reporting modules related to Quality/HEDIS for various markets.
6. Analyze managed care data including claims, pharmacy, lab, and HEDIS rates.
7. Support HEDIS measure analysis to aid audits and revenue reporting.
8. Calculate and monitor HEDIS rates for interventions and markets.
9. Perform data analysis, mining, verification, and root cause analysis in an agile environment.
10. Conduct root cause analysis for data issues.
11. Identify trends, anomalies, and opportunities using statistical tools and methodologies.
12. Participate in research and special projects as needed.
13. Manage data warehouse changes and perform upgrades without disrupting end users.
14. Analyze the impact of logic and source code changes in analytics modules.
15. Develop expertise in HEDIS to improve health plan performance on measures.

Job Qualifications

• Bachelor's Degree in Computer Science, Finance, Math, Economics, or related field.
• 5+ years of experience with data cleaning, mapping, and scrubbing.
• 5+ years in a managed care environment with SQL, functions, procedures, and data design.
• Proficiency in Microsoft T-SQL, SSIS, and SSRS.
• Knowledge of data science techniques and languages like Python and R is a plus.
• 3+ years experience with cloud platforms like Azure, AWS, or Hadoop.
• 3+ years experience with predictive modeling in healthcare quality data.
• 3+ years working with HEDIS rate tracking, medical record reviews, and interventions.
• Experience analyzing complex data problems related to healthcare metrics.
• Background in statistical analysis and trend forecasting.

Physical Demands

The work environment is generally office-based with minimal hazards. Must be able to sit for extended periods. Accommodations are available for individuals with disabilities.

Interested current Molina employees should apply via the intranet. Molina offers competitive benefits and is an Equal Opportunity Employer.