Molina Healthcare · 1 hour ago
Senior Analyst, Risk & Quality Reporting (Remote in IL)
United States
Full-time
Remote
Mid, Senior Level
3+ years expMolina Healthcare is a leading provider in the healthcare sector, and they are seeking a Senior Analyst for their Risk and Quality Health Plan team. The role involves designing and developing custom health plan reports, educating users on report utilization, and supporting performance improvement projects through data analysis and reporting.
Health CareHospitalMedical
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 intervention strategy reporting for the Risk and Quality interventions and measures gap closure
Builds ad hoc reports as requested to track HEDIS performance and supplemental data monitoring
Develops and QA custom health plan reports related to Risk and Quality/HEDIS for Medicaid, Marketplace and Medicare/MMP
Develops 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
Calculates and tracks gap closure and intervention outcome reporting for the assigned state
Works in an agile business environment to derive meaningful information out of complex 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 databricks SQL, PowerBi, excel, and techniques to determine significance 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 perform transparent upgrades to reporting modules to ensure no impact to the end users
Conducts preliminary and post impact analyses for any logic and source 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
Qualification
Required
Bachelor's Degree or equivalent combination of education and work experience
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 complex SQL Queries, Functions, Procedures and Data design
3-5 years of experience working with Microsoft T-SQL, Databricks SQL and PowerBI
1-3 years of experience with Microsoft Azure, AWS, or Hadoop
3-5 years of experience in Analysis related to HEDIS and/or Risk Adjustment
3-5 years of experience in working with complex data to include quantifying, measuring, and analyzing financial/performance management and utilization metrics
Benefits
Competitive benefits and compensation package
Company
Molina Healthcare
Molina Healthcare is a healthcare company that specializes in government-sponsored healthcare programs for families and individuals.
10001+ employees
H1B Sponsorship
Molina Healthcare has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2025 (47)
2024 (45)
2023 (43)
2022 (31)
2021 (35)
2020 (55)
Funding
Current Stage
Public CompanyTotal Funding
$2.35B2025-11-17Post Ipo Debt· $850M
2024-11-13Post Ipo Debt· $750M
2021-11-16Post Ipo Debt· $750M
Leadership Team
Dave Reynolds
Executive Vice President, Health Plans & Medicaid Chief Operating Officer
Debbie Simkins
Vice President, Office of the CIO
Recent News
2025-12-30
The Motley Fool
2025-12-30
Company data provided by crunchbase