HEDIS Data Analyst at Molina Healthcare - Remote USA — Columbus
Traveler-Friendly Insight
This role at Molina Healthcare is not explicitly advertised as remote, but Molina Healthcare is a large, distributed managed care organization known to support remote and hybrid work arrangements for analytical roles. However, nothing in this posting confirms full remote availability — prospective applicants should verify directly.
From a nomad perspective, the work itself — SQL querying, Power BI reporting, data analysis — is highly conducive to async, location-independent work. There are no explicit timezone requirements stated, though collaboration with national risk and quality teams may imply some US business hours alignment.
If remote work is confirmed, the US-only hiring constraint limits visa flexibility. Digital nomad visas in countries like Portugal, Costa Rica, or Georgia typically require employment outside those countries, so a US-based employer contract may still allow living abroad legally — but this varies. Travelers should investigate carefully.
- Lisbon, Portugal: Monthly costs ~$2,000–$2,800 for a comfortable lifestyle — very favorable against likely US analyst salaries ($70K–$90K range).
- Bangkok, Thailand: Monthly costs ~$1,200–$1,800 — even more favorable, though Thai LTR visa eligibility requires employer verification.
- Medellín, Colombia: Monthly costs ~$1,000–$1,600 — excellent value, with a growing digital nomad community.
No specific travel perks (coworking stipend, equipment allowance) are mentioned. Ask about remote work policy and equipment support during the interview process.
Job Summary
Provides analyst support for health plan risk and quality reporting activities. Designs and develops custom health plan reports to support local interventions, provider outreach, and tracks outcomes of initiatives. Educates users on how to use reports related to risk and quality/Healthcare Effectiveness Data and Information Set (HEDIS) for Medicaid, Medicare, Marketplace and Medicare/Medicare-Medicaid Plan (MMP). Assists with research, development, and completion of special quality performance improvement projects including root-cause analysis.
Essential Job Duties
- Captures and documents health plan quality reporting requirements, builds custom reports, and educates 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 quality reports as requested to track HEDIS performance and supplemental data monitoring.
- Develops quality assurance (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 including medical claims, pharmacy, lab and HEDIS rates.
- Collaborates with the national risk and quality team on testing of pre-production reporting for assigned health plan.
- Calculates and tracks gap closure and intervention outcome reporting for the assigned health plan.
- 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, Power BI, Microsoft Excel, and other techniques to determine significance and relevance.
- Assists with research, development and completion of special quality-related projects as requested by internal departments or in support of requests from regulatory agencies, contracting agencies, or other external organizations.
- Serves as a key partner to assist with testing changes in the Data Warehouse platform and performs transparent upgrades to reporting modules to ensure no impact to end users.
- Conducts preliminary and post-impact analyses for any logic and source code changes for data and reporting modules, keeping other variables constant that are not of focus.
- Represents as a HEDIS subject matter expert and supports health plans to improve performance on underperforming quality measures.
Required Qualifications
- At least 2 years of experience mapping, scrubbing, scrapping, and cleaning data, and analysis experience related to HEDIS and/or risk adjustment, and 1 year of experience in a managed care organization, or equivalent combination of relevant education and experience.
- Analytical mindset with excellent attention to detail.
- Experience working with complex data including quantifying, measuring, and analyzing financial/performance management and utilization metrics.
- Experience working with Microsoft T-SQL, Databricks SQL, and Power BI.
- Experience writing complex SQL queries, functions, procedures and data design.
- Experience with Microsoft Azure, Amazon Web Services (AWS), or Hadoop.
- Ability to manage multiple priorities in a fast-paced, deadline-driven environment.
- Strong business acumen with the ability to connect data insights to strategic goals.
- Self-starter with a continuous improvement mindset.
- Effective verbal and written communication skills.
- Proficiency in Microsoft Office suite (including advanced Excel) and applicable software programs.
Preferred Qualifications
- Certified Professional in Healthcare Quality (CPHQ).
- Certified HEDIS Compliance Auditor (CHCA).
- Registered Nurse — if licensed, license must be active and unrestricted in state of practice.
To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
Frequently Asked Questions
Is this HEDIS Data Analyst position at Molina Healthcare remote?
What technical skills are required for this role?
Is a HEDIS certification required or just preferred?
Does Molina Healthcare offer benefits for this position?
Can current Molina employees apply for this position?
