Quality Analytics Analyst III

The Quality Analytics Healthcare Analyst is responsible for delivering analytics and insights that support Medica’s Quality Strategy, including performance across STARS, HEDIS, NCQA, and regulatory quality programs. This role translates healthcare, clinical, and claims data into actionable insights that drive improvements in quality outcomes, member experience, provider performance, and financial results. Performs other duties as assigned., Quality Analytics & Reporting

• Develop, maintain, and enhance analytics and reporting supporting: o STARS performance o HEDIS measures o Provider quality outcomes o Member engagement and care management effectiveness

• Translate complex healthcare data into actionable insights that support quality improvement and business decision-making
• Ensure outputs are accurate, timely, and aligned with business and regulatory requirements

Cross-Functional Partnership

• Collaborate with Quality, Clinical, Actuarial, Finance, Network, and Operations teams to align analytics to business outcomes

• Serve as an analytic consultant by explaining: o Results o Methodology o Assumptions o Implications for quality performance

• Support enterprise initiatives tied to Healthcare Value (HCV), affordability, and quality integration

Data Quality, Validation & Governance

• Ensure integrity and reliability of quality data through: o Validation processes o Data quality checks o Peer reviews

• Identify data issues, perform root-cause analysis, and recommend corrective actions
• Contribute to data governance and stewardship practices across the team

Performance Monitoring & Insight Generation

• Monitor key quality KPIs (e.g., STARS ratings, HEDIS rates, gap closure)
• Identify trends, variances, and emerging risks or opportunities
• Proactively communicate insights and actionable recommendations to stakeholders.

Data Visualization & Communication

• Design dashboards and visualizations using tools such as Power BI or Tableau
• Tailor communication to audiences ranging from technical teams to executive leadership
• Apply storytelling techniques to clearly articulate insights and business impact

Regulatory & Quality Program Expertise

• Maintain working knowledge of: o STARS and HEDIS methodologies o NCQA standards o CMS quality programs

• Ensure analytics and reporting align to evolving regulatory requirements

Benchmarking & Comparative Analysis

• Conduct benchmarking and comparative analysis using: o Industry standards o Internal historical performance o Peer comparisons

• Identify opportunities for improvement and inform quality strategy

Process Improvement & Innovation

• Identify opportunities to improve: o Analytic efficiency o Reporting automation o Data usability

• Contribute to standardization, documentation, and best practices
• Support adoption of new tools, including automation and AI-enabled analytics

• Bachelor’s degree or equivalent experience in related field
• 5+ years of work experience beyond degree

Preferred Qualifications

• Technical Skills
• SQL and data analysis tools (R, Python, SAS, etc.)
• Data visualization tools (Power BI, Tableau)
• Experience with healthcare data (claims, clinical, provider)
• Familiarity with Snowflake or enterprise data platforms
• Analytical Skills
• Ability to analyze complex datasets and generate actionable insights
• Expertise in trend analysis, benchmarking, and performance monitoring
• Strong problem-solving and critical-thinking capabilities
• Communication & Collaboration
• Ability to communicate complex insights clearly across audiences
• Strong cross-functional collaboration skills
• Experience presenting to leadership stakeholders
• Attention to Detail & Accountability
• High level of accuracy and ownership of analytic outputs
• Strong commitment to data quality and validation
• Ability to manage multiple priorities and deadline

401(k), The full salary grade for this position is $90,500 - $155,200. While the full salary grade is provided, the typical hiring salary range for this role is expected to be between $90,500 - $122,835. Annual salary range placement will depend on a variety of factors including, but not limited to, education, work experience, applicable certifications and/or licensure, the position’s scope and responsibility, internal pay equity and external market salary data. In addition to compensation, Medica offers a generous total rewards package that includes competitive medical, dental, vision, PTO, Holidays, paid volunteer time off, 401K contributions, caregiver services and many other benefits to support our employees.

Medica is a nonprofit health plan with more than a million members that serves communities in Minnesota, Nebraska, Wisconsin, Missouri, and beyond. We deliver personalized health care experiences and partner closely with providers to ensure members are genuinely cared for.

We’re a team that owns our work with accountability, makes data-driven decisions, embraces continuous learning, and celebrates collaboration - because success is a team sport. It’s our mission to be there in the moments that matter most for our members and employees. Join us in creating a community of connected care, where coordinated, quality service is the norm and every member feels valued.