Analyst, Risk & Quality Reporting (Remote)

Remote, USA Full-time
JOB DESCRIPTION Job Summary The Analyst, Risk and Quality Reporting role supports Molina’s Risk and Quality Health Plan team. This position designs and develops custom health plan reports to support local interventions, provider outreach, and tracks outcomes of the initiatives. Educates users on how to use reports related to Risk and Quality/HEDIS for Medicaid, Marketplace and Medicare/MMP. Job Duties Work with assigned health plan to capture and document requirements, build custom health plan reports, and educate health plan users on how to use reports Build intervention strategy reporting for the Risk and Quality interventions and measure gap closure. Build ad hoc reports as requested to track HEDIS performance and supplemental data monitoring Development and QA of custom health plan reports related to Risk and Quality/HEDIS for Medicaid, Marketplace and Medicare/MMP Develop custom health plan reports related to managed care data like Medical Claims, Pharmacy, Lab and HEDIS rates Assists and collaborates with the national Risk and Quality department with testing of pre-production reporting for the assigned health plan Calculate and track gap closure and intervention outcome reporting for the assigned state Work in an agile business environment to derive meaningful information out of organizational data sets through data analysis and data profiling Analyze data sets and trends for anomalies, outliers, trend changes, and opportunities, using databricks SQL, PowerBi, excel, and techniques to determine significance and relevance Assist with research, development and completion of special projects as requested by various internal departments, or in support of requests from regulatory agencies, contracting agencies, or other external organizations JOB QUALIFICATIONS REQUIRED QUALIFICATIONS: Bachelor's Degree or equivalent combination of education and work experience 1-3 years of experience in working with data mapping, data profiling, scrapping, and cleaning of data. 1-3 years of experience in a Managed Care Organization executing similar techno functional role that involves writing SQL Queries, Functions, Procedures, and Data design 1-3 years of experience working with Microsoft T-SQL, Databricks SQL and PowerBI Familiarity with Microsoft Azure, AWS or Hadoop 1-3 years of experience in Analysis related to health care reporting 1-3 years of experience in working with data to include quantifying, measuring, and analyzing financial/performance management and utilization metrics Familiarity with HEDIS and Risk data 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: $80,168 - $116,835 / ANNUAL • Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. Apply tot his job
Apply Now

Similar Jobs

[Remote] AI Training - Research Scientist (PST)

Remote, USA Full-time

Lead Research Scientist, Foundation Models & Agentic Systems - Remote

Remote, USA Full-time

Clinical Research Scientist - Breast Cancer Franchise

Remote, USA Full-time

Implementation Science Research Scientist

Remote, USA Full-time

Research Scientist II

Remote, USA Full-time

Revenue Cycle Analyst, Associate

Remote, USA Full-time

Retirement Plan Consultant - PGA

Remote, USA Full-time

Retirement Plan Advisor- Jacksonville

Remote, USA Full-time

Senior Research Scientist, AI/ML, Imaging

Remote, USA Full-time

**Experienced Customer Retention Manager – Driving Customer Loyalty and Growth at blithequark**

Remote, USA Full-time

Paralegal (Lemon Law Preferred)- Phoenix, AZ

Remote, USA Full-time

Online Personal Trainer | Leads Provided | Flexible Work

Remote, USA Full-time

**Experienced Customer Service Representative – Remote Opportunity with blithequark**

Remote, USA Full-time

Experienced Part-Time Data Entry Professional for Remote Opportunities with CVS Health - Career Growth and Development in Healthcare Operations

Remote, USA Full-time

Club Manager

Remote, USA Full-time

**Experienced Full Stack Operations Engineer – Mechatronics and Sustainable Packaging Deployment & Ramp-up**

Remote, USA Full-time

Associate Bank Recruiter (1099) - Remote (Rockport, TX) - Job 3433b

Remote, USA Full-time

[Fractional] CFO w/ Fundraising Experience (Equity-Based)

Remote, USA Full-time

Vice President of Finance and Administration

Remote, USA Full-time

Experienced Remote Customer Service Representative – Delivering Exceptional Experiences in Aviation at Blithequark

Remote, USA Full-time
Back to Home