Molina's Quality Improvement function oversees, plans, and implements new and existing healthcare quality improvement initiatives and education programs; ensures maintenance of programs for members in accordance with prescribed quality standards; conducts data collection, reporting and monitoring for key performance measurement activities; and provides direction and implementation of NCQA accreditation surveys and federal/state QI compliance activities.
In collaboration with Quality Improvement (QI) management, the Senior Analyst, HEDIS/Quality Reporting develops and provides reports and cost-benefit analysis tools to meet QI requirements and uses automated software tools and processes to help streamline activities and improve data/analytics for the quality team.
* Acts as a lead analyst to provide project-, program-, and / or initiative-related direction and guidance for other analysts within the department and/or collaboratively with other departments. * Develops, codes, runs, and/or prepares formatted reports to support critical Quality Improvement functions (e.g., reporting for key performance measurement activities, including HEDIS, state-based measure reporting and medical record review). * Collaborates and / or assists in performing quality assurance checks on reports prior to completion * Works with Director and / or Manager to establish and / or document quality assurance process checks to be utilized by all staff to ensure the integrity, completeness and validity of external and internal reports * Understands how to prioritize reports according to business need, regulatory requirements, urgency and / or other key business factors * Collaborates with department leads and other partnering departments to understand and / or document business requirements and / or implement required reporting. * Writes and / or produces accurate reports and conducts analyses according to set timelines and project plans. * Collaborates with other department staff to convert HEDIS data sources for use in HEDIS reporting as needed. * Coordinates data and analyses from MHI and / or Health Plans as needed. * Assists with generation of State-specific performance measurement requirements. * Assists program managers with research regarding performance measurement outliers when asked. * Uses industry standard techniques determined by the department to reduce report writing errors. * Modifies reports in response to error identification and / or approved change requests; understand the balance between responsiveness to business requests for enhancements versus department needs to complete work efficiently and timely Job Qualifications * Hands-on BI and ETL Developer. * 3-5 years of experience in Microsoft Technology stack such as SQL , ETL , SSIS * 1-2 years of experience in Data Visualization tools such as Microsoft Power BI * 2-4 years in building dimensional data models ( Star schema). * Experience in Data profiling and data quality check * Experience with O&M support * Healthcare experience preferably quality ( HEDIS)
Bachelor's Degree or equivalent combination of education and work experience.
* 3 years of experience in healthcare, or equivalent experience in a non-financial regulated industry. * 1 year experience in managed healthcare, or equivalent * Technical experience in reporting and/or programming. * Proficiency with Excel and Visio (flow chart equivalent) and demonstrated ability to learn new information systems and software programs. * Proficiency with data manipulation and interpretation. * Knowledge of basic statistics.
Required License, Certification, Association
Master's Degree or higher in a clinical field, IT, Public Health or Healthcare.
* HEDIS reporting or collection experience. * CAHPS improvement experience. * 1 years in managed healthcare non-financial reporting. * 1 years health care information systems experience or in a role as an IS liaison/contact for QI projects. * State QI experience. * Supervisory experience. * Project management and team building experience. * Experience developing performance measures that support business objectives. * Experience using multiple programming languages, including but not limited to, SQL / SSRS.
Preferred License, Certification, Association
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.
About Molina Healthcare
Molina Healthcare is a healthcare organization that delivers health care services and offers health information management solutions.