Lead Analyst, Quality Analytics and Performance Improvement (HEDIS)
Molina Healthcare
**Job Summary**
The Lead Analyst, Quality Analytics and Performance Improvement role will support Molina's Quality Reporting team. Designs and develops reporting solutions to assist HEDIS Outbound, Inbound extracts, Data Ingestions, Dashboards, Reports & Extracts for rate tracking and other outreach purposes.
**ESSENTIAL JOB DUTIES:**
• Work cross functionally with various departments to capture and document requirements, build reporting solutions, and educate users on how to use reports.
• Assist Quality Data Analytics Leaders in Predictive Intervention Strategy Analytics along with corresponding tracking of progress and impact of such interventions.
• Assist retrospective HEDIS rate tracking and supplemental data impact reporting.
• Builds ad hoc reports as requested to track HEDIS performance and supplemental data monitoring
• Develops and QA custom health plan reports related to Risk and Quality/HEDIS for Medicaid, Marketplace and Medicare/MMP
• Develops custom health plan reports related to managed care data like Medical Claims, Pharmacy, Lab and HEDIS rates
• Assists and collaborates with the national Risk and Quality department with testing of pre-production reporting for the assigned health plan
• Calculates and tracks gap closure and intervention outcome reporting for the assigned state
• Works in an agile business environment to derive meaningful information out of complex and large organizational data sets through data analysis, data mining, verification, scrubbing, and root cause analysis
• Conducts root cause analysis for business data issues
• Analyzes data sets and trends for anomalies, outliers, trend changes, and opportunities, using databricks SQL, PowerBi, excel, and techniques to determine significance and relevance
• Assists with research, development and completion of special projects as requested by various internal departments, or in support of requests from regulatory agencies, contracting agencies, or other external organizations
• Key partner to assist with testing changes in the Datawarehouse platform and perform transparent upgrades to reporting modules to ensure no impact to the end users
• Conducts preliminary and post impact analyses for any logic and source code changes for data and reporting module keeping other variables as constant that are not of focus
• Develops oneself as a HEDIS subject matter expert to help health plan improve performance on underperforming measures
• Development and QA of ad-hoc as well as automated analytical Reporting modules related to Quality/HEDIS for Medicaid, Marketplace and Medicare/MMP.
**JOB QUALIFICATIONS**
**Required Education**
Bachelor's Degree in Computer Science, Finance, Math or Economics or equivalent discipline
**Required Experience**
**•** 5+ years’ experience supporting, designing and/or implementing application changes.
**Highly Preferred Experience**
• 5+ Years of experience in working with **HEDIS** tools such as **Inovalon** or **ClaimSphere**
• 5+ Years of experience in working with HEDIS Domain – such as Measure analysis/reconciliation on data w.r.t measure specifications.
• 5+ Years of experience in working with data mapping, scrubbing, scrapping, and cleaning of data.
• 5+ Years of experience in Managed Care Organization executing similar techno functional role that involves writing complex SQL Queries, Functions, Procedures and Data design
• 5+ years of experience in working with **Microsoft T-SQL, Databricks SQL and PowerBI.**
• Familiarity with Data Science Techniques and languages like Python and R programming would be an added advantage.
• Familiarity with Microsoft Azure, AWS or Hadoop.
• 3-5 Years of experience with predictive modeling in healthcare quality data.
• 5+ Years of experience in Analysis related to HEDIS rate tracking, Medical Record Review tracking, Interventions tracking for at least one line of business among Medicaid, Marketplace and Medicare/MMP.
• 5+ Years of experience in working with increasingly complex data problems in quantifying, measuring, and analyzing financial/performance management and utilization metrics.
• 5+ Years of experience in Statistical Analysis and forecasting of trends in HEDIS rates to provide analytic support for quality, finance, and health plan functions
• 5 years of experience in working with complex data to include quantifying, measuring, and analyzing financial/performance management and utilization metrics
To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
Pay Range: $80,412 - $188,164 / ANNUAL
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
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