Talent.com
Lead Analyst, Quality Analytics and Performance Improvement (HEDIS)

Lead Analyst, Quality Analytics and Performance Improvement (HEDIS)

Molina HealthcareIdaho Falls, ID, United States
20 hours 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 • Idaho Falls, ID, United States

    Related jobs
    • Promoted
    • New!
    Process Improvement Engineer

    Process Improvement Engineer

    Amy's KitchenPocatello, ID, United States
    Full-time
    The Process Improvement Engineer is responsible for driving continuous and sustainable improvement projects in the manufacturing plant. They demonstrate proficiency in continuous improvement product...Show moreLast updated: 6 hours ago
    • Promoted
    • New!
    Senior Director, Solution Architect (Solution Competitive Estimation)

    Senior Director, Solution Architect (Solution Competitive Estimation)

    MAXIMUSIdaho Falls, ID, United States
    Full-time
    Senior Director, Solution Architect.The candidate will be a Lead for solution architecture and estimation with a focus in the healthcare managed services domain (public health and clinical health)....Show moreLast updated: 20 hours ago
    • Promoted
    Operations Manager, 2nd Shift

    Operations Manager, 2nd Shift

    Amy's KitchenPocatello, ID, United States
    Full-time
    At Amy's Kitchen, we're more than just a food company-we're a family-owned, proudly independent organic, and vegetarian food company on a mission. As a Certified B Corporation, our purpose is clear : ...Show moreLast updated: 30+ days ago
    • Promoted
    Remote Investment Analyst – AI Trainer ($50-$60 / hour)

    Remote Investment Analyst – AI Trainer ($50-$60 / hour)

    Data AnnotationPocatello, Idaho
    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 moreLast updated: 20 days ago
    • Promoted
    Remote FP&A Manager – AI Trainer ($50-$60 / hour)

    Remote FP&A Manager – AI Trainer ($50-$60 / hour)

    Data AnnotationPocatello, Idaho
    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 moreLast updated: 20 days ago
    • Promoted
    • New!
    Business Applications Specialist

    Business Applications Specialist

    IRIS Consulting CorporationRigby, ID, United States
    Full-time
    This role is responsible for supporting and continuously improving the Teton Outfitters business applications landscape.The incumbent will play a vital role in optimizing our business processes thr...Show moreLast updated: 10 hours ago
    • Promoted
    • New!
    Mental Health Lead

    Mental Health Lead

    Loyal SourcePocatello, Idaho, United States
    Full-time
    Loyal Source is seeking a Mental Health Lead for a notional travel opportunity.As a Mental Health Lead, you will be responsible for overseeing the delivery of mental health services within a federa...Show moreLast updated: 10 hours ago
    • Promoted
    • New!
    Senior Analyst, Technical Configuration Information Management - REMOTE

    Senior Analyst, Technical Configuration Information Management - REMOTE

    Molina HealthcareIdaho Falls, ID, United States
    Remote
    Permanent
    Responsible for accurate and timely implementation and maintenance of critical information on claims databases.Maintains critical information on claims databases. Synchronizes data among operational...Show moreLast updated: 20 hours ago
    • Promoted
    • New!
    Business Applications Specialist

    Business Applications Specialist

    Horizontal TalentRigby, ID, United States
    Full-time
    Join a dynamic team as a Business Applications Specialist where you'll support and optimize key business applications, driving process improvements and system integration.This role is perfect for t...Show moreLast updated: 20 hours ago
    • Promoted
    Remote Side Hustle Evaluator - Flexible Online Gig Work

    Remote Side Hustle Evaluator - Flexible Online Gig Work

    Finance BuzzRigby, Idaho, US
    Remote
    Temporary
    Are you looking to earn extra income from the comfort of your home? We're seeking motivated individuals to explore and test a variety of remote side hustle opportunities featured on FinanceBuzz.Thi...Show moreLast updated: 30+ days ago
    • Promoted
    Remote FinTech Product Analyst - AI Trainer ($50-$60 / hour)

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

    Data AnnotationPocatello, Idaho
    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 moreLast updated: 20 days ago
    • Promoted
    • New!
    Data Analytics Lead

    Data Analytics Lead

    GlocommsIdaho Falls, ID, United States
    Full-time
    A well-established consumer-focused organization is seeking a Digital Analytics Lead to lead strategic data initiatives and drive digital transformation. This is a full-time, onsite role based in Id...Show moreLast updated: 20 hours ago
    • Promoted
    • New!
    Retail Sales Consultant

    Retail Sales Consultant

    AT&TRoberts, ID, US
    Full-time
    Job Description : It’s time to take your sales career to the next level.Every day you’ll be at the center of it all.Your goal? Create meaningful connections with every customer, with your personaliz...Show moreLast updated: 20 hours ago
    • Promoted
    Senior Quality Manager

    Senior Quality Manager

    Amy's KitchenPocatello, ID, United States
    Full-time
    At Amy's Kitchen, we're more than just a food company-we're a family-owned, proudly independent organic, and vegetarian food company on a mission. As a Certified B Corporation, our purpose is clear : ...Show moreLast updated: 30+ days ago
    • Promoted
    • New!
    Senior Analyst, Provider Configuration

    Senior Analyst, Provider Configuration

    Molina HealthcareIdaho Falls, ID, United States
    Full-time
    Designs and implements processes and solutions associated with a wide variety of data sets used for data / text mining, analysis, modeling, and predicting to enable informed business decisions.Gains ...Show moreLast updated: 20 hours ago
    • Promoted
    • New!
    Lead Analyst, Healthcare Analytics- Managed care analytics & financial contracts

    Lead Analyst, Healthcare Analytics- Managed care analytics & financial contracts

    Molina HealthcareIdaho Falls, ID, United States
    Full-time
    Candidates must be located in California and work PST hours.Performs research and analysis of complex healthcare claims data, pharmacy data, and lab data regarding network utilization and cost cont...Show moreLast updated: 20 hours ago
    • Promoted
    Side Hustle Project Lead

    Side Hustle Project Lead

    Finance BuzzRexburg, Idaho, 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 moreLast updated: 29 days ago
    • Promoted
    • New!
    Sr Analyst - DataAnalytics

    Sr Analyst - DataAnalytics

    MAXIMUSIdaho Falls, ID, United States
    Full-time
    Are you ready to make a meaningful impact-no matter where you're located in the United States? Our Global Technology Services organization is seeking a highly skilled Senior Analyst to join our for...Show moreLast updated: 2 hours ago