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

Lensa; Miami (FL); Remote; USD 77,000 - 156,000; Full time

Job summary

A leading company in IT Services and Consulting is seeking a Senior Analyst for Quality Analytics and Performance Improvement. This role involves designing reporting solutions for HEDIS audits, analyzing complex data sets, and supporting quality improvement initiatives in a remote capacity. Candidates should possess a Bachelor's degree and extensive experience in data management and healthcare analytics.

Qualifications

• 5+ years in data mapping, scrubbing, and cleaning.
• 5+ years in managed care organizations, writing complex SQL queries.
• 3+ years analyzing HEDIS rates and interventions.

Responsibilities

• Develop reporting solutions for HEDIS audits and rate tracking.
• Analyze managed care data and support predictive intervention strategies.
• Work cross-functionally to document requirements and educate users.

Skills

Data mapping

Data scrubbing

SQL

Statistical analysis

Data analysis

Education

Bachelor's Degree in Computer Science, Finance, Math, 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

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. Designs and develops reporting solutions to assist with HEDIS audits, rate tracking, targeted interventions, and outcome tracking. Assists with research, development, and completion of special performance improvement projects.

Essential Job Duties

• Work cross-functionally with various departments to capture and document requirements, build reporting solutions, and educate users on report usage.
• Assist Quality Data Analytics Leaders in predictive intervention strategy analytics, tracking progress and impact.
• Support retrospective HEDIS rate tracking and supplemental data impact reporting.
• Develop Medical Record Review project reporting to monitor progress and team 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 such as medical claims, pharmacy, lab, and HEDIS rates.
• Support HEDIS measure deep dives to aid audits and revenue at risk reporting.
• Calculate and track HEDIS rates for interventions and overall markets and lines of business.
• Work in an agile environment to analyze large and complex data sets, perform data mining, verification, scrubbing, and root cause analysis.
• Perform root cause analysis for data issues as assigned.
• Analyze data trends for anomalies, outliers, and opportunities using statistical tools and techniques.
• Assist in research and development of special projects for internal and external stakeholders.
• Manage changes in the Datawarehouse platform and perform upgrades to ensure no impact on end users.
• Conduct impact analyses for logic and source code changes in analytics and reporting modules.
• Develop expertise as a HEDIS subject matter expert to improve performance on underperforming measures.

Job Qualifications
EDUCATION: Bachelor's Degree in Computer Science, Finance, Math, Economics, or equivalent.

EXPERIENCE:

• 5+ years in data mapping, scrubbing, and cleaning.
• 5+ years in managed care organizations, writing complex SQL queries, functions, procedures, and data design.
• 5+ years with 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 for 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 in healthcare.

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

To current Molina employees: Apply through the intranet job listing.

Molina Healthcare offers competitive benefits. We are an Equal Opportunity Employer (EOE) M/F/D/V.

Pay Range: $77,969 - $155,508 annually.

• Compensation varies based on location, experience, education, and skills.

Additional Details

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