Medical Informatics Analyst, Senior

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. Were excited to share Blue Shield of California has received awards and recognition for LGBT diversity, quality improvement, most influential women in corporate America, Bay Areas top companies in volunteering & giving, and one of the worlds most ethical companies. Here at Blue Shield of California, were striving to make a positive change across our industry and the communities we live in Join us!

Description

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 Role The Network and Provider Analytics team drives the development of an affordable provider network through data analytics and expertise . The Senior Medical Informatics Analyst will report to the Medical Informatics Manager . In this role, you will perform financial analyses and modeling for complicated provider contract terms changes/renewals for hospitals, ambulatory surgery centers, and other types of providers .

Your Work In this role, you will:

  • Conduct independent analysis of high complexity under moderate supervision and guidance, develop novel analyses and reports
  • Develop documentation and create and execute workplans for analyses of high complexity
  • Create financial unit cost trend reporting and rate calculations under moderate supervision using Excel modeling tools
  • Run and maintain SAS queries to gather data required for complex financial analysis
  • Reprice historical data against provider contract terms based on deep understanding on contract structure and configuration


  • Model network contract proposals from hospitals and ambulatory surgery centers and assess the financial implication
  • Partner with network management department in developing provider network and contracting strategy






Qualifications

Your Knowledge and Experience
  • Requires a bachelor's degree in mathematics, statistics, computer science or with demonstrated equivalent work experience
  • Requires at least 5 years of prior relevant experience
  • Requires at least 3 years of experience in Health Care (managed care, academic, or government payer)
  • Experience analyzing financial and health data, trends, and forecasting
  • Proficient in Excel. Be comfortable working with large data sets. Inspired to learn other technical skills
  • Knowledge of SAS is a plus
  • Strong candidates will have intellectual curiosity, learn fast, and be a self-starter
  • Need to have strong analytics and problem-solving skills


Our Values
  • 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


Physical Requirements

Office Environment - roles involving part to full time schedule in Office Environment. Due to the current public health emergency in California, Blue Shield employees are almost all working remotely. Based in our physical offices and work from home office/deskwork Activity level: Sedentary, frequency most of work day.
Please click here for further physical requirement detail.
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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.
COVID-19 update: From the earliest days of the pandemic, Blue Shield of California has been unyielding in our commitment to putting the health and safety of our people, our members and our communities first. As a federal contractor and a health care company, Blue Shield requires all employees to be fully vaccinated prior to start date as a condition of employment and provide proof of vaccination status. Blue Shield will consider requests for medical or religious accommodation to this vaccination requirement prior to your start date
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