Analyst - QualityAstrana Health • California, MO, US
Analyst - Quality
Astrana Health • California, MO, US
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job_description.job_card.job_descriptionEvaluate CMS HCC risk scores and risk model performance to support accurate coding, RAF score improvement, and documentation integrity. Use SQL and Python to query and manipulate large healthcare datasets to identify trends, anomalies, and improvement opportunities. Develop dashboards, reports, and scorecards using tools like Tableau, Power BI, or Excel to communicate performance to internal and external stakeholders. Conduct root-cause analyses and evaluate ROI on initiatives aimed at closing gaps, improving coding accuracy, and optimizing outcomes. Program Strategy & Operations Translate regulatory and contractual requirements into data queries and programmatic deliverables. Forecast performance and monitor KPIs across value-based contracts. Stay current on evolving quality measurement methodologies and value-based care structures. Cross-Functional Collaboration Collaborate with coding, provider engagement, and compliance teams to support HCC documentation and accuracy. Serve as a translator between technical findings and operational strategy—ensuring insights are actionable for clinical and non-technical audiences. Continuous Improvement Contribute to enhancements in analytics methodologies and reporting frameworks. Stay up to date with healthcare analytics best practices and regulatory trends. Bachelor's degree in Public Health, Healthcare Administration, Statistics, Business, or a related field. Minimum 3 years of experience in healthcare analytics, population health, managed care, or program evaluation roles. Familiarity with healthcare performance frameworks such as HEDIS, Stars, ACO, or Medicaid quality programs. Strong data analysis skills using SQL, Excel, Tableau, Power BI, or other BI tools. Experience analyzing HCC coding, diagnosis codes, and RAF score trends to drive improvement initiatives. Ability to thrive in a fast-paced, cross-functional environment. Understanding of healthcare delivery systems, provider networks, quality improvement concepts, and risk adjustment methodologies. You bridge clinical, operational, coding, and technical teams effectively. Excellent communication skills to explain complex topics to non-technical stakeholders. Strong organizational skills with attention to detail and ability to manage competing priorities. Passion for improving healthcare outcomes through data, strategy, HCC risk adjustment, and innovation. This is a remote role with the home office aligned to the department location at 600 City Parkway West, Orange, CA 92868. The total compensation target pay range is $80,000 - $95,000. Astrana Health is an Equal Employment Opportunity and Affirmative Action employer. All employment decisions are based on qualifications, merit, and business need. We do not discriminate based on protected characteristics. If you require assistance applying due to a disability, please email humanresourcesdept@networkmedicalmanagement.com to request an accommodation.
Overview
Analyst – Quality & Risk role at Astrana Health
Location : 600 City Parkway West, 10th Floor, Orange, CA 92868
Compensation : $80,000 - $95,000 / year
Department : Quality - Strategy & Ops
Environment : This is a remote role with the home office aligned to the department location.
What You'll Do
- Data Analysis & Insights
Analyze program performance data including cost, utilization, risk adjustment, HCC capture, diagnosis codes, medical claims, and quality metrics (e.g., HEDIS, Stars, CMS, Medi-Cal ECM).
Support the design, tracking, and evaluation of initiatives aligned with performance programs focused on quality improvement and cost containment.
Partner with Population Health, Risk Adjustment, Quality, Clinical Programs, Finance, and IT to align strategies and ensure consistency across data sources and reporting.
Ensure data quality through validation and standardization of reporting sources.
Qualifications
Nice-to-Have
Environment & Equal Opportunity
Additional Information : The job description does not constitute an employment agreement and is subject to change by the employer.
Seniority level : Mid-Senior level
Employment type : Full-time
Job function : Quality Assurance
Industries : Hospitals and Health Care
J-18808-Ljbffr
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