Talent.com
Lead Analyst, Quality Analytics and Performance Improvement (HEDIS)
Lead Analyst, Quality Analytics and Performance Improvement (HEDIS)Molina Healthcare • Covington, KY, United States
Lead Analyst, Quality Analytics and Performance Improvement (HEDIS)

Lead Analyst, Quality Analytics and Performance Improvement (HEDIS)

Molina Healthcare • Covington, KY, United States
2 days ago
Job type
  • Full-time
Job description

Job Summary

The Lead Analyst, Quality Analytics and Performance Improvement role will support Molina's Quality Reporting team. Designs and develops reporting solutions to assist HEDIS Outbound, Inbound extracts, Data Ingestions, Dashboards, Reports & Extracts for rate tracking and other outreach purposes.

ESSENTIAL JOB DUTIES :

  • Mentors and leads 2-10 software engineers on multiple projects for project deliverables, assess deliverables' quality, plan and implement corrective and preventive actions to improve application quality.
  • Evaluates alternative systems solutions and recommends solution that best meets the need of the business.
  • Develops the BRDs along with business stakeholders, Conceptual Designs for multiple projects concurrently. SOX compliant Project deliveries and Project coordination.
  • Translates user requirements into overall functional architecture for complex s / w solutions in compliance with industry regulations.
  • Provides subject matter expertise and reviews applications designs built using .Net Framework 1.1 / 2.0, C#, VB.NET, ASP.NET, VB6.0, VB Script, Java Script, XML, HTML, DHTML, SharePoint server, BizTalk Server 2004 / 6, Microsoft SQL Server 2000 / 5, DTS / SSIS / SSRS on windows platform.
  • Drives Joint Applications Development session with business stakeholders to define business requirements and provides systems / application expertise for multiple projects concurrently.
  • Communicates with cross functional teams (and if applicable, vended partners) to coordinate requirements, design and enhancements with the development team(s).
  • Assesses and analyzes computer system capabilities, work flow and scheduling limitations to determine if requested program or program change is possible within existing system.
  • Recognizes, identifies and documents potential areas where existing business processes require change, or where new processes need to be developed, and makes recommendations in these areas.
  • Works independently and resolves complex business problems with no supervision.
  • Mentors and leads 2-10 systems or programmer analysts on multiple projects for project deliverables, assesses deliverables' quality, plans and implements corrective and preventive actions to improve application quality.
  • Works with project managers to define work assignments for development team(s).
  • Identifies, defines and plans software engineering process improvements and verifies compliance.
  • Mentors and trains systems / programmer analysts on software applications, business domain and design standards.
  • Conducts peer review of other analysts (internal and contract staff) to ensure standards and quality.
  • Recommends, schedules and performs software systems / applications improvements and updates.
  • Conducts studies pertaining to designs of new information systems to meet current and projected needs.
  • Defines and plans software releases in accordance with other software applications.

Assists in the project definition, execution and implementation. Provides application, business process or functional domain leadership / expertise and peer mentoring to IT staff. Provides expertise to one or multiple domain such as application development, business process re-engineering, enterprise integration, logical data modeling, project coordination, estimation, metrics generation, status reporting. Provides thought leadership or hands-on expertise for problem resolution, application enhancements, user training and documentation of business processes. Strong application delivery methodology or SDLC background, functional domain or software engineering expertise or proficiency. Manages small or medium size projects as assigned.

  • Excellent verbal and written communication skills.
  • Must be knowledgeable of business processes, industry standard quality norms, systems and applications development best practices, project management methodologies and estimation processes.
  • JOB QUALIFICATIONS

    Required Education

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

    Required Experience

  • 5+ years’ experience supporting, designing and / or implementing application changes.
  • Highly Preferred Experience

  • 5+ Years of experience in working with HEDIS tools such as Inovalon or ClaimSphere
  • 5+ Years of experience in working with HEDIS Domain – such as Measure analysis / reconciliation on data w.r.t measure specifications.
  • 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, Databricks SQL and PowerBI.
  • Familiarity with Data Science Techniques and languages like Python and R programming would be an added advantage.
  • Familiarity with Microsoft Azure, AWS or Hadoop.
  • 3-5 Years of experience with predictive modeling in healthcare quality data.
  • 5+ 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.
  • 5+ Years of experience in working with increasingly complex data problems in quantifying, measuring, and analyzing financial / performance management and utilization metrics.
  • 5+ Years of experience in Statistical Analysis and forecasting of trends in HEDIS rates to provide analytic support for quality, finance, and health plan functions
  • 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.

    Pay Range : $80,412 - $188,164 / ANNUAL

  • Actual compensation may vary from posting based on geographic location, work experience, education and / or skill level.
  • Create a job alert for this search

    Lead Quality Analyst • Covington, KY, United States

    Related jobs
    Remote FinTech Product Analyst - AI Trainer ($50-$60 / hour)

    Remote FinTech Product Analyst - AI Trainer ($50-$60 / hour)

    Data Annotation • Hamilton, Ohio
    Remote
    Full-time +1
    We are looking for a finance professional to join our team to train AI models.You will measure the progress of these AI chatbots, evaluate their logic, and solve problems to improve the quality of ...Show more
    Last updated: 30+ days ago • Promoted
    Customer Service Representative- Covington, KY

    Customer Service Representative- Covington, KY

    Fidelity Investments • Williamstown, KY, US
    Full-time
    Join our team of Customer Service Representatives, also known as Customer Relationship Advocates (CRA).This first-of-its-kind experience supercharges your early career growth at Fidelity with perso...Show more
    Last updated: 30+ days ago • Promoted
    Interventional Specialty Tech-Cardiology Invasive Lab

    Interventional Specialty Tech-Cardiology Invasive Lab

    MetroHealth • Hamilton, OH, United States
    Full-time
    Making sure you fit the guidelines as an applicant for this role is essential, please read the below carefully.Variable Shifts and Days. On Call Requirement.Sign On Bonus • • • External applicants onl...Show more
    Last updated: 7 days ago • Promoted
    Senior Quality Assurance Manager - BioScience

    Senior Quality Assurance Manager - BioScience

    Smithfield Foods • Cincinnati, OH, United States
    Full-time
    If you are currently employed at Smithfield, please log into Workday and submit your application through the Jobs Hub.A great job-and a great future-awaits you at Smithfield Foods.We are an America...Show more
    Last updated: 30+ days ago • Promoted
    Director, Strategic Programs

    Director, Strategic Programs

    Element Materials Technology • Fairfield, OH, United States
    Full-time
    Element is seeking an experienced, highly dynamic, and organized.Aerospace & Energy Business Unit.The Director, Strategic Programs will serve as a trusted thought partner to executive leadership wi...Show more
    Last updated: 19 days ago • Promoted
    Immunology Sales Specialist

    Immunology Sales Specialist

    Syneos Health / inVentiv Health Commercial LLC • Hamilton, OH, United States
    Full-time
    You have what it takes : a competitive drive coupled with exceptional sales ability.In this role, you will be responsible for implementing the sales plan by delivering proficient sales presentations...Show more
    Last updated: 27 days ago • Promoted
    Manufacturing Quality Analyst (FLORENCE)

    Manufacturing Quality Analyst (FLORENCE)

    JABIL CIRCUIT, INC • Florence, Kentucky, US
    Temporary
    Apply promptly! A high volume of applicants is expected for the role as detailed below, do not wait to send your CV.Assist in the operation of the manufacturing line while ensuring the highest qual...Show more
    Last updated: 2 days ago • Promoted
    Side Hustle Project Lead

    Side Hustle Project Lead

    Finance Buzz • Verona, Kentucky, US
    Full-time +1
    We’re offering a role for someone who wants to lead their own side-income project in their spare time.You’ll explore various proven side hustles, select the ones that fit your lifestyle, and run th...Show more
    Last updated: 30+ days ago • Promoted
    Assistant Store Manager

    Assistant Store Manager

    Community Choice Financial Family of Brands • Dry Ridge, KY, US
    Full-time
    As an Assistant Store Manager (ASM), you’ll support our customers through real financial needs while gaining hands-on experience running a store. You’ll develop your leadership skills in...Show more
    Last updated: 30+ days ago • Promoted
    Remote Content QA Reviewer

    Remote Content QA Reviewer

    Outlier • Hamilton, OH, United States
    Remote
    Full-time
    Earn up to $15 / hour + performance bonuses.Outlier, a platform owned and operated by Scale AI, is looking for.If you're passionate about improving models and excited by the future of AI, this is you...Show more
    Last updated: 4 days ago • Promoted
    Innovation Analyst

    Innovation Analyst

    Taft Stettinius & Hollister LLP • Cincinnati, OH, United States
    Full-time
    Taft is currently seeking an Innovation Analyst to serve our team in Taft's Chicago, Cincinnati, Cleveland, Columbus, Dayton, Denver, Detroit, Indianapolis or Minneapolis office.We are seeking an I...Show more
    Last updated: 30+ days ago • Promoted
    Operational Excellence Lean Specialist

    Operational Excellence Lean Specialist

    Ohio Staffing • Cincinnati, OH, US
    Full-time
    Operational Excellence Lean Specialist - Blue Ash, Ohio.At Allegion, we help keep the people you know and love safe and secure where they live, work and visit. With more than 30 brands, 12,000+ empl...Show more
    Last updated: 2 days ago • Promoted
    Dashers - Sign Up and Start Earning

    Dashers - Sign Up and Start Earning

    DoorDash • Dry Ridge, US
    Full-time +1
    DoorDash is the #1 category leader in food delivery, food pickup, and convenience store delivery in the US, trusted by millions of customers every day. As a Dasher, you’ll stay busy with a variety o...Show more
    Last updated: 12 hours ago • Promoted • New!
    Team Lead

    Team Lead

    Tempur Sealy • Cincinnati, OH, United States
    Full-time
    Tempur Sealy is committed to improving the sleep of more people, every night, all around the world.As a leading designer, manufacturer, distributor, and retailer of bedding products worldwide, we k...Show more
    Last updated: 30+ days ago • Promoted
    CDL-A Refrigerated Truck Driver in Crittenden, KY

    CDL-A Refrigerated Truck Driver in Crittenden, KY

    AllTruckJobs • Crittenden, KY, US
    Full-time
    Regional Van Truckload truck driver - home weekly.Predictable power lanes with a high volume of freight.Consistent freight allows for maximum drive time and less down time.Dispatched in advance, al...Show more
    Last updated: 30+ days ago • Promoted
    Territory Sales Manager - Grant County, KY

    Territory Sales Manager - Grant County, KY

    Global Medical Response • Williamstown, KY, United States
    Full-time
    Territory Sales Manager - Grant County, KY.Hybrid (90% field-based within the market; 10% remote).Candidate must live within 50 to 75 miles of. Base Salary : $35,000 - Non-negotiable, Car Allowance, ...Show more
    Last updated: 20 days ago • Promoted
    Travel - CT Technologist

    Travel - CT Technologist

    Titan Medical (Nebraska) • Crittenden, KY, United States
    Full-time
    WHEN YOU WORK FOR US, WE WORK FOR YOU.With Titan Medical, you gain access to thousands of travel nursing and allied health jobs across the country. You also get unmatched service.From the moment you...Show more
    Last updated: 1 hour ago • Promoted • New!
    Senior Analyst HR Data Analytics

    Senior Analyst HR Data Analytics

    Tower Consultants Search Group • Cincinnati, OH, US
    Full-time
    Senior Analyst, HR Data Analytics.The Christ Hospital Health Network.The Christ Hospital Health Network, a leading Cincinnati-based healthcare system known for its commitment to excellence in patie...Show more
    Last updated: 10 days ago • Promoted