| Description | 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 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 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 REQU I RED ED U C A TI O N : Bachelor's Degree in Computer Science Finance Math or Economics or equivalent discipline REQU I RED E X PE R I E N C E: 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 and SSRS. 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 quality data. 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 Medicare/MMP. 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 PHY S I C AL DEM A N D S : W o rki n g en v i r o nm ent is g e n erally f a vo r a b le and li gh t i n g and t e m p erature are a d eq u at e . W o rk is g eneral l y p erf o r m ed in an o ff i ce e n v i r o n m ent in w h i c h t h ere is o n l y m i n i m al e x p o su r e to u np leasa n t a nd /o r ha z ar d o u s w o rki n g c o nd iti o n s. M u s t h a v e t h e a b ility t o s i t f o r l o n g p eri o d s. Rea s o n a b le acc om mo d a ti o n s m a y be m a d e to e n a b le in d i v i du als with d i sa b ilities t o p er f o r m t h e e ssential fu n cti o n . 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: $77969 - $128519 / ANNUAL Actual compensation may vary from posting based on geographic location work experience education and/or skill level. |