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

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

Job summary

A leading company is seeking a Senior Analyst for Quality Analytics & Performance Improvement. This remote role involves designing reporting solutions, supporting HEDIS audits, and collaborating across departments. Ideal candidates will have extensive experience in data management and analytics, particularly in healthcare settings. Join a dynamic team focused on improving health plan performance through data-driven insights and innovative solutions.

Qualifications

• At least 5 years in data mapping, cleaning, and management.
• Proficiency with Microsoft T-SQL, SSIS, and SSRS for 5+ years.
• Experience with HEDIS rate tracking and medical record review analysis (3+ years).

Responsibilities

• Collaborate cross-functionally to gather requirements and develop reporting solutions.
• Support predictive intervention strategy analytics and monitor progress.
• Analyze and report on managed care data, including Medical Claims and HEDIS rates.

Skills

Data Analysis

Statistical Analysis

SQL

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

2 days ago Be among the first 25 applicants

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 execution of special performance improvement projects.

Essential Job Duties

• Collaborate cross-functionally with various departments to gather requirements, develop reporting solutions, and train users.
• Support predictive intervention strategy analytics and monitor 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 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, including Medical Claims, Pharmacy, Lab, and HEDIS rates.
• Support the Quality department with HEDIS measure analysis to aid audits and revenue risk assessments.
• Calculate and track HEDIS rates for interventions, markets, and lines of business.
• Work in an agile environment to extract insights from large datasets through data analysis, mining, verification, and root cause analysis.
• Perform root cause analysis on data issues as assigned.
• Identify trends, anomalies, and opportunities using statistical tools and techniques, including forecasting future trends.
• Participate in research and development of special projects and respond to external agency requests.
• Manage changes and upgrades in the Datawarehouse platform to ensure seamless reporting.
• Conduct impact analyses for logic and source code changes in analytics modules.
• Develop expertise as a HEDIS subject matter expert to improve health plan performance on underperforming measures.

Job Qualifications

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

Experience:

• At least 5 years in data mapping, cleaning, and management.
• At least 5 years in a managed care organization with SQL, data design, and techno-functional roles.
• Proficiency with Microsoft T-SQL, SSIS, and SSRS for 5+ years.
• Knowledge of data science techniques and languages like Python and R is advantageous.
• Experience with cloud platforms such as Azure, AWS, or Hadoop (3+ years).
• Predictive modeling experience in healthcare quality data (3+ years).
• Experience with HEDIS rate tracking and medical record review analysis (3+ years).
• Strong background in analyzing complex data to measure financial and performance metrics (3+ years).
• Statistical analysis and trend forecasting experience in healthcare (3+ years).

Physical Demands

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

Interested current Molina employees should apply via the intranet. Molina offers competitive benefits and is an EOE M/F/D/V.

Compensation Range

$59,810.60 - $129,589.63 annually. Actual pay 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 Consulting

Referrals increase your chances of interviewing at Lensa by 2x. Set up job alerts for similar roles.