Quality Analytics and Performance Improvement Analyst

Job Description Job Summary Join Molina's Quality Analytics team as an Analyst, focusing on improving quality through innovative data solutions. In this pivotal role, you will design and develop comprehensive reporting solutions to support HEDIS audits, monitor rate tracking, and identify targeted interventions while tracking performance outcomes. ESSENTIAL JOB DUTIES: Collaborate with various departments to gather and document requirements, create reporting solutions, and provide training to users on how to utilize the reports effectively. Support Quality Data Analytics Leaders in developing Predictive Intervention Strategy Analytics and track progress and impacts. Assist in retrospective HEDIS rate tracking and impact reporting for supplemental data. Create Medical Record Review project reports to monitor progress and productivity. Develop and conduct quality assurance for both ad-hoc and automated analytical reporting modules related to Quality/HEDIS for Medicaid, Marketplace, and Medicare/MMP. Analyze managed care data such as Medical Claims, Pharmacy, Lab, and HEDIS rates. Support the Quality department with HEDIS measure assessments to aid in audits and revenue at risk reporting. Calculate and monitor HEDIS rates for intervention outcomes across all markets and lines of business. Utilize an agile working environment to extract insights from complex organizational datasets through in-depth analysis, data mining, verification, and root cause analysis. Conduct root cause analysis for assigned business data issues as directed by the team lead. Evaluate datasets and trends for anomalies, outliers, and opportunities using statistical tools, and apply statistical methodologies to forecast future trends in costs, utilization, and performance. Assist in the research, development, and execution of special projects as requested by internal departments or external regulatory and contracting agencies. Job Qualifications EDUCATION REQUIRED: Bachelor's Degree in Computer Science, Finance, Mathematics, Economics, or a related field. EXPERIENCE REQUIRED: Minimum of 3 years of experience in data mapping, scrubbing, and cleaning processes. At least 3 years in a Managed Care Organization in a similar techno-functional role, including the ability to write complex SQL queries and manage data design. 3+ years of experience with Microsoft T-SQL, SSIS, and SSRS. Knowledge of Data Science techniques and familiarity with programming languages such as Python or R is a plus. Experience with cloud technologies such as Microsoft Azure, AWS, or Hadoop is preferred. 1-3 years of predictive modeling experience in healthcare quality data. 1-3 years of experience analyzing HEDIS rate tracking, Medical Record Review tracking, and interventions tracking across at least one line of business (Medicaid, Marketplace, or Medicare/MMP). 1-3 years of experience solving complex data problems to quantify and analyze financial and performance metrics. 1-3 years of experience in statistical analysis and forecasting trends in HEDIS rates to support quality, finance, and health plan functions. PHYSICAL DEMANDS: The working environment is generally favorable with adequate lighting and temperature. Work primarily occurs in an office setting with minimal exposure to unpleasant or hazardous conditions. Must be able to sit for extended periods. Reasonable accommodations may be made for individuals with disabilities to perform essential functions. 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 - $128,519 / ANNUAL Actual compensation may vary based on geographic location, work experience, education, and/or skill level.

Created: 2026-03-04