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

Lensa; Orem (UT); 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 role involves designing reporting solutions for HEDIS audits, analyzing healthcare data, and supporting quality initiatives. Candidates should have extensive experience in data analytics within managed care, particularly with SQL and statistical analysis. This position offers competitive benefits and a salary range reflective of the candidate's experience and skills.

Qualifications

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

Responsibilities

• Design and develop reporting solutions for HEDIS audits and rate tracking.
• Analyze managed care data and support quality department audits.
• Work cross-functionally to document requirements and educate users.

Skills

Data mapping

Data scrubbing

Data cleaning

SQL

Statistical analysis

Predictive modeling

Trend forecasting

Education

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

Tools

Microsoft T-SQL

SSIS

SSRS

Python

R

Azure

AWS

Hadoop

Job description

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

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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. It also includes 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 how to use reports.
• Assist Quality Data Analytics Leaders in predictive intervention strategy analytics, along with tracking progress and impact of interventions.
• Assist with retrospective HEDIS rate tracking and supplemental data impact reporting.
• Develop medical record review project reporting 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, lab, and HEDIS rates.
• Support the quality department with HEDIS measure deep dives to aid audits and revenue at risk reporting.
• Calculate and track HEDIS rates for intervention outcomes, overall markets, and lines of business.
• Work in an agile environment to derive meaningful insights from large, complex data sets through analysis, 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 predict future trends.
• Support research and development of special projects for internal departments and external agencies.
• Manage changes in the Datawarehouse platform and perform transparent upgrades to analytic modules.
• Conduct impact analyses for logic and source code changes, keeping other variables constant.
• 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 equivalent.

Experience:

• 5+ years in data mapping, scrubbing, and cleaning.
• 5+ years in a managed care organization involving SQL, data design, and complex queries.
• 5+ years with Microsoft T-SQL, SSIS, and SSRS.
• Familiarity with data science techniques and languages like Python and R is an advantage.
• 3+ years with cloud platforms like Azure, AWS, or Hadoop.
• 3+ years with 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 data.

Physical & Other Requirements
Work environment is generally office-based with adequate lighting and temperature. Must be able to sit for long periods. Reasonable accommodations are available for individuals with disabilities.

To current Molina employees: Apply through the intranet.

Molina Healthcare offers competitive benefits. We are an Equal Opportunity Employer.
Pay Range: $77,969 - $155,508 annually. Actual pay may vary based on location, experience, and skills.

Additional Details

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