Quality Analytics Analyst III

Medica•St. Louis, MO

5h•$90,500 - $155,200•Hybrid

About The Position

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.

Requirements

Bachelor's degree or equivalent experience in related field
5+ years of work experience beyond degree
Eligibility to work in the US: Medica does not offer work visa sponsorship for this role. All candidates must be legally authorized to work in the United States at the time of application. Employment is contingent on verification of identity and eligibility to work in the United States.

Nice To Haves

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
Ability to analyze complex datasets and generate actionable insights
Expertise in trend analysis, benchmarking, and performance monitoring
Strong problem-solving and critical-thinking capabilities
Ability to communicate complex insights clearly across audiences
Strong cross-functional collaboration skills
Experience presenting to leadership stakeholders
High level of accuracy and ownership of analytic outputs
Strong commitment to data quality and validation
Ability to manage multiple priorities and deadlines

Responsibilities

Develop, maintain, and enhance analytics and reporting supporting STARS performance, HEDIS measures, Provider quality outcomes, and 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.
Collaborate with Quality, Clinical, Actuarial, Finance, Network, and Operations teams to align analytics to business outcomes.
Serve as an analytic consultant by explaining results, methodology, assumptions, and implications for quality performance.
Support enterprise initiatives tied to Healthcare Value (HCV), affordability, and quality integration.
Ensure integrity and reliability of quality data through validation processes, data quality checks, and peer reviews.
Identify data issues, perform root-cause analysis, and recommend corrective actions.
Contribute to data governance and stewardship practices across the team.
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.
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.
Maintain working knowledge of STARS and HEDIS methodologies, NCQA standards, and CMS quality programs.
Ensure analytics and reporting align to evolving regulatory requirements.
Conduct benchmarking and comparative analysis using industry standards, internal historical performance, and peer comparisons.
Identify opportunities for improvement and inform quality strategy.
Identify opportunities to improve analytic efficiency, reporting automation, and data usability.
Contribute to standardization, documentation, and best practices.
Support adoption of new tools, including automation and AI-enabled analytics.