Medical Informatics Analyst, Consultant

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At Blue Shield of California we are parents, leader, students, visionaries, heroes, and providers. Everyday we come together striving to fulfill our mission, to ensure all Californians have access to high-quality health care at a sustainably affordable price. For more than 80 years, Blue Shield of California has been dedicated to transforming health care by making it more accessible, cost-effective, and customer-centric. We are a not-for-profit, independent member of the Blue Cross Blue Shield Association with 6,800 employees, more than $20 billion in annual revenue and 4.3 million members. The company has contributed more than $500 million to Blue Shield of California Foundation since 2002 to have a positive impact on California communities. Blue Shield of California is headquartered in Oakland, California with 18 additional locations including Sacramento, Los Angeles, and San Diego. We're excited to share Blue Shield of California has received awards and recognition for - LGBT diversity, quality improvement, most influential women in corporate America, Bay Area's top companies in volunteering & giving, and one of the world's most ethical companies. Here at Blue Shield of California, we're striving to make a positive change across our industry and the communities we live in - Join us!


Job Summary

Program Evaluation is an analytical function under Data & Analytics division in IT department and provides population-based analytics, identifying opportunities to delivery health care worthy of our family and friends and drive health care cost down. We utilize BSCs claims and membership data and other sources of information to evaluate various care management and population health programs, by discovering utilization patterns, assessing ROI, and identifying opportunities for better care outcomes. We work closely with Health Quality and Affordability, Health Transformation, Finance and other D&A / IT teams and partners.

This position will work with a various team focused on cost of health care who are creatively identifying, designing, testing, and developing best practices of providing health care at a lower cost and best outcome for or members. In this role you will collect, analyze, synthesize information, and guide business decision making for BSC populations' health management, cost of health care management, quality of care, healthcare transformation and innovation, and network design and strategies.

You will work closely with various teams throughout the organization, acting as both team leader and member, supporting the team's overall objectives. Use SAS / SQL and Tableau to design, build, enhance and manage complex data systems and analysis methods that better serve ongoing analytical and reporting requirements. Identify opportunities and make recommendations and/or implement solutions. Act as facilitator, trainer, consultant and mentor to team members and analysis throughout the organization. Use technical, analytical, clinical, and financial knowledge to assess the completeness and reliability of data and the validity and accuracy of analytical results. Lead and guide peers with analytical best practices and methods, coordination and oversight, peer reviews, and training sessions.

  • Using statistical methods perform analyses and modeling in support of organization-wide program evaluation.
  • Use SAS statistical tools to provide program evaluation.
  • Present and communicate evaluation result and recommendation to Program Management teams and other stakeholders across the company.
  • Use SAS / SQL to design, build, enhance and manage complex data systems and analysis methods that better serve ongoing analytical and reporting requirements.
  • Use Tableau / Excel to design, maintain dashboard and self-service reporting.
  • Extract, clean, analyze and summarize historical claims experience efficiently with SAS or other tools.
  • Lead and guide peers with analytical best practices and methods, coordinating standardization.
  • Partner with other departments throughout the organization and communicate technical analytic results and recommendations that are easily understood by non-technical persons.
  • Act as facilitator, trainer, consultant and mentor to team members and analyst throughout the organization.


Knowledge and Experience
  • Typically requires at least six years of professional experience.
  • Typically requires at least four years of health care industry background.
  • Strong statistical knowledge
  • Strong analytics skills and technically savvy
  • Expert level in SAS/SQL.
  • Tableau and Data Visualization experience is highly desired.
  • Strong communications skills
  • Be comfortable working with data.
  • Have intellectual curiosity and be a self-starter.
  • Strong problem-solving skills
  • Enjoy working within a team and independently.
  • College degree with at least a minor in mathematics, statistics, computer science or equivalent business experience.

Physical Requirements

Office Environment - roles involving part to full time schedule in Office Environment. Based in our physical offices and work from home office/deskwork - Activity level: Sedentary, frequency most of work day.
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External hires must pass a background check/drug screen. Qualified applicants with arrest records and/or conviction records will be considered for employment in a manner consistent with Federal, State and local laws, including but not limited to the San Francisco Fair Chance Ordinance. All qualified applicants will receive consideration for employment without regards to race, color, religion, sex, national origin, sexual orientation, gender identity, protected veteran status or disability status and any other classification protected by Federal, State and local laws.EEO Policy