Vacancy expired!
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 Medical Analytics team supports the Medi-Cal Business Unit . The Data Analyst-Health will report to the Regulatory & Compliance Senior Manager . In this role you will support compliance & regulatory reporting, mandated projects and clinical key indicators for Medi-Cal, Cal MediConnect, and Medicare. .Your WorkIn this role, you will:- Develop and conduct evaluations and studies within limited time frames and produce analyses that are easy for non-technical persons to understand
- Develop technical specs and execute a work plan for uncomplicated analyses
- Prepare documents, correspondence, and other communication materials to convey information to appropriate audiences internally and/or externally
- Participate in the process to design and implement reports/analytics; able to follow business requirement and technical specification to bring the product to fruition
- Assist in identifying systems and operational problems and recommend solutions and changes to streamline procedures for more effective reporting
- Manage and prioritize workload while meeting deliverables and expectations in a timely manner
- Prepare complex reports and studies for a variety of uses including cost of health care analysis, quality improvement, enhancing operations and addressing identified issues
- Support design, implementation and maintenance of data logic and processes to support Medi-Cal data integration into health data technology platform
- Responible to create system QA processes and documentation
- Utilize programming software to efficiently develop process or tools to analyze relevant data from various sources (e.g., claims, membership, provider, financial, operation and other ancillary data sources), interpret and present analytic results for all ad hoc and ongoing reporting requests
- Requires a bachelor's degree 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) and demonstrated ability to work with all clinical coding systems (e.g., ICD10, CPT, DRG, LOINC, RxHUB)
- Experience with Base SAS and/or SAS EG is required. Experience in Tableau and SAP BusinessObjects is a plus.
- Insight of Managed Care, Medi-Cal/Medicaid and coordination of Care.
- Excellent verbal and written communication and presentation skills
- Prepares complex reports and studies for a variety of use cases, including cost of health care analysis, quality improvement, enhancing operations and addressing identified issues.
- Practical knowledge of agile and project management skills
- 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!