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

Lensa; Layton (UT); Remote; USD 77,000 - 156,000; Full time

Job summary

A leading company in IT services is seeking a Senior Analyst for Quality Analytics and Performance Improvement. This role involves designing reporting solutions, analyzing healthcare data, and supporting HEDIS audits. The ideal candidate will have a strong background in data analytics, SQL, and experience in managed care organizations.

Qualifications

• 5+ years experience in data mapping, scrubbing, and cleaning.
• Proficiency with Microsoft T-SQL, SSIS, and SSRS.
• 3+ years experience with predictive modeling in healthcare quality data.

Responsibilities

• Collaborate cross-functionally to gather requirements and build reporting solutions.
• Analyze managed care data such as medical claims and HEDIS rates.
• Support retrospective HEDIS rate tracking and impact reporting.

Skills

Data mapping

Data scrubbing

Data cleaning

Statistical analysis

Predictive modeling

Trend forecasting

SQL

Python

R

Education

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

Tools

Microsoft T-SQL

SSIS

SSRS

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 completion of special performance improvement projects.

Essential Job Duties

1. Collaborate cross-functionally with various departments to gather requirements, build reporting solutions, and educate users on report usage.
2. Assist Quality Data Analytics Leaders with predictive intervention strategy analytics and tracking the progress and impact of interventions.
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 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, 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 and overall markets and lines of business.
9. Work in an agile environment to analyze large and complex data sets, performing data analysis, mining, verification, scrubbing, and root cause analysis.
10. Conduct root cause analysis for business data issues as assigned.
11. Identify trends, anomalies, outliers, and opportunities using statistical tools and techniques to determine significance and relevance, and predict future trends.
12. Support research and development of special projects requested by internal departments or external agencies.
13. Manage changes in the Datawarehouse platform and perform upgrades to ensure no impact on end users.
14. Conduct impact analyses for logic and source code changes, maintaining other variables.
15. Develop expertise as a HEDIS subject matter expert to help improve health plan performance on underperforming measures.

Job Qualifications

Education and Experience:

• Bachelor's Degree in Computer Science, Finance, Math, Economics, or related discipline.
• 5+ years experience in data mapping, scrubbing, and cleaning.
• 5+ years experience in a managed care organization with SQL, data design, and techno-functional roles.
• Proficiency with Microsoft T-SQL, SSIS, and SSRS.
• Familiarity with 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 experience with HEDIS rate tracking, Medical Record Review, and interventions for Medicaid, Marketplace, or Medicare/MMP.
• 3+ years experience analyzing complex data problems related to financial and performance metrics.
• 3+ years experience 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 are available for individuals with disabilities.

Additional Information:

If you are a current Molina employee interested in this position, please apply through the intranet. Molina offers competitive benefits and is an Equal Opportunity Employer. Pay range: $77,969 - $155,508 annually, with actual compensation based on location, experience, education, and skills.

Additional Details

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