JOB DESCRIPTION

Job Summary

Molina's Quality Improvement function oversees, plans, and implements new and existing healthcare quality improvement initiatives and education programs; ensures maintenance of programs for members in accordance with prescribed quality standards; conducts data collection, reporting and monitoring for key performance measurement activities; and provides direction and implementation of NCQA accreditation surveys and federal/state QI compliance activities.

Candidates residing in Michigan with SQL, Quality/HEDIS and Health plan experience are strongly preferred.

KNOWLEDGE/SKILLS/ABILITIES

In collaboration with Quality Improvement (QI) management, the Senior Analyst, HEDIS/Quality Reporting develops and provides reports and cost-benefit analysis tools to meet QI requirements and uses automated software tools and processes to help streamline activities and improve data/analytics for the quality team.

• Acts as a lead analyst to provide project-, program-, and / or initiative-related direction and guidance for other analysts within the department and/or collaboratively with other departments.

• Develops, codes, runs, and/or prepares formatted reports to support critical Quality Improvement functions (e.g., reporting for key performance measurement activities, including HEDIS, state-based measure reporting and medical record review).

• Collaborates and / or assists in performing quality assurance checks on reports prior to completion

• Works with Director and / or Manager to establish and / or document quality assurance process checks to be utilized by all staff to ensure the integrity, completeness and validity of external and internal reports

• Understands how to prioritize reports according to business need, regulatory requirements, urgency and / or other key business factors

• Collaborates with department leads and other partnering departments to understand and / or document business requirements and / or implement required reporting.

• Writes and / or produces accurate reports and conducts analyses according to set timelines and project plans.

• Collaborates with other department staff to convert HEDIS data sources for use in HEDIS reporting as needed.

• Coordinates data and analyses from MHI and / or Health Plans as needed.

• Assists with generation of State-specific performance measurement requirements.

• Assists program managers with research regarding performance measurement outliers when asked.

• Uses industry standard techniques determined by the department to reduce report writing errors.

• Modifies reports in response to error identification and / or approved change requests; understand the balance between responsiveness to business requests for enhancements versus department needs to complete work efficiently and timely.

JOB QUALIFICATIONS

Required Education

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

Required Experience

• 3 years of experience in healthcare, or equivalent experience in a non-financial regulated industry.

• 1 year experience in managed healthcare, or equivalent

• Technical experience in reporting and/or programming.

• Proficiency with Excel and Visio (flow chart equivalent) and demonstrated ability to learn new information systems and software programs.

• Proficiency with data manipulation and interpretation.

• Knowledge of basic statistics.

Preferred Education

Master's Degree or higher in a clinical field, IT, Public Health or Healthcare.

Preferred Experience

• HEDIS reporting or collection experience.

• CAHPS improvement experience.

• 1+ years in managed healthcare non-financial reporting.

• 1+ years health care information systems experience or in a role as an IS liaison/contact for QI projects.

• State QI experience.

• Supervisory experience.

• Project management and team building experience.

• Experience developing performance measures that support business objectives.

• Experience using multiple programming languages, including but not limited to, SQL / SSRS.

Preferred License, Certification, Association

Microsoft Certification(s)

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: $54,373.27 - $117,808.76 / ANNUAL

*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.