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

Lensa; Tampa (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, supporting HEDIS audits, and conducting data analysis to enhance healthcare quality metrics. The ideal candidate will have extensive experience in data management and SQL, with a focus on healthcare quality data. Join a dynamic team dedicated to improving health plan performance through data-driven insights and innovative solutions.

Benefits

Competitive benefits

Qualifications

• 5+ years in data mapping, cleaning, and management.
• 3+ years analyzing HEDIS rates, medical record reviews, and interventions.

Responsibilities

• Develop reports for Medical Record Review projects and team productivity.
• Collaborate cross-functionally to gather requirements and train users.
• Analyze and report on Managed Care data including Medical Claims.

Skills

Data Mapping

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

Python

R

Azure

AWS

Hadoop

Job description

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

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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 will support 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 execution of special performance improvement projects.

Essential Job Duties

• Collaborate cross-functionally to gather requirements, build reports, and train users.
• Support predictive intervention strategy analytics and track progress and impact.
• 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 and report on Managed Care data including Medical Claims, Pharmacy, Lab, and HEDIS rates.
• Assist with deep dives into HEDIS measures to support audits and revenue risk reporting.
• Calculate and monitor HEDIS rates for interventions, markets, and lines of business.
• Extract meaningful insights from large datasets through analysis, mining, verification, and root cause analysis.
• Perform root cause analysis for data issues.
• Identify trends, anomalies, and opportunities using statistical tools and methodologies.
• Contribute to research and development of special projects as needed.
• Manage changes in the Datawarehouse platform and ensure smooth upgrades.
• Conduct impact analyses for logic and source code changes.
• Develop expertise in HEDIS measures to improve health plan performance.

Job Qualifications

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

Experience:

• 5+ years in data mapping, cleaning, and management.
• 5+ years in managed care organizations with SQL, data design, and technical roles.
• Proficiency in Microsoft T-SQL, SSIS, and SSRS.
• Familiarity with data science languages like Python and R is a plus.
• 3+ years with cloud platforms like Azure, AWS, or Hadoop.
• 3+ years in predictive modeling within healthcare quality data.
• 3+ years analyzing HEDIS rates, medical record reviews, and interventions.
• Experience with complex data problems related to financial and performance metrics.
• Statistical analysis and trend forecasting skills.

Physical and Work Environment

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

Interested Molina employees should apply through the intranet. The company offers competitive benefits. Molina Healthcare is an Equal Opportunity Employer. Pay range: $59,810.60 - $129,589.63 annually, with actual compensation depending on various factors.

Additional Details

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