Quality Analytics and Performance Improvement Analyst

Job Description Job Summary As a Quality Analytics and Performance Improvement Analyst, you will support the Quality Analytics team at Molina by designing and developing reporting solutions that aid in HEDIS audits, rate tracking, and identifying targeted interventions while tracking outcomes on performance metrics. Key Responsibilities: Collaborate with various departments to gather and document requirements, create reporting solutions, and train users on report functionalities. Support Quality Data Analytics Leaders in developing predictive intervention strategies and tracking the progress and impacts of these interventions. Assist in retrospective tracking of HEDIS rates and report on the impact of supplemental data. Develop reporting for Medical Record Review projects to monitor progress and team productivity. Create and perform quality assurance on both ad-hoc and automated reporting modules related to Quality/HEDIS for Medicaid, Marketplace, and Medicare/MMP. Conduct analysis and reporting on managed care data such as Medical Claims, Pharmacy, Lab, and HEDIS rates. Help the Quality department with in-depth analyses of HEDIS measures to support audits and revenue at risk reporting. Calculate and monitor HEDIS rates related to intervention outcomes across all markets and Lines of Business. Utilize an agile business approach to extract meaningful insights from complex organizational data sets through data analysis, mining, scrubbing, and root cause analysis. Perform root cause analysis for business data issues as directed by the team lead. Analyze data sets and trends to detect anomalies, outliers, and shifts, employing statistical tools to assess significance and relevance while predicting future trends in costs, utilization, and performance. Engage in research and development for special projects as requested by internal departments or in response to inquiries from regulatory or contracting agencies. Qualifications: Education: Bachelor's Degree in Computer Science, Finance, Mathematics, Economics, or a related field. Experience: 3+ years of experience in data mapping, cleaning, and scrubbing. 3+ years of experience in a Managed Care Organization in a techno-functional role, including writing complex SQL queries, functions, and data design. 3+ years of experience with Microsoft T-SQL, SSIS, and SSRS. Knowledge of Data Science techniques and languages such as Python and R is a plus. Familiarity with Microsoft Azure, AWS, or Hadoop is preferred. 1-3 years of experience with predictive modeling in healthcare quality data. 1-3 years of experience in analyzing HEDIS rate tracking, Medical Record Reviews, and intervention tracking across at least one line of business such as Medicaid, Marketplace, or Medicare/MMP. 1-3 years of experience handling increasingly complex data challenges in measuring financial/performance management and utilization metrics. 1-3 years of experience in statistical analysis and forecasting trends in HEDIS rates to support quality, finance, and healthcare functions. Physical Demands: The work environment is generally favorable with adequate lighting and temperature. The role is office-based and may require prolonged periods of sitting. Reasonable accommodations may be available to assist individuals with disabilities in performing essential functions. If you are currently employed by Molina and wish to apply for this position, please do so through the internal job listings. Molina Healthcare offers a competitive benefits and compensation package and is an Equal Opportunity Employer (EOE) M/F/D/V. Pay Range: $83,252 - $128,519 / ANNUAL Note: Actual compensation may vary based on geographic location, work experience, education, and/or skill level.

Created: 2026-03-10