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Software Quality Analyst

$71.7k - $103.73k

SCAN Health Plan

Founded in 1977 as the Senior Care Action Network, SCAN began with a simple but radical idea: that older adults deserve to stay healthy and independent. That belief was championed by a group of community activists we still honor today as the “12 Angry Seniors.” Their mission continues to guide everything we do.Today, SCAN is a nonprofit health organization serving more than 500,000 people across Arizona, California, Nevada, New Mexico, Texas, and Washington, with over $8 billion in annual revenue. With nearly five decades of experience, we have built a distinctive, values-driven platform dedicated to improving care for older adults.Our work spans Medicare Advantage, fully integrated care models, primary care, care for the most medically and socially complex populations, and next-generation care delivery models. Across all of this, we are united by a shared commitment: combining compassion with discipline, innovation with stewardship, and growth with integrity.At SCAN, we believe scale should strengthen—not dilute—our mission. We are building the future of care for older adults, grounded in purpose, accountability, and respect for the people and communities we serve.The JobThe Senior Quality Analyst is a key contributor to the Medicare Advantage STAR Program, responsible for analyzing performance data, supporting quality improvement initiatives, managing measure-level interventions, interpretations, and ensuring the organization meets CMS STAR rating goals. This role provides advanced analytical expertise, cross-functional collaboration, and operational support to drive improvements in clinical quality, customer experience, pharmacy measures, and operational compliance. The Analyst must stay current on CMS rules, technical specifications, and methodological changesrelated to STAR Ratings, HEDIS, CAHPS, and Medicare Advantage.You WillMonitor, 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.We seek Rebels who are curious about AI and its power to transform how we operate and serve our members.Actively support the achievement of SCAN’s Vision and Goals.Other duties as assigned.Your QualificationsExperience 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.What's in it for you?Base salary range: $71,700 to $103,732 per yearInternal title: STARS Quality Analyst SrWork Mode: Mostly RemoteAn annual employee bonus programRobust Wellness ProgramGenerous paid-time-off (PTO)11 paid holidays per year, plus 1 floating holiday, plus 1 birthday holidayExcellent 401(k) Retirement Saving Plan with employer match and contributionRobust employee recognition programTuition reimbursementAn opportunity to become part of a team that makes a difference to our members and our community every day!We're always looking for talented people to join our team! Qualified applicants are encouraged to apply now!At SCAN we believe that it is our business to improve the state of our world. Each of us has a responsibility to drive Equality in our communities and workplaces. We are committed to creating a workforce that reflects our community through inclusive programs and initiatives such as equal pay, employee resource groups, inclusive benefits, and more.SCAN is proud to be an Equal Employment Opportunity and Affirmative Action workplace. Individuals seeking employment will receive consideration for employment without regard to race, color, national origin, religion, age, sex (including pregnancy, childbirth or related medical conditions), sexual orientation, gender perception or identity, age, marital status, disability, protected veteran status or any other status protected by law. A background check is required.#LI-CS2#LI-HybridEqual Opportunity Employer/Protected Veterans/Individuals with DisabilitiesThe contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor’s legal duty to furnish information. 41 CFR 60-1.35(c) #J-18808-Ljbffr

Vacancy posted 7 hours ago
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