Senior Risk-Adjustment Predictive Analytics Lead

Molina Healthcare; United States; On-site; USD 72,000 - 157,000; Full time

Job summary

Molina Healthcare is seeking an experienced lead-level analyst to support enterprise risk adjustment predictive analytics. The role designs and develops suspect, targeting, and tracking systems to support prospective and retrospective interventions.

The position requires strong SQL, Power BI, and data analytics skills, with experience in Medicaid, Marketplace, and MMP risk adjustment. Collaboration across departments and agile delivery are essential to success.

Qualifications

• At least 4 years of experience with SQL, T-SQL, SSIS, SSRS and Power BI.
• Experience with predictive modeling in health care quality and HEDIS forecasting.
• Ability to manage multiple priorities in a fast-paced environment.
• Strong communication and problem-solving skills.

Responsibilities

• Assists risk adjustment analytics leaders in prospective and retrospective intervention analytics and tracking of progress and impact.
• Designs and leads tracking systems for risk scores across interventions and markets.
• Develops QA-ad hoc and automated reporting modules for risk adjustment across Medicaid, Marketplace, and MMP lines.
• Creates automated suspect and target/ranking engines for multiple lines of business.
• Performs analysis of managed care data (claims, pharmacy, lab, financial data) related to risk scores, revenue, and costs.
• Calculates and tracks risk scores for all intervention outcomes across markets and lines of business.
• Works in an agile environment to derive meaningful insights from large data sets.

Skills

SQL proficiency

Power BI

Analytical mindset

Communication skills

Cross-functional collaboration

Project leadership

Data visualization

Time management

Tools

T-SQL

SSIS

SSRS

Power BI

Azure

AWS

Hadoop

Job description

Molina Healthcare is seeking an experienced lead-level analyst to support enterprise risk adjustment predictive analytics. The role designs and develops suspect, targeting, and tracking systems to support prospective and retrospective interventions.

The position requires strong SQL, Power BI, and data analytics skills, with experience in Medicaid, Marketplace, and MMP risk adjustment. Collaboration across departments and agile delivery are essential to success.