Job Details

**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.