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

Lensa; Tampa (FL); Remote; USD 77,000 - 156,000; Full time

Job summary

A leading company in IT services is seeking a Senior Analyst for Quality Analytics and Performance Improvement. This remote role involves designing reporting solutions, analyzing healthcare data, and supporting HEDIS audits. Candidates should have a Bachelor's degree in a related field and extensive experience in data analytics, particularly within managed care organizations.

Qualifications

• At least 5 years of experience with data mapping and cleaning.
• 5+ years in a managed care organization with SQL skills.
• Experience in HEDIS rate tracking and predictive modeling.

Responsibilities

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

Skills

Data mapping

Data scrubbing

SQL

Statistical analysis

Trend forecasting

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

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 monitor progress and team productivity.
• Develop and QA analytical and reporting modules related to Quality/HEDIS for Medicaid, Marketplace, and Medicare/MMP, both ad-hoc and automated.
• Analyze and report on managed care data such as medical claims, pharmacy, lab, and HEDIS rates.
• Assist in deep dives into HEDIS measures 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 extract meaningful insights from large and complex data sets through analysis, data 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, and employ methodologies like extrapolation and interpolation to forecast future trends.
• Contribute to research and development of special projects as needed, including compliance with external agencies.
• Manage changes in the Data Warehouse platform and perform transparent upgrades to ensure continuous service.
• Conduct impact analyses for logic and source code changes in analytics and reporting modules.
• 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 related discipline.

Experience:

• At least 5 years of experience with data mapping, scrubbing, scrapping, and cleaning.
• 5+ years in a managed care organization with skills in SQL, data design, and techno-functional roles.
• Proficiency in Microsoft T-SQL, SSIS, and SSRS.
• Familiarity with data science techniques and languages like Python and R is a plus.
• At least 3 years of experience with cloud platforms like Azure, AWS, or Hadoop.
• 3+ years in predictive modeling within healthcare quality data.
• Experience in HEDIS rate tracking, medical record review, and intervention tracking for Medicaid, Marketplace, or Medicare/MMP.
• Experience handling complex data problems related to financial and performance metrics.
• Statistical analysis and trend forecasting skills in healthcare contexts.

Physical and Work Environment: The role is performed in a typical office setting with adequate lighting and temperature. Must be able to sit for long periods. Reasonable accommodations can be provided for individuals with disabilities.

Interested Molina employees should apply through the intranet. Molina Healthcare offers competitive benefits and is an Equal Opportunity Employer (EOE) M/F/D/V.

Pay Range: $77,969 - $155,508 annually. Actual compensation 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