Senior Analyst, Risk & Quality Reporting (Remote)

Remote Full-time
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 outreach, and tracks outcomes of the initiatives. Educates users on how to use reports related to Risk and Quality/HEDIS for Medicaid, 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 educate health plan users on how to use reports Builds intervention strategy reporting for the Risk and Quality interventions and measures gap closure Builds ad hoc reports as requested to track HEDIS performance and supplemental data monitoring Develops and QA custom health plan reports related to Risk and Quality/HEDIS for Medicaid, Marketplace and Medicare/MMP Develops custom health plan reports related 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 intervention outcome reporting for the assigned state Works in an agile business environment to derive meaningful information out of complex 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 databricks SQL, PowerBi, excel, and techniques to determine significance 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 perform transparent upgrades to reporting modules to ensure no impact to the end users Conducts preliminary and post impact analyses for any logic and source 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 complex SQL Queries, Functions, Procedures and Data design 3-5 years of experience working with Microsoft T-SQL, Databricks SQL and PowerBI 1-3 years of experience with Microsoft Azure, AWS, or Hadoop 3-5 years of experience in Analysis related to HEDIS and/or Risk Adjustment 3-5 years of experience in working with complex data to include quantifying, measuring, and analyzing financial/performance management and utilization metrics 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 #PJCorp #LI-AC1 Pay Range: $63,435 - $123,699 / ANNUAL • Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. Apply tot his job
Apply Now

Similar Opportunities

Experienced Registered Behavior Technician for In-Home ABA Therapy - Atlanta, GA

Remote Full-time

Immediate Hiring: Experienced Registered Behavioral Technician (RBT) for Clinic-Based ABA Therapy Services

Remote Full-time

Experienced Registered Behavioral Technician (RBT) - ABA Therapy for Children with Autism Spectrum Disorder

Remote Full-time

Experienced Registered Nurse - Telehealth: Providing Remote Care Coordination and Patient Support

Remote Full-time

Experienced Substitute Teacher for Riverside County Schools - Join Scoot Education's Innovative Team

Remote Full-time

Experienced Substitute Teacher for San Bernardino County - Flexible Schedules & Competitive Pay

Remote Full-time

Experienced School Year Instructional Coach for High-Dosage Tutoring Programs in Edgewater Park, NJ

Remote Full-time

Experienced School Year Tutor for K-8 Students in Math and Literacy - Mickleton, NJ

Remote Full-time

Experienced Secondary Social Studies Teacher for Kansas - Flexible Hybrid Remote Arrangement

Remote Full-time

USPS Office Helper

Remote Full-time

Part-Time Freelance Website Coordinator (E-commerce)

Remote Full-time

Experienced Key Account Manager for Public and General Customers – Driving Business Growth through Strategic Partnerships and Excellent Customer Service

Remote Full-time

Services Project Coordinator - Eastern Standard Time - Remote Opportunity at Lowe's: Driving Customer Satisfaction in Installation Projects

Remote Full-time

Experienced Remote English Tutor for Global Online Language Learning - Part Time

Remote Full-time

**Experienced Remote Chat Support Associate – Community Engagement and Customer Service**

Remote Full-time

Experienced Remote Customer Care Chat Professional – Delivering Exceptional Service in a Dynamic Virtual Environment at blithequark

Remote Full-time

Experienced Customer Service Representative – Part-Time Live Chat Agent for Dynamic Remote Team at arenaflex

Remote Full-time

**Data Entry Clerk (Work From Home) – Unlock a World of Flexibility and Opportunity at arenaflex**

Remote Full-time

FAA Cybersecurity Process Consultant (PartTime)

Remote Full-time

CSAIII – Amazon Store

Remote Full-time
← Back to Home