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

Lensa; Iowa City (IA); 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 designing reporting solutions, analyzing healthcare data, and supporting HEDIS audits. Ideal candidates will have extensive experience in data management and analytics within a healthcare context. Join a dynamic team focused on improving health outcomes through data-driven insights and innovative reporting solutions.

Qualifications

• 5+ years in data mapping, scrubbing, and cleaning.
• 5+ years in a managed care organization with SQL and data design.
• 3+ years analyzing HEDIS rates and interventions.

Responsibilities

• Design and develop reporting solutions for HEDIS audits.
• Analyze managed care data including medical claims and HEDIS rates.
• Work cross-functionally to capture and document requirements.

Skills

Data Mapping

Data Scrubbing

Statistical Analysis

Predictive Modeling

SQL

Python

R

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

Azure

AWS

Hadoop

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. The 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

1. Work cross-functionally with various departments to capture and document requirements, build reporting solutions, and educate users on report usage.
2. Assist Quality Data Analytics Leaders in predictive intervention strategy analytics, including tracking progress and impact.
3. Support retrospective HEDIS rate tracking and supplemental data impact reporting.
4. Develop medical record review project reports to track progress and team productivity.
5. Develop and QA ad-hoc and automated analytical and reporting modules related to Quality/HEDIS for Medicaid, Marketplace, and Medicare/MMP.
6. Analyze and report on managed care data, including medical claims, pharmacy, lab, and HEDIS rates.
7. Assist the Quality department with HEDIS measure deep dives to support audits and revenue at risk reporting.
8. Calculate and track HEDIS rates for intervention outcomes, overall markets, and lines of business.
9. Work in an agile environment to derive meaningful insights from large, complex data sets through analysis, mining, verification, scrubbing, and root cause analysis.
10. Perform root cause analysis for data issues as assigned.
11. Analyze data trends for anomalies, outliers, and opportunities, using statistical tools to determine significance and relevance, and predict future trends.
12. Support research and development of special projects requested by internal departments or external organizations.
13. Manage changes in the Data Warehouse platform and perform transparent upgrades to ensure no impact on end users.
14. Conduct impact analyses for logic and source code changes in analytics and reporting modules.
15. Develop expertise in HEDIS to help improve health plan performance on underperforming measures.

Job Qualifications

Required Education: Bachelor's Degree in Computer Science, Finance, Math, Economics, or related discipline.

Experience:

• 5+ years in data mapping, scrubbing, and cleaning.
• 5+ years in a managed care organization with SQL, data design, and techno-functional roles.
• 5+ years in 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 across 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.

Physical Demands

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

Interested Molina employees should apply through the intranet. Molina offers competitive benefits. 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 Details

• Seniority level: Mid-Senior level
• Employment type: Full-time
• Job function: Quality Assurance
• Industry: IT Services and IT Consulting