Astrana Health, Inc.
Analyst - Quality
Department:
Quality - Strategy & Ops Employment Type:
Full Time Location:
600 City Parkway West 10th Floor, Orange, CA 92868 Compensation:
$80,000 - $95,000 / year Description
We are seeking a data-driven and strategic Analyst – Quality & Risk to join our Quality - Strategy & Operations team. This role will focus on supporting performance improvement efforts across value-based care programs—including Medicaid, Medicare Advantage, and commercial populations—by analyzing program data, risk adjustment performance, HCC coding accuracy, diagnosis code capture, and CMS HCC risk scores. The analyst will identify actionable insights and drive operational initiatives to improve both quality and risk outcomes. The ideal candidate will have experience working with healthcare data, particularly in risk adjustment and coding analytics, and will be skilled at translating performance trends into actionable recommendations that support strategic decision-making and optimize program outcomes. Our Values: Putt Patients First Empower Entrepreneurial Provider and Care Teams Operate with Integrity & Excellence Be Innovative Work As One Team 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). Evaluate 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 Support the design, tracking, and evaluation of initiatives aligned with performance programs focused on quality improvement and cost containment. 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 Partner with departments including Population Health, Risk Adjustment, Quality, Clinical Programs, Finance, and IT to align strategies and ensure consistency across data sources and reporting. Collaborate with coding, provider engagement, and compliance teams to support HCC documentation and accuracy. Serve as a key translator between technical findings and operational strategy—ensuring insights are actionable for clinical and non-technical audiences. Continuous Improvement Ensure data quality through validation and standardization of reporting sources. Contribute to enhancements in analytics methodologies and reporting frameworks. Stay up to date with healthcare analytics best practices and regulatory trends. Qualifications
Bachelor’s degree in Public Health, Healthcare Administration, Statistics, Business, or a related field. Minimum 3 years of experience working 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 business intelligence 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’re great for this role if you: You thrive in cross-functional settings and can bridge the gap between clinical, operational, coding, and technical teams. You have excellent communication skills and can explain complex topics—such as risk adjustment methodologies, HCC coding, and RAF score drivers—to non-technical stakeholders. You are highly organized, detail-oriented, and able to manage competing priorities in a fast-paced environment while ensuring accuracy in quality and risk reporting. You are passionate about improving healthcare outcomes through data, strategy, HCC risk adjustment, and innovation. Environmental Job Requirements and Working Conditions
This is a remote role. The home office is aligned with your department at 600 City Parkway West, 10th Floor, Orange, CA 92868. The total compensation target pay range for this role is: $80,000 - $95,000. The salary range represents our national target range for this role. Astrana Health is proud to be an Equal Employment Opportunity and Affirmative Action employer. We do not discriminate based upon race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity, gender expression, age, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. All employment is decided on the basis of qualifications, merit, and business need. If you require assistance in applying for open positions due to a disability, please email us at
humanresourcesdept@networkmedicalmanagement.com
to request an accommodation. Additional Information: The job description does not constitute an employment agreement between the employer and employee and is subject to change by the employer as the needs of the employer and requirements of the job change.
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Department:
Quality - Strategy & Ops Employment Type:
Full Time Location:
600 City Parkway West 10th Floor, Orange, CA 92868 Compensation:
$80,000 - $95,000 / year Description
We are seeking a data-driven and strategic Analyst – Quality & Risk to join our Quality - Strategy & Operations team. This role will focus on supporting performance improvement efforts across value-based care programs—including Medicaid, Medicare Advantage, and commercial populations—by analyzing program data, risk adjustment performance, HCC coding accuracy, diagnosis code capture, and CMS HCC risk scores. The analyst will identify actionable insights and drive operational initiatives to improve both quality and risk outcomes. The ideal candidate will have experience working with healthcare data, particularly in risk adjustment and coding analytics, and will be skilled at translating performance trends into actionable recommendations that support strategic decision-making and optimize program outcomes. Our Values: Putt Patients First Empower Entrepreneurial Provider and Care Teams Operate with Integrity & Excellence Be Innovative Work As One Team 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). Evaluate 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 Support the design, tracking, and evaluation of initiatives aligned with performance programs focused on quality improvement and cost containment. 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 Partner with departments including Population Health, Risk Adjustment, Quality, Clinical Programs, Finance, and IT to align strategies and ensure consistency across data sources and reporting. Collaborate with coding, provider engagement, and compliance teams to support HCC documentation and accuracy. Serve as a key translator between technical findings and operational strategy—ensuring insights are actionable for clinical and non-technical audiences. Continuous Improvement Ensure data quality through validation and standardization of reporting sources. Contribute to enhancements in analytics methodologies and reporting frameworks. Stay up to date with healthcare analytics best practices and regulatory trends. Qualifications
Bachelor’s degree in Public Health, Healthcare Administration, Statistics, Business, or a related field. Minimum 3 years of experience working 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 business intelligence 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’re great for this role if you: You thrive in cross-functional settings and can bridge the gap between clinical, operational, coding, and technical teams. You have excellent communication skills and can explain complex topics—such as risk adjustment methodologies, HCC coding, and RAF score drivers—to non-technical stakeholders. You are highly organized, detail-oriented, and able to manage competing priorities in a fast-paced environment while ensuring accuracy in quality and risk reporting. You are passionate about improving healthcare outcomes through data, strategy, HCC risk adjustment, and innovation. Environmental Job Requirements and Working Conditions
This is a remote role. The home office is aligned with your department at 600 City Parkway West, 10th Floor, Orange, CA 92868. The total compensation target pay range for this role is: $80,000 - $95,000. The salary range represents our national target range for this role. Astrana Health is proud to be an Equal Employment Opportunity and Affirmative Action employer. We do not discriminate based upon race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity, gender expression, age, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. All employment is decided on the basis of qualifications, merit, and business need. If you require assistance in applying for open positions due to a disability, please email us at
humanresourcesdept@networkmedicalmanagement.com
to request an accommodation. Additional Information: The job description does not constitute an employment agreement between the employer and employee and is subject to change by the employer as the needs of the employer and requirements of the job change.
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