Analyst, Quality Analytics & Performance Improvement
Company: Molina Healthcare
Location: Boca Raton
Posted on: September 19, 2022
Job Description Job Summary The Analyst, Quality Analytics and
Performance Improvement role will support Molina's Quality
Analytics team. Designs and develops reporting solutions to assist
HEDIS audit, rate tracking, and Identifying targeted Interventions
and tracking outcomes on performance metrics. - ESSENTIAL JOB
- 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
- Develop Medical Record Review project reporting to track
progress and team productivity reporting.
- Development and QA of ad-hoc as well as automated analytical
Reporting modules related to Quality/HEDIS for Medicaid,
Marketplace and Medicare/MMP.
- Analysis and reporting related to Managed care data like
Medical Claims, Pharmacy, Lab and HEDIS rates.
- Assist Quality department with HEDIS measure deep dive to
support HEDIS audit and revenue at risk reporting.
- Calculate and track HEDIS rates for all intervention outcome
and for overall markets and LOB.
- Work in an agile business environment to derive meaningful
information out of complex as well as large organizational data
sets through data analysis, data mining, verification, scrubbing,
and root cause analysis.
- Do root cause analysis for business data issues as assigned by
the team lead.
- Analyze data sets and trends for anomalies, outliers, trend
changes and opportunities, using statistical tools and techniques
to determine significance and relevance. Utilize extrapolation,
interpolation, and other statistical methodologies to predict
future trends in cost, utilization, and performance.
- Assist 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. - Job Qualifications REQUIRED
EDUCATION: Bachelor's Degree in Computer Science, Finance, Math or
Economics or equivalent discipline REQUIRED EXPERIENCE:
- 3+ Years of experience in working with data mapping, scrubbing,
scrapping, and cleaning of data.
- 3+ Years of experience in Managed Care Organization executing
similar techno functional role that involves writing complex SQL
Queries, Functions, Procedures and Data design
- 3+ years of experience in working with Microsoft T-SQL, SSIS
- Familiarity with Data Science Techniques and languages like
Python and R programming would be an added advantage.
- Familiarity with Microsoft Azure, AWS or Hadoop.
- 1-3 Years of experience with predictive modeling in healthcare
- 1-3 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
- 1-3 Years of experience in working with increasingly complex
data problems in quantifying, measuring, and analyzing
financial/performance management and utilization metrics.
- 1-3 Years of experience in Statistical Analysis and forecasting
of trends in HEDIS rates to provide analytic support for quality,
finance, and health plan functions PHYSICAL DEMANDS: Working
environment is generally favorable and lighting and temperature are
adequate. Work is generally performed in an office environment in
which there is only minimal exposure to unpleasant and/or hazardous
working conditions. Must have the ability to sit for long periods.
-Reasonable accommodations may be made to enable individuals with
disabilities to perform the essential function. - - 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.
Keywords: Molina Healthcare, Boca Raton , Analyst, Quality Analytics & Performance Improvement, Professions , Boca Raton, Florida
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