Molina Healthcare · 1 month ago
Senior Analyst, Quality Analytics & Performance Improvement
Molina Healthcare is a company focused on quality healthcare, and they are seeking a Senior Analyst for their Quality Analytics team. The role involves designing and developing reporting solutions, supporting HEDIS audits, and assisting with performance improvement projects.
Health CareHospitalMedical
Responsibilities
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 as well as 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
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 subject matter expert to help health plan improve performance on underperforming measures
Qualification
Required
Bachelor's Degree in Computer Science, Finance, Math or Economics or equivalent discipline
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
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
Preferred
Familiarity with Data Science Techniques and languages like Python and R programming would be an added advantage
Benefits
Molina Healthcare offers a competitive benefits and compensation package.
Company
Molina Healthcare
Molina Healthcare is a healthcare company that specializes in government-sponsored healthcare programs for families and individuals.
H1B Sponsorship
Molina Healthcare has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2025 (56)
2024 (45)
2023 (43)
2022 (31)
2021 (35)
2020 (55)
Funding
Current Stage
Public CompanyTotal Funding
$2.35B2025-11-17Post Ipo Debt· $850M
2024-11-13Post Ipo Debt· $750M
2021-11-16Post Ipo Debt· $750M
Leadership Team
Recent News
Sherwood News
2026-01-09
2026-01-03
Company data provided by crunchbase