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

Lensa; Lincoln (NE); 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 have extensive experience in data management and healthcare analytics, particularly with SQL and statistical analysis. Join a dynamic team and contribute to improving health plan performance.

Qualifications

• 5+ years in data mapping, scrubbing, and cleaning.
• 3+ years analyzing HEDIS rates and Medical Record Reviews.

Responsibilities

• Design and develop reporting solutions for HEDIS audits.
• Analyze managed care data including Medical Claims and Pharmacy.
• Collaborate with departments to build reports and educate users.

Skills

Data Mapping

Statistical Analysis

Trend Forecasting

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

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 for 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

• Collaborate with various departments to capture requirements, build reports, and educate users.
• Support predictive intervention strategy analytics and track progress and impact.
• Assist with retrospective HEDIS rate tracking and supplemental data impact reporting.
• Create reports for Medical Record Review projects to monitor progress and productivity.
• Develop and QA ad-hoc and automated analytics 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 HEDIS measure deep dives to assist audits and revenue risk reporting.
• Calculate and monitor HEDIS rates for interventions and overall markets.
• Work in an agile environment to analyze large data sets, perform data mining, verification, and root cause analysis.
• Conduct root cause analysis for data issues.
• Identify trends, anomalies, and opportunities using statistical tools and techniques, and predict future trends.
• Participate in research and development of special projects and respond to external agency requests.
• Manage changes in the Datawarehouse platform and perform upgrades to ensure seamless reporting.
• Analyze the impact of logic and source code changes on analytics and reporting modules.
• Develop expertise in HEDIS to help improve health plan performance on underperforming measures.

Job Qualifications

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

Experience:

• 5+ years in data mapping, scrubbing, and cleaning.
• 5+ years in a managed care organization with SQL, data design, and techno-functional roles.
• Proficiency in Microsoft T-SQL, SSIS, and SSRS.
• Knowledge of data science techniques; familiarity with Python and R is a plus.
• 3+ years with cloud platforms like Azure, AWS, or Hadoop.
• 3+ years in healthcare quality data predictive modeling.
• 3+ years analyzing HEDIS rates, Medical Record Reviews, and interventions across Medicaid, Marketplace, or Medicare/MMP.
• Experience with complex data problems related to financial and performance metrics.
• Statistical analysis and trend forecasting experience.

Physical and Sensory Requirements

Work environment is generally office-based with minimal hazards. Ability to sit for long periods is required. Accommodations can be provided for individuals with disabilities.

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