Talent.com
Lead Analyst, Quality Analytics and Performance Improvement (HEDIS)
Lead Analyst, Quality Analytics and Performance Improvement (HEDIS)Molina Healthcare • Rio Rancho, NM, United States
Lead Analyst, Quality Analytics and Performance Improvement (HEDIS)

Lead Analyst, Quality Analytics and Performance Improvement (HEDIS)

Molina Healthcare • Rio Rancho, NM, United States
[job_card.30_days_ago]
[job_preview.job_type]
  • [job_card.full_time]
[job_card.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.
  • [job_alerts.create_a_job]

    Lead Quality Analyst • Rio Rancho, NM, United States

    [internal_linking.related_jobs]
    STORE MANAGER IN SAN YSIDRO, NM

    STORE MANAGER IN SAN YSIDRO, NM

    Dollar General • San Ysidro, New Mexico, United States
    [job_card.full_time]
    At Dollar General, our mission is Serving Others! We value each and every one of our employees.Whether you are looking to launch a new career in one of our many convenient Store locations, Distribu...[show_more]
    [last_updated.last_updated_variable_days] • [promoted]
    Travel Cath Lab Tech - $2,711 to $2,889 per week in Santa Fe, NM

    Travel Cath Lab Tech - $2,711 to $2,889 per week in Santa Fe, NM

    AlliedTravelNetwork • Rio Rancho, New Mexico, US
    [job_card.full_time]
    AlliedTravelNetwork is working with Host Healthcare to find a qualified Cath Lab Tech in Santa Fe, New Mexico, 87505!.Host Healthcare is an award-winning travel healthcare company with an immediate...[show_more]
    [last_updated.last_updated_variable_days] • [promoted]
    Travel Board Certified Behavioral Analyst - School (BCBA) in Las Vegas, NM

    Travel Board Certified Behavioral Analyst - School (BCBA) in Las Vegas, NM

    AlliedTravelCareers • Rio Rancho, New Mexico, US
    [job_card.full_time]
    AlliedTravelCareers is working with Aequor to find a qualified BCBA - School in Las Vegas, New Mexico, 87701!.Aequor is now hiring a full-time Board Certified Behavior Analyst (BCBA) for the 2023-2...[show_more]
    [last_updated.last_updated_30] • [promoted]
    Internal Audit - SOX Senior Manager

    Internal Audit - SOX Senior Manager

    Coinbase • Albuquerque, New Mexico, United States
    [filters.remote]
    [job_card.full_time]
    Ready to be pushed beyond what you think you’re capable of?.At Coinbase, our mission is to increase economic freedom in the world. It’s a massive, ambitious opportunity that demands the best of us, ...[show_more]
    [last_updated.last_updated_30] • [promoted]
    Senior Manager, Business Development, Cell & Gene Therapies

    Senior Manager, Business Development, Cell & Gene Therapies

    Fresenius Kabi USA, LLC • Albuquerque, NM, United States
    [job_card.full_time]
    The Senior Manager, Business Development, will play a critical role in driving global sales and business development strategy for our cutting-edge Cell and Gene Therapies (CGT) Technologies divisio...[show_more]
    [last_updated.last_updated_30] • [promoted]
    Remote Financial Analyst - AI Trainer ($150 per hour)

    Remote Financial Analyst - AI Trainer ($150 per hour)

    Mercor • Rio Rancho, New Mexico, US
    [filters.remote]
    [job_card.full_time]
    UK / Canada / Europe / Singapore / Dubai / Australia-based • •Investment Banking or Private Equity Experts • • for a research project with a leading foundational model AI lab. You are a good fit if you : - Have •...[show_more]
    [last_updated.last_updated_variable_days] • [promoted]
    System Analyst, (Imaging Team) / Full-time

    System Analyst, (Imaging Team) / Full-time

    Christus Health • Albuquerque, New Mexico, US
    [job_card.full_time] +1
    Read on to find out what you will need to succeed in this position, including skills, qualifications, and experience.The Systems Analyst I is expected to configure and provide fundamental functiona...[show_more]
    [last_updated.last_updated_variable_days] • [promoted]
    Flexible $ : Earn At Least $1740 For Your First 148 Trips, Guaranteed.

    Flexible $ : Earn At Least $1740 For Your First 148 Trips, Guaranteed.

    Uber • Jemez Springs, New Mexico, United States
    [job_card.full_time] +1
    Earn at least $1740 driving with Uber when you complete your first 148 trips in 30 days.Why Uber? Driving is an easy way to boost your income while maintaining the flexibility your schedule require...[show_more]
    [last_updated.last_updated_variable_days] • [promoted]
    Lead Analyst, Quality Analytics and Performance Improvement (HEDIS)

    Lead Analyst, Quality Analytics and Performance Improvement (HEDIS)

    Molina Healthcare • Albuquerque, NM, United States
    [job_card.full_time]
    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...[show_more]
    [last_updated.last_updated_30] • [promoted]
    Business Analyst (Remote)

    Business Analyst (Remote)

    Scale AI • Albuquerque, New Mexico, United States
    [filters.remote]
    [job_card.full_time]
    Join a global community of talented professionals to shape the future of AI.Earn up to $15 USD / hr and additional rewards based on quality of submission. Outlier is committed to improving the intelli...[show_more]
    [last_updated.last_updated_variable_hours] • [promoted] • [new]
    Senior Systems Engineer / Team Lead

    Senior Systems Engineer / Team Lead

    TSymmetry • Albuquerque, NM, United States
    [job_card.full_time]
    Senior Systems Engineer / Team Lead.Tsymmetry is an IT professional services company dedicated to delivering flexible, scalable solutions to our customers around the globe when and where their miss...[show_more]
    [last_updated.last_updated_30] • [promoted]
    NAVWAR / Data Science Analyst

    NAVWAR / Data Science Analyst

    BlueHalo LLC • Albuquerque, NM, US
    [job_card.full_time]
    In support of the Joint Navigation Warfare Center (JNWC) contract, you will be part of our team's efforts to empower the Department of Defense's navigation warfare (NAVWAR) mission to ensure positi...[show_more]
    [last_updated.last_updated_variable_days] • [promoted]
    Lead Configuration Quality / Audit Analyst

    Lead Configuration Quality / Audit Analyst

    New Mexico Staffing • Albuquerque, NM, US
    [job_card.full_time]
    Responsible for accurate and timely auditing of critical information on claims databases.Maintains critical auditing and outcome information. Synchronizes data among operational and claims systems a...[show_more]
    [last_updated.last_updated_30] • [promoted]
    QUALITY SAFETY SPECIALIST - PERINATAL

    QUALITY SAFETY SPECIALIST - PERINATAL

    University of New Mexico • Albuquerque, NM, United States
    [job_card.full_time]
    Relocation Assistance Available.This position will work within the Labor and Delivery Department and align closely with the Process Improvement Team within Quality Outcomes.Compensation for this ro...[show_more]
    [last_updated.last_updated_30] • [promoted]
    Remote Content QA Reviewer

    Remote Content QA Reviewer

    Outlier • Rio Rancho, NM, United States
    [filters.remote]
    [job_card.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.last_updated_variable_days] • [promoted]
    Director, Global Quality Management & Improvement

    Director, Global Quality Management & Improvement

    AeroVironment • Albuquerque, NM, US
    [job_card.permanent]
    Director, Global Quality Management & Improvement.The Director, Global Quality Management & Improvement is responsible for the leadership and management of the Quality Management System (QMS) acros...[show_more]
    [last_updated.last_updated_variable_days] • [promoted]
    Travel Cath Lab Tech - $2791.6 / Week

    Travel Cath Lab Tech - $2791.6 / Week

    Atlas MedStaff • Rio Rancho, NM, US
    [job_card.full_time]
    Atlas MedStaff is seeking an experienced Cath Lab Tech for an exciting Travel Allied job in Rio Rancho, NM.Shift : 4x10 hr days Start Date : 12 / 15 / 2025 Duration : 13 weeks Pay : $2791.Atlas Medstaff is...[show_more]
    [last_updated.last_updated_30] • [promoted]
    Cleared R&D Senior Manager - Modern Systems Actualization, Onsite

    Cleared R&D Senior Manager - Modern Systems Actualization, Onsite

    Sandia National Laboratories • Albuquerque, NM, United States
    [job_card.full_time] +1
    Sandia National Laboratories is the nation's premier science and engineering lab for national security and technology innovation, with teams of specialists focused on cutting-edge work in a broad a...[show_more]
    [last_updated.last_updated_1_day] • [promoted]