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

Lensa; Saint Petersburg (FL); 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 for HEDIS audits and supporting quality data analysis. The ideal candidate will collaborate across departments and manage large datasets to improve health plan performance.

Qualifications

• At least 5 years in data mapping, scrubbing, and cleaning.
• 5+ years in managed care roles involving SQL.
• 3+ years in healthcare quality data analysis, including HEDIS.

Responsibilities

• Collaborate with departments to gather requirements and build reports.
• Support retrospective HEDIS rate tracking and data impact reporting.
• Analyze managed care data, including Medical Claims and HEDIS rates.

Skills

Data Mapping

Statistical Analysis

Predictive Modeling

Data Mining

Education

Bachelor's Degree in Computer Science

Bachelor's Degree in Finance

Bachelor's Degree in Math

Bachelor's Degree in Economics

Tools

SQL

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 supports Molina's Quality Analytics team. Responsibilities include designing and developing reporting solutions for HEDIS audits, rate tracking, targeted interventions, and outcome tracking. The role also involves research, development, and completion of special performance improvement projects.

Essential Job Duties

• Collaborate with various departments to gather requirements, build reports, and educate users.
• Assist in predictive intervention strategy analytics and track progress and impacts.
• Support retrospective HEDIS rate tracking and supplemental data impact reporting.
• Develop reports for Medical Record Review projects and team productivity.
• Create and QA ad-hoc and automated reports related to Quality/HEDIS for Medicaid, Marketplace, and Medicare/MMP.
• Analyze managed care data, including Medical Claims, Pharmacy, Lab, and HEDIS rates.
• Support HEDIS measure deep dives to aid audits and revenue reporting.
• Calculate and monitor HEDIS rates for interventions and overall markets.
• Work in an agile environment to analyze large datasets, perform data mining, verification, and root cause analysis.
• Conduct root cause analysis for data issues.
• Analyze data trends for anomalies, outliers, and opportunities, using statistical tools to predict future trends.
• Participate in research and special projects as needed.
• Manage changes in the Datawarehouse platform and upgrade reporting modules with minimal impact.
• Perform impact analyses for logic and source code changes.
• Develop expertise in HEDIS to improve health plan performance on measures.

Job Qualifications

Education: Bachelor's Degree in Computer Science, Finance, Math, Economics, or related field.
Experience: At least 5 years in data mapping, scrubbing, and cleaning; 5+ years in managed care roles involving SQL; 3+ years with cloud platforms like Azure, AWS, or Hadoop; 3+ years in healthcare quality data analysis, including HEDIS; experience with predictive modeling, statistical analysis, and trend forecasting.

Physical Demands

Work environment is generally office-based with adequate lighting and temperature. Must be able to sit for long periods. Accommodations available for disabilities.

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

Additional Details

Pay Range: $59,810.60 - $129,589.63 annually. Actual compensation varies based on location, experience, and skills.

Additional Information

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