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

Lead Analyst, Quality Analytics and Performance Improvement (HEDIS)

Molina Healthcare • Bellevue, NE, United States
[job_card.variable_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 • Bellevue, NE, United States

    [internal_linking.related_jobs]
    CDL-A Refrigerated Truck Driver in Nebraska City, NE

    CDL-A Refrigerated Truck Driver in Nebraska City, NE

    AllTruckJobs • Nebraska City, NE, US
    [job_card.full_time]
    Ready for a career upgrade? Join Marten Transport! As a stable, financially healthy carrier – and a 2025 TCA Elite Fleet honoree – we offer the best of both worlds : high miles in your region and th...[show_more]
    [last_updated.last_updated_30] • [promoted]
    Lead Gen Analyst

    Lead Gen Analyst

    Sojern • Omaha, NE, US
    [job_card.full_time]
    The Lead Gen Analyst serves as a critical part of the Commercial Strategy team, focusing on optimizing and scaling our lead generation campaigns and processes. As a driven, self-motivated, and deter...[show_more]
    [last_updated.last_updated_variable_days] • [promoted]
    Data Entry Product Support - No Experience

    Data Entry Product Support - No Experience

    GLOCPA • Nebraska City, Nebraska
    [job_card.full_time]
    We’re looking for Customer Support Product Testers across the US to work from home and help top brands improve their products before they hit the market.[show_more]
    [last_updated.last_updated_30] • [promoted]
    IT Endpoint Analyst

    IT Endpoint Analyst

    Smithfield Foods • Omaha, NE, United States
    [job_card.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.last_updated_variable_days] • [promoted]
    Side Hustle Project Lead

    Side Hustle Project Lead

    Finance Buzz • Nebraska City, Nebraska, US
    [job_card.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.last_updated_30] • [promoted]
    CSSP DCO Analyst

    CSSP DCO Analyst

    General Dynamics Information Technology • Offutt Air Force Base, NE, United States
    [job_card.full_time]
    Clearance Level Must Currently Possess : .Clearance Level Must Be Able to Obtain : .Computer Networking, Cyber Defense, Cybersecurity, Enterprise IT. USSTRATCOM is a Combatant Command responsible for st...[show_more]
    [last_updated.last_updated_variable_days] • [promoted]
    Internal Audit - SOX Senior Manager

    Internal Audit - SOX Senior Manager

    Coinbase • Omaha, Nebraska, 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]
    Remote Content QA Reviewer

    Remote Content QA Reviewer

    Outlier • Bellevue, NE, 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]
    Travel Labor & Delivery (LDRP) RN - $2,467 per week

    Travel Labor & Delivery (LDRP) RN - $2,467 per week

    Host Healthcare • Nebraska City, NE, United States
    [job_card.full_time]
    Host Healthcare is seeking a travel nurse RN LDRP - Labor Delivery Recovery & Postpartum for a travel nursing job in Nebraska City, Nebraska. Job Description & Requirements.LDRP - Labor Delivery Rec...[show_more]
    [last_updated.last_updated_30] • [promoted]
    Remote SaaS Software Data Reviewer - AI Trainer ($30-$37 per hour)

    Remote SaaS Software Data Reviewer - AI Trainer ($30-$37 per hour)

    Mercor • Bellevue, Nebraska, US
    [filters.remote]
    [job_card.part_time]
    Role Overview • •Mercor is looking for freelance contributors who are able to analyze the output of various B2B SAAS systems, ranging from Slack messages to Linear tickets to Salesforce entries.This ...[show_more]
    [last_updated.last_updated_variable_days] • [promoted]
    Senior Risk Analyst

    Senior Risk Analyst

    Argonaut Management Services, Inc • Omaha, NE, United States
    [job_card.full_time]
    Argo Group International Holdings, Inc.American National, US based specialty P&C companies, (together known as BP&C, Inc. Brookfield Wealth Solutions, Ltd.BWS"), a New York and Toronto-listed public...[show_more]
    [last_updated.last_updated_variable_days] • [promoted]
    Senior Performance Audit Consultant

    Senior Performance Audit Consultant

    Blue Cross Blue Shield companies • Omaha, NE, United States
    [job_card.full_time]
    Join our team as a Senior Performance Audit Consultant, where you will play a key role in ensuring that our operations handle customer interactions with accuracy and efficiency, leaving a positive ...[show_more]
    [last_updated.last_updated_variable_days] • [promoted]
    Restaurant Delivery - Flexible Onboarding

    Restaurant Delivery - Flexible Onboarding

    DoorDash • Nebraska City, NE, United States
    [job_card.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.last_updated_30] • [promoted]
    Customer Support Quality Lead

    Customer Support Quality Lead

    VirtualVocations • Omaha, Nebraska, United States
    [job_card.full_time]
    A company is looking for a Customer Support Quality Lead to enhance customer support interactions.Key Responsibilities Establish and improve a QA program for evaluating agent performance across s...[show_more]
    [last_updated.last_updated_variable_days] • [promoted]
    Revenue Cycle Systems Analyst / FT, M-F 8-5 p.m. Flexible Schedule

    Revenue Cycle Systems Analyst / FT, M-F 8-5 p.m. Flexible Schedule

    Omaha Children's Hospital • Omaha, NE, United States
    [job_card.full_time]
    At Children’s, the region’s only full-service pediatric healthcare center, our people make us the very best for kids.Come cultivate your passion, purpose and professional development in an environm...[show_more]
    [last_updated.last_updated_variable_days] • [promoted]
    Lead Configuration Quality / Audit Analyst

    Lead Configuration Quality / Audit Analyst

    Omaha Staffing • Omaha, NE, 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]
    JASSM Targeting Analyst

    JASSM Targeting Analyst

    Leidos • Omaha, NE, US
    [job_card.permanent]
    Accelerate Your Career with Leidos – JASSM Targeting Analyst Position.Ready to take your career to the next level?.Leidos is seeking an experienced. This role offers the perfect combination of...[show_more]
    [last_updated.last_updated_1_day] • [promoted]
    NC3 Analyst

    NC3 Analyst

    Calvert Systems Engineering • Papillion, NE, United States
    [job_card.full_time]
    NC3 (Nuclear Command, Control and Communications) Analyst.Minimum Clearance Required : Top Secret / SCI eligible.This position requires the ability to obtain and maintain a Top Secret / SCI U.Citizenshi...[show_more]
    [last_updated.last_updated_variable_days] • [promoted]