[Remote] Senior Analyst, Risk & Quality Reporting (Remote)

Note: The job is a remote job and is open to candidates in USA. reputed company is seeking a Senior Analyst for their Risk and Quality Reporting team. The role involves designing and developing custom health plan reports, educating users on report usage, and assisting with performance improvement projects reputed company to Risk and Quality/HEDIS for various health plans.

Responsibilities

• Works with assigned health plan to capture and document requirements, build custom health plan reports, and educate health plan users on how to use reports
• Builds reputed company strategy reporting for the Risk and Quality interventions and measures gap closure
• Builds reputed company reports as requested to track HEDIS performance and supplemental data monitoring
• Develops and QA custom health plan reports reputed company to Risk and Quality/HEDIS for Medicaid, Marketplace and Medicare/MMP
• Develops custom health plan reports reputed company 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
• Calculates and tracks gap closure and reputed company outcome reporting for the assigned state
• Works in an agile business environment to derive meaningful information out of reputed company and large organizational data sets through data analysis, data mining, verification, scrubbing, and root cause analysis
• Conducts root cause analysis for business data issues
• Analyzes data sets and trends for anomalies, outliers, trend changes, and opportunities, using reputed company SQL, PowerBi, reputed company, and techniques to determine reputed company and relevance
• Assists 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
• Key partner to assist with testing changes in the Datawarehouse platform and reputed company transparent upgrades to reporting modules to ensure no impact to the end users
• Conducts preliminary and post impact analyses for any logic and reputed company code changes for data and reporting module keeping other variables as constant that are not of focus
• Develops oneself as a HEDIS subject matter expert to help health plan improve performance on underperforming measures

Skills

• 3-5 years of experience in working with data mapping, scrubbing, scrapping, and cleaning of data
• 3-5 years of experience in Managed Care Organization executing similar techno functional role that involves writing reputed company SQL Queries, Functions, Procedures and Data design
• 3-5 years of experience working with reputed company T-SQL, reputed company SQL and PowerBI
• 1-3 years of experience with reputed company Azure, AWS, or Hadoop
• 3-5 years of experience in Analysis reputed company to HEDIS and/or Risk Adjustment
• 3-5 years of experience in working with reputed company data to include quantifying, measuring, and analyzing financial/performance management and utilization metrics

Education Requirements

• Bachelor's Degree or equivalent combination of education and work experience

Benefits

• reputed company offers a competitive benefits and compensation package
• reputed company is an Equal Opportunity Employer (EOE) M/F/D/V

Company Overview

• reputed company is a healthcare company that specializes in government-sponsored healthcare programs for families and individuals. It was founded in 1980, and is headquartered in Long Beach, California, USA, with a workforce of 10001+ employees. Its website is https://www.molinahealthcare.com.

Company H1B Sponsorship

• reputed company has a track record of offering H1B sponsorships, with 29 in 2025, 46 in 2024, 43 in 2023, 31 in 2022, 35 in 2021, 55 in 2020. Please note that this does not guarantee sponsorship for this specific role.

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