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

Lensa; Phoenix (AZ); Remote; USD 77,000 - 156,000; Full time

Job summary

A leading healthcare organization is seeking a Senior Analyst in Quality Analytics to support data-driven decision-making. This role involves developing reporting solutions for HEDIS audits, analyzing complex data sets, and collaborating across departments to enhance performance improvement initiatives. Ideal candidates will have a strong background in data management and experience in healthcare analytics.

Qualifications

• 5+ years in data mapping, scrubbing, and cleaning.
• Experience in managed care organizations with SQL and data design.
• Familiarity with data science techniques is a plus.

Responsibilities

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

Skills

Data Mapping

Data Scrubbing

Data Cleaning

SQL

Statistical Analysis

Predictive Modeling

Data Analysis

Education

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

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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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 tracking outcomes. Also, 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, including tracking progress and impact.
• Support retrospective HEDIS rate tracking and supplemental data impact reporting.
• Develop Medical Record Review project reporting to track progress and team productivity.
• Develop and QA of 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.
• 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 derive meaningful insights from large, complex data sets through analysis, mining, verification, scrubbing, and root cause analysis.
• Perform root cause analysis for business data issues as assigned.
• Analyze data trends for anomalies, outliers, and opportunities, using statistical tools to determine significance and relevance. Use methodologies like extrapolation and interpolation to predict future trends.
• Support research and development of special projects as requested by internal or external stakeholders.
• Manage changes in the Data Warehouse platform and perform upgrades to analytic reporting modules with minimal impact on users.
• Conduct impact analyses for logic and source code changes in analytics and reporting modules.
• Develop expertise as a HEDIS subject matter expert to help improve performance on underperforming measures.

Job Qualifications

Education:

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

Experience:

• 5+ years in data mapping, scrubbing, scrapping, and cleaning.
• 5+ years in a managed care organization with SQL, 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 with predictive modeling in healthcare quality data.
• 3+ years analyzing HEDIS rate tracking, Medical Record Review, and interventions for Medicaid, Marketplace, or Medicare/MMP.
• 3+ years working with complex data problems related to financial and performance metrics.
• 3+ years in statistical analysis and trend forecasting in healthcare quality data.

Physical & Sensory Requirements

The 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.

Interested Molina employees should apply through the intranet. Molina offers competitive benefits and is an Equal Opportunity Employer.

Additional Details

• Pay Range: $77,969 - $155,508 annually, varies by location and experience.
• Seniority Level: Mid-Senior level
• Employment Type: Full-time
• Job Function: Quality Assurance
• Industries: IT Services and Consulting