Note: The job is a remote job and is open to candidates in USA. Molina Healthcare is a company focused on providing quality healthcare solutions. The Analyst for National Quality Analytics & Performance Improvement will support enterprise risk and quality reporting activities, design reporting solutions, and analyze data to drive operational and strategic decision-making.
Responsibilities
- Collaborates cross-functionally with internal departments across the enterprise to capture and document quality-related reporting requirements; builds reporting solutions, and educates users on how to use reports
- Assists quality data analytics leaders in predictive intervention strategic analytics, and corresponding tracking of progress and impact of interventions
- Assists with retrospective HEDIS rate tracking and supplemental data impact reporting
- Develops medical record review project reporting to track progress and team productivity reporting
- Develops quality assurance (QA) reporting and automated analytical reporting modules for the Medicaid, Marketplace and Medicare/Medicare-Medicaid Plan (MMP) lines of business
- Analyzes and reports managed care data including claims, pharmacy, lab and HEDIS rates
- Assists quality department with HEDIS measure deep dives to support HEDIS audit and revenue at risk reporting
- Calculates and tracks HEDIS rates for all intervention outcomes for all markets and lines of business
- Works in an agile business environment to derive meaningful information out of complex/large 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 statistical tools and techniques to determine significance and relevance; utilizes extrapolation, interpolation, and other statistical methodologies to predict future trends in cost, utilization, and performance
- 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
Skills
- At least 2 years of experience mapping, scrubbing, scrapping, and cleaning data, and analysis experience related to HEDIS and/or risk adjustment, including experience working with relational databases, Microsoft Transact-SQL (T-SQL), SQL Server Integration Services (SSIS), SQL Server Reporting Services (SSRS), and Power BI, and at least 1 year of experience in a managed care organization, in addition to predictive modeling experience in health care quality and HEDIS rate tracking, medical record review tracking, interventions tracking, and statistical analysis/HEDIS forecasting experience supporting quality, finance, and health plan functions, or equivalent combination of relevant education and experience
- Analytical mindset, excellent attention to detail, and problem-solving skills
- Experience in working with complex data to include quantifying, measuring, and analyzing financial/performance management and utilization metrics
- Experience working with Microsoft T-SQL, Databricks SQL and Power BI
- Experience writing complex SQL queries, functions, procedures and data design
- Experience with Microsoft Azure, Amazon Web Services (AWS), or Hadoop
- Ability to manage multiple priorities in a fast-paced, deadline-driven environment
- Strong business acumen with the ability to connect data insights to strategic goals
- Ability to communicate complex analytical results clearly to non-technical audiences
- Self-starter with a continuous improvement mindset
- Effective verbal and written communication skills
- Microsoft Office suite proficiency
- Familiarity with data science techniques and languages like Python and R programming
Benefits
- Molina Healthcare offers a competitive benefits and compensation package.
Company Overview
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