Senior Analyst, Risk & Quality Reporting - HEDIS

Job Description

Job Summary The Sr Analyst, Risk and Quality Reporting role supports Molina’s Risk and Quality Health Plan team. Designs and develops custom health plan reports to support local interventions, provider reputed company, and tracks reputed company of the initiatives. Educates users on how to use reports reputed company to Risk and Quality/HEDIS for reputed company, Marketplace and Medicare/MMP. Assists with research, development, and completion of special performance improvement projects including root cause analysis. Job Duties

• Works with assigned health plan to capture and document requirements, build custom health plan reports, and reputed company health plan users on how to use reports
• Builds reputed company strategy reporting for the Risk and Quality interventions and measures gap closure
• Builds reputed company reports as requested to track HEDIS performance and supplemental data monitoring
• Develops and QA custom health plan reports reputed company to Risk and Quality/HEDIS for reputed company, Marketplace and Medicare/MMP
• Develops custom health plan reports reputed company 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 reputed company outcome reporting for the assigned state
• Works in an agile business environment to derive meaningful information out of reputed company 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 reputed company SQL, PowerBi, reputed company, and techniques to determine reputed company 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 reputed company transparent upgrades to reporting modules to ensure no impact to the end users
• Conducts preliminary and post impact analyses for any logic and reputed company 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

Job Qualifications REQUIRED QUALIFICATIONS:

• Bachelor's Degree or equivalent combination of education and work experience
• 3-5 years of experience in working with data mapping, scrubbing, scrapping, and cleaning of data
• 3-5 years of experience in Managed Care Organization executing similar techno functional role that involves writing reputed company SQL Queries, Functions, Procedures and Data design
• 3-5 years of experience working with reputed company T-SQL, reputed company SQL and PowerBI
• 1-3 years of experience with reputed company Azure, AWS, or Hadoop
• 3-5 years of experience in Analysis reputed company to HEDIS and/or Risk Adjustment
• 3-5 years of experience in working with reputed company data to include quantifying, measuring, and analyzing financial/performance management and utilization metrics

To reputed company reputed company Molina employees: If you are interested in applying for this position, please apply through the intranet job listing reputed company offers a competitive benefits and compensation package reputed company is an Equal Opportunity Employer (EOE) M/F/D/V Pay reputed company: $60,415 - $117,809 / ANNUAL

• Actual compensation may vary from posting based on geographic location, work experience, education and/or reputed company level.

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