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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