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

Lensa; Santa Fe (NM); Remote; USD 77,000 - 156,000; Full time

Job summary

A leading company in healthcare analytics is seeking a Senior Analyst to support Quality Analytics. This role involves designing reporting solutions for HEDIS audits and performance improvement projects, requiring strong data management skills and experience in healthcare analytics. Candidates should have a Bachelor's degree and significant experience in data analysis and SQL.

Qualifications

• 5+ years in data mapping, scrubbing, and management.
• Experience in managed care organizations with SQL.
• Proficiency in Microsoft T-SQL and data science techniques.

Responsibilities

• Design and develop reporting solutions for HEDIS audits.
• Analyze managed care data and support performance improvement projects.
• Work cross-functionally to document requirements and educate users.

Skills

Data mapping

Data management

Statistical analysis

Data cleaning

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

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Job Description

Job Summary

The Analyst, Quality Analytics and Performance Improvement role will support Molina's Quality Analytics team. The role involves designing and developing reporting solutions to assist with HEDIS audits, rate tracking, and identifying targeted interventions and tracking outcomes. The analyst will also assist 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 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 across 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.
• Conduct root cause analysis for business data issues as assigned.
• Analyze data trends for anomalies, outliers, and opportunities using statistical tools and techniques to determine significance and relevance, including extrapolation and interpolation for trend prediction.
• Support research, development, and completion of special projects as needed.
• 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 help 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, cleaning, and data management.
• 5+ years in a managed care organization with 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 a plus.
• 3+ years with cloud platforms such as 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.
• Experience with complex data problems related to financial and performance metrics.
• Statistical analysis and forecasting experience in healthcare.

Physical Demands

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

Interested Molina employees should apply through the intranet. Molina Healthcare offers competitive benefits and is an Equal Opportunity Employer. Pay range: $77,969 - $155,508 annually. Actual pay may vary based on location, experience, education, and skills.

Additional Details

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