Molina Healthcare

Senior Analyst, Quality Analytics & Performance Improvement - SQL/Python/Modeling - Remote

Molina Healthcare • $90K — $120K *
Long Beach, CA 90802In-Person
Healthcare
5 - 7 years of experience
More than 3 months ago
Job Overview by Ladders

Qualifications

  • Bachelor's Degree in Computer Science, Finance, Math, Economics, or a related field.
  • 5+ years of experience in data mapping, scrubbing, and cleaning.
  • 5+ years in a Managed Care Organization with a techno-functional role in SQL and data design.
  • 5+ years with Microsoft T-SQL, SSIS, and SSRS.
  • Familiarity with Python or R programming is beneficial.
  • 3+ years with Microsoft Azure, AWS, or Hadoop.
  • 3+ years in predictive modeling for healthcare quality data.

Responsibilities

  • Collaborate with departments to document requirements and build reporting solutions.
  • Support predictive intervention analytics and track their impact.
  • Assist in retrospective HEDIS rate tracking and data impact reporting.
  • Develop methodologies for medical record data cleanup and streamline reviews.
  • Create reporting to track progress and productivity in Quality and Risk Adjustment initiatives.
  • Conduct strategic data mining to identify performance gaps and improvement solutions.
  • Analyze data sets for trends and anomalies using statistical tools.

Benefits

  • Competitive benefits package including healthcare and wellness programs.
  • Access to growth and development opportunities within the organization.
  • Employee assistance programs for personal and professional challenges.
Full Job Description
Job Description

Job Description

Job Summary
The Senior Analyst, Clinical Data Acquisition Molina's Quality team. Responsible for data analysis for prospective and retrospective Quality, Risk Adjustment and RADV programs. Design and develop strategic data solutions to improve the data quality and utilization of provider and historical data to enhance performance of Medical Record Review. Designs and develops reporting solutions to assist HEDIS audit, rate tracking, and Identifying targeted Interventions and tracking outcome. Design and develop reporting to drive initiatives prompting provider engagement and reducing manual interventions across the Clinical Data Acquisition team. Assist with research, development, and completion of special performance improvement projects.

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.
  • Develop provider and medical record collection data clean up methodology and logic to streamline Medical Record Review execution.
  • Develop Medical Record Review project reporting to track progress, team productivity reporting and staffing models for Quality and Risk Adjustment initiatives
  • Development and QA of ad-hoc as well as automated analytical as well as Reporting modules related to Quality/HEDIS and Risk Adjustment for Medicaid, Marketplace and Medicare/MMP.
  • Perform strategic data mining to identify gaps in provider performance and participation and aid in identification of improvement solutions.
  • 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.
  • 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.
  • Track, Facilitate and Manage changes in the Datawarehouse platform and perform transparent upgrades to analytic reporting modules to ensure no impact to the end users.
  • Conduct preliminary and post impact analyses for any logic and source code changes for data analytics and reporting module keeping other variables as constant that are not of focus.
  • Develop oneself as HEDIS and Risk Adjustment subject matter expert to help health plan improve performance on underperforming measures and unsupported diagnosis codes

Job Qualifications

REQUIRED EDUCATION:

Bachelor's Degree in Computer Science, Finance, Math or Economics or equivalent discipline

REQUIRED EXPERIENCE:
  • 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, SSIS and SSRS.
  • Familiarity with Data Science Techniques and languages like Python and R programming would be an added advantage.
  • 3+ years of experience with Microsoft Azure, AWS, or Hadoop.
  • 3+ Years of experience with predictive modeling in healthcare quality data.
  • 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 Medicare/MMP.
  • 3+ Years of experience in working with increasingly complex data problems in quantifying, measuring, and analyzing financial/performance management and utilization metrics.
  • 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.

About Molina Healthcare

Molina Healthcare focuses exclusively on government-sponsored health care programs for families and individuals who qualify for government-sponsored health care. It contracts with state governments and serves as a health plan, providing a wide range of quality health care services to families and individuals.

Molina Healthcare Careers

Join the dedicated team at Molina Healthcare, a leader in providing quality healthcare services to families and individuals who qualify for government-sponsored programs, including Medicaid and Medicare. As one of the most respected companies in the health services industry, Molina Healthcare offers unparalleled job opportunities aimed at empowering your career growth and professional development.

Work You’ll Do

At Molina Healthcare, you will engage in meaningful work that directly impacts lives across the country. Our team is committed to innovation in healthcare, ensuring that all members receive the best care possible. By joining us, you will collaborate with skilled professionals dedicated to our mission of providing accessible, high-quality healthcare.

Career Opportunities and Growth

Whether you are looking for your first job, seeking a leadership role, or aiming to specialize in healthcare professions, Molina Healthcare offers a range of career paths. Our job opportunities span across various functions, including clinical services, customer support, IT, project management, and more. We believe in fostering the growth of our employees through professional development, leadership training, and diversity initiatives.

Internship Programs

Kickstart your career with a Molina Healthcare internship. Our internships provide invaluable workplace experience, offering a glimpse into the healthcare industry through hands-on projects and mentorship. Interns at Molina Healthcare gain critical skills that prepare them for future employment, making them competitive candidates in the job market.

Culture and Benefits

Molina Healthcare is not just a company; it’s a community. We prioritize a culture of inclusivity and respect, where all team members are encouraged to bring their whole selves to work. Our employees enjoy comprehensive benefits, including health insurance, retirement plans, and wellness programs, all designed to support both their professional and personal lives.

Join Our Team

Explore the various positions available at Molina Healthcare and find where your skills and interests align with our needs. We are continuously hiring talented individuals who are passionate about making a difference in healthcare. Prepare your resume, sharpen your interview skills, and become part of a team that values hard work and creativity.

Stay Connected

Keep up to date with the latest at Molina Healthcare: - **Career Growth and Networking:** Advance your career through our professional development and networking opportunities. Learn from leaders and peers alike to build connections that propel your career forward. - **Innovation and Leadership:** Drive change and lead with confidence by participating in our leadership and innovation training programs.

Apply Now

Ready to take the next step in your healthcare career? Search open positions that match your skills and interests on the Molina Healthcare Jobs portal. We look for driven, curious, and compassionate team players ready to make an impact.

Stay Informed

Subscribe to Molina Healthcare job alerts and receive updates on new openings and company news directly to your inbox. Tailor your subscription to match your career preferences and stay ahead in the dynamic field of healthcare. Join Molina Healthcare, where your career is nurtured, your contributions are valued, and your growth is guaranteed.
Learn more about Molina Healthcare
Size
14,000 employees
Market Cap
$19.5 billion
Industry
Healthcare
Net Income
$673 million
Founded
1980
5 Year Trend
+9.3%
Revenue
$19.4 billion
NASDAQ
MOH
* Ladders Estimates

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