Lead Analyst, Quality Analytics and Performance Improvement (HEDIS)

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:

•Mentors and leads 2-10 software engineers on multiple projects for project deliverables, assess deliverables' quality, plan and implement corrective and preventive actions to improve application quality.
•Evaluates alternative systems solutions and recommends solution that best meets the need of the business.
•Develops the BRDs along with business stakeholders, Conceptual Designs for multiple projects concurrently. SOX compliant Project deliveries and Project coordination.
•Translates user requirements into overall functional architecture for complex s/w solutions in compliance with industry regulations.
•Provides subject matter expertise and reviews applications designs built using .Net Framework 1.1/2.0, C#, VB.NET, ASP.NET, VB6.0, VB Script, Java Script, XML, HTML, DHTML, SharePoint server, BizTalk Server 2004/6, Microsoft SQL Server 2000/5, DTS/SSIS/SSRS on windows platform.
•Drives Joint Applications Development session with business stakeholders to define business requirements and provides systems/application expertise for multiple projects concurrently.
•Communicates with cross functional teams (and if applicable, vended partners) to coordinate requirements, design and enhancements with the development team(s).
•Assesses and analyzes computer system capabilities, work flow and scheduling limitations to determine if requested program or program change is possible within existing system.
•Recognizes, identifies and documents potential areas where existing business processes require change, or where new processes need to be developed, and makes recommendations in these areas.
•Works independently and resolves complex business problems with no supervision.
•Mentors and leads 2-10 systems or programmer analysts on multiple projects for project deliverables, assesses deliverables' quality, plans and implements corrective and preventive actions to improve application quality.
•Works with project managers to define work assignments for development team(s).
•Identifies, defines and plans software engineering process improvements and verifies compliance.
•Mentors and trains systems/programmer analysts on software applications, business domain and design standards.
•Conducts peer review of other analysts (internal and contract staff) to ensure standards and quality.
•Recommends, schedules and performs software systems/applications improvements and updates.
•Conducts studies pertaining to designs of new information systems to meet current and projected needs.
•Defines and plans software releases in accordance with other software applications.
Assists in the project definition, execution and implementation. Provides application, business process or functional domain leadership/expertise and peer mentoring to IT staff. Provides expertise to one or multiple domain such as application development, business process re-engineering, enterprise integration, logical data modeling, project coordination, estimation, metrics generation, status reporting. Provides thought leadership or hands-on expertise for problem resolution, application enhancements, user training and documentation of business processes. Strong application delivery methodology or SDLC background, functional domain or software engineering expertise or proficiency. Manages small or medium size projects as assigned.

•Excellent verbal and written communication skills.
•Must be knowledgeable of business processes, industry standard quality norms, systems and applications development best practices, project management methodologies and estimation processes.

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.

About Us

Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.