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.