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

Lensa; Omaha (NE); Remote; USD 77,000 - 156,000; Full time

Job summary

A leading company in healthcare analytics is seeking a Senior Analyst to join their Quality Analytics team. This role focuses on designing reporting solutions for HEDIS audits and analyzing data trends to improve healthcare quality. Candidates should have substantial experience in data analytics, SQL, and familiarity with healthcare metrics. This full-time position offers competitive compensation and benefits.

Qualifications

• 5+ years of experience in data mapping, scrubbing, and cleaning.
• Experience in managed care organizations with SQL and data design.
• 3+ years working with HEDIS rate tracking and healthcare quality metrics.

Responsibilities

• Design and develop reporting solutions for HEDIS audits and rate tracking.
• Analyze and report on managed care data including medical claims and pharmacy.
• Conduct root cause analysis for data issues and support special performance projects.

Skills

Data mapping

Data scrubbing

Data cleaning

Statistical analysis

Forecasting trends

Predictive modeling

SQL

Data science techniques

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

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. This role involves designing and developing reporting solutions to assist with HEDIS audits, rate tracking, identifying targeted interventions, and tracking outcomes. The analyst will also support 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 of interventions.
• Support retrospective HEDIS rate tracking and supplemental data impact reporting.
• Develop reports for Medical Record Review projects to track 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, labs, and HEDIS rates.
• Assist the Quality department with HEDIS measure deep dives to support audits and revenue at risk reporting.
• Calculate and track HEDIS rates for intervention outcomes and overall markets and lines of business.
• Work in an agile environment to extract meaningful insights from large and complex data sets through analysis, 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 forecast future trends.
• Support research and development of special projects as requested by internal departments or external agencies.
• Manage changes in the Datawarehouse platform and perform transparent upgrades to analytic reporting modules.
• Conduct impact analyses for logic and source code changes, maintaining other variables constant.
• Develop expertise as a HEDIS subject matter expert to help improve health plan performance on underperforming measures.

Job Qualifications

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

EXPERIENCE:

• 5+ years of experience with data mapping, scrubbing, and cleaning.
• 5+ years in a managed care organization with experience in 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 advantageous.
• 3+ years of experience with cloud platforms like Azure, AWS, or Hadoop.
• 3+ years of experience with predictive modeling in healthcare quality data.
• 3+ years working with HEDIS rate tracking, medical record review, and intervention tracking across Medicaid, Marketplace, or Medicare/MMP.
• 3+ years analyzing complex data problems related to financial, performance, and utilization metrics.
• 3+ years in statistical analysis and forecasting trends in healthcare quality metrics.

PHYSICAL DEMANDS

The work environment is generally office-based with adequate lighting and temperature. Must be able to sit for long periods. Reasonable accommodations will be provided for individuals with disabilities.

Interested current Molina employees should apply through the intranet. Molina offers competitive benefits and compensation. We are an Equal Opportunity Employer (EOE) M/F/D/V.

Pay Range: $77,969 - $155,508 annually. Compensation may vary based on location, experience, education, and skills.

Additional Details

• Level: Mid-Senior
• Type: Full-time
• Function: Quality Assurance
• Industries: IT Services and Consulting