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:
•    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.

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.