SCAN

SCAN is a mission-driven organization that is tackling some of the biggest issues in health care for older adults.

Senior Quality Analyst

AnalystAnalystFull TimeRemoteTeam 1,001-5,000Since 1977Company SiteLinkedIn

Location

California

Posted

21 hours ago

Salary

$71.7K - $103.7K / year

Bachelor DegreeEnglishPythonSQLTableau

Job Description

• Monitor, analyze, and develop insights on STAR measure performance for HEDIS, CAHPS, HOS, Pharmacy (PQA), and Operational measures. • Perform root-cause analysis to identify drivers of performance gaps and recommend targeted interventions. • Partner with Health Care Informatics and other internal analytics team to ensure dashboards, scorecards, and routine performance reports for leadership and operational partners. • Model future projections and perform “What-if” scenarios for STAR rating forecasts. • Conduct routine process analysis for department’s operating procedures and validate compliance with regulatory requirements or develop details assessment outlining gaps/risks identified with proposed process redesigns to mitigate identified gaps and risks. • Collaborate with internal teams (Clinical Operations, Pharmacy, Member Experience, Network, Provider Relations) to design and implement quality improvement strategies. • Track performance of interventions and provide data-driven insights on progress and effectiveness. • Conduct Star competitor analysis and develop insights for all SCAN markets, potential partnerships, or growth opportunities. • Work with IT and data teams to enhance data infrastructure and ensure data quality for STAR reports, and troubleshoot data discrepancies. • Support the design and evaluation of interventions aimed at improving provider performance, member satisfaction, and clinical outcomes.

Job Requirements

  • Experience as a Senior Quality Analyst within a health plan or healthcare organization working with a STAR program is highly desirable.
  • Bachelor's Degree or equivalent experience required.
  • Master’s degree in a related field preferred.
  • Experience working within a health plan STAR team.
  • Familiarity with claims, encounter, and EMR data.
  • Experience supporting provider engagement or quality improvement initiatives.
  • Strong knowledge of CMS STAR Ratings methodology, HEDIS measures, CAHPS, HOS, and Medicare Advantage quality programs.
  • Advanced proficiency in data analysis tools (Excel, SQL, Python, SAS, R, Tableau, or Power BI).
  • Proficient with MS Office (Access, Word, Excel, PowerPoint) and e-mail.
  • Ability to communicate complex analytical information to diverse audiences.
  • Analytical Thinking and Problem-Solving - excel in breaking down complex information and deriving actionable insights.
  • Strong organizational and project management skills.
  • Ability to work independently and in a team environment.
  • Strong team player.
  • Ability to work under tight deadlines & manage multiple responsibilities independently.

Benefits

  • Internal title: STARS Quality Analyst Sr
  • Work Mode: Mostly Remote
  • An annual employee bonus program
  • Robust Wellness Program
  • Generous paid-time-off (PTO)
  • 11 paid holidays per year, plus 1 floating holiday, plus 1 birthday holiday
  • Excellent 401(k) Retirement Saving Plan with employer match and contribution
  • Robust employee recognition program
  • Tuition reimbursement
  • An opportunity to become part of a team that makes a difference to our members and our community every day!

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