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Blue Shield of California's mission is to ensure all Californians have access to high-quality health care at a sustainably affordable price. We are transforming health care in a way that truly serves our nonprofit mission by lowering costs, improving quality, and enhancing the member and physician experience.
To fulfill our mission, we must ensure a diverse, equitable, and inclusive environment where all employees can be their authentic selves and fully contribute to meet the needs of the multifaceted communities we serve. Our comprehensive approach to diversity, equity, and inclusion combines a focus on our people, processes, and systems with a deep commitment to promoting social justice and health equity through our products, business practices, and presence as a corporate citizen.Blue Shield has received awards and recognition for being a certified Great Place to Work, best place to work for LGBTQ equality, leading disability employer, one of the best companies for women to advance, Bay Area's top companies in volunteering & giving, and one of the world's most ethical companies. Here at Blue Shield of California, we are striving to make a positive change across our industry and the communities we live in - join us!Your RoleThe Network and Provider Analytics team drives the development of an affordable provider network through data analytics and expertise. The Experienced Medical Informatics Analyst will report to the Medical Informatics Manager. In this role you will join a team of 4 analysts supporting state-wide hospital and ambulatory surgery center contract renewal and amendment, including Commercial and Medi-Cal LOBs.Your WorkIn this role, you will:- Conduct independent analysis of moderate complexity under moderate supervision and guidance, develop novel features for existing analyses and reports
- Develop documentation and create and execute workplans for analyses of moderate complexity
- Support analysis of high complexity under the guidance and direction of Medical Informatics Analyst III/IV/V, supervisor or manager
- Enhance database systems and applications so that they better serve specific reporting requirements
- Interact with internal customers to define reporting needs and report specifications
- Perform financial analyses and modeling for complicated provider contract terms changes/renewals for hospitals and ambulatory surgery centers
- Extract, clean, analyze and summarize historical claims experience efficiently with SAS and Excel
- Partner with network management department in developing provider network and contracting strategy
- Provide network contract financial results to downstream pricing team for premium pricing
- Requires a bachelor's degree in health science, quantitative social science, public health, health services research or business or equivalent experience
- Requires at least 3 years of prior relevant experience
- Requires at least 1 year experience in Health Care (managed care, academic, or gov't payer); or equivalent combination of education and experience
- Requires ability to use MS Office, esp. Excel and Access, Unix, SQL/PL-SQL, SAS with minimal supervision and support
- Proficient in Excel. Be comfortable working with large data set. Inspired to learn other technical skills. Have intellectual curiosity, fast learner, be a self-starter
- Strong analytics skills, strong problem-solving skills
- Prior experience in government programs Medi-Cal and Medicare is a plus
- Honest. We hold ourselves to the highest ethical and integrity standards. We build trust by doing what we say we're going to do and by acknowledging and correcting where we fall short
- Human. We strive to be our authentic selves, listening and communicating effectively, and showing empathy towards others by walking in their shoes
- Courageous. We stand up for what we believe in and are committed to the hard work necessary to achieve our ambitious goals
Vacancy expired!