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

Lensa; Tacoma (WA); Remote; USD 77,000 - 156,000; Full time

Job summary

A leading company is seeking a Senior Analyst for Quality Analytics & Performance Improvement. This remote role involves designing reporting solutions, conducting data analysis, and supporting HEDIS audits. The ideal candidate has extensive experience in data management and analytics, especially within managed care settings. Join a dynamic team focused on improving healthcare quality through data-driven insights.

Qualifications

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

Responsibilities

• Design and develop reporting solutions for HEDIS audits.
• Analyze managed care data and track outcomes.
• Work cross-functionally to capture and document requirements.

Skills

Data Mapping

Data Scrubbing

SQL

Statistical Analysis

Predictive Modeling

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

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. Responsibilities include designing and developing reporting solutions to assist with HEDIS audits, rate tracking, identifying targeted interventions, and tracking outcomes. The role also involves 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 and overall markets and lines of business.
• Work in an agile environment to analyze large and complex data sets, performing data 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 techniques to determine significance and relevance.
• Assist with 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, ensuring stability and consistency.
• 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 discipline.

Experience:

• 5+ years in data mapping, scrubbing, scrapping, and cleaning.
• 5+ years in a managed care organization with SQL, data design, and techno-functional roles.
• 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 such as Azure, AWS, or Hadoop.
• 3+ years with predictive modeling in healthcare quality data.
• 3+ years analyzing HEDIS rates, medical record reviews, and interventions across 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 favorable, with adequate lighting and temperature. Work is performed in an office setting with minimal exposure to hazards. 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 (EOE) M/F/D/V.

Additional Details

Pay Range: $77,969 - $155,508 annually. Actual compensation varies based on location, experience, education, and skills.

Job Details

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