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

Lensa; Las Cruces (NM); Remote; USD 77,000 - 156,000; 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 managed care data, and supporting HEDIS audits. The ideal candidate will have extensive experience in data analysis and managed care, along with a Bachelor's degree in a relevant field.

Benefits

Competitive benefits

Qualifications

• At least 5 years of experience in data mapping, scrubbing, and cleaning.
• Experience in a managed care organization involving SQL and data design.
• Knowledge of Data Science techniques; familiarity with Python and R is a plus.

Responsibilities

• Design and develop reporting solutions to support HEDIS audits and rate tracking.
• Work cross-functionally to capture requirements and build reporting solutions.
• Analyze and report on managed care data including medical claims and HEDIS rates.

Skills

Data mapping

Data scrubbing

SQL

Statistical analysis

Trend forecasting

Education

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

Tools

Microsoft T-SQL

SSIS

SSRS

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 support 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

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 reports for Medical Record Review projects to monitor progress and team productivity.
5. Develop and QA of 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 such as medical claims, pharmacy, labs, and HEDIS rates.
7. Assist the Quality department with HEDIS measure analysis to support audits and revenue risk reporting.
8. Calculate and track HEDIS rates for intervention outcomes, overall markets, and lines of business.
9. Work in an agile environment to analyze large, complex data sets, perform data mining, verification, scrubbing, and root cause analysis.
10. Conduct root cause analysis for data issues as assigned.
11. Analyze data trends for anomalies, outliers, and opportunities, using statistical tools and techniques.
12. Assist with research and development of special projects and external reporting requirements.
13. Manage changes in the Data Warehouse platform and perform transparent upgrades to reporting modules.
14. Conduct impact analyses for logic and source code changes in analytics and reporting modules.
15. Develop expertise as a HEDIS subject matter expert to improve performance on underperforming measures.

Job Qualifications

Education and Experience:

• Bachelor's Degree in Computer Science, Finance, Math, Economics, or related field.
• At least 5 years of experience in data mapping, scrubbing, and cleaning.
• At least 5 years of experience in a managed care organization involving SQL, data design, and techno-functional roles.
• Proficiency with Microsoft T-SQL, SSIS, and SSRS.
• Knowledge of Data Science techniques; familiarity with Python and R is a plus.
• Experience with cloud platforms like Azure, AWS, or Hadoop (3+ years).
• Experience with predictive modeling in healthcare quality data (3+ years).
• Experience with HEDIS rate tracking, medical record review, and intervention tracking (3+ years).
• Ability to analyze complex data problems related to financial and performance metrics (3+ years).
• Statistical analysis and trend forecasting experience (3+ years).

Physical and Working Environment:

The work environment is generally office-based with adequate lighting and temperature. Must be able to sit for long periods. Accommodations can be made for disabilities.

Additional Information

Interested Molina employees should apply through the intranet. Molina offers competitive benefits. The position is full-time, mid-senior level, with a pay range of $77,969 - $155,508 annually. Actual compensation varies based on location, experience, education, and skills.