Business Analyst, Senior - Provider Incentives

Job Description

Are you the right candidate for this opportunity Make sure to read the full description below.

Your Role

The Quality Improvement and Provider & Plan Quality Incentives (PPQI) team strives to improve the health outcomes of our members.

We strategize, plan and execute programs that support provider efforts to get patients into preventive care. We work with a broad spectrum of both internal and external stakeholders to develop programs that are directly aligned to national standards for high-quality healthcare.

The Business Analyst, Senior Provider Incentives will report to the Senior Manager. In this role you will provide complex analytical support to the Provider & Plan Quality Incentives (PPQI) team, including but not limited to payout modeling, forecasting, calculation and program evaluation.

You will bridge both performance and cost views across targeted populations including Commercial HMO, Covered CA HMO, Covered CA PPO, Medicare and Medi-Cal.

You will support the improvement of our work and our positive impact on both providers and members.

Your Work

In this role, you will :

• Provide analytical support through the analysis and interpretation of data in support of cross-functional business operations
• Develop budgets and forecasts for existing programs; build business cases for new initiatives (cost / benefit analysis)
• Define business requirements and provide analysis of operational efficiency
• Work cross-functionally in analyzing, designing and launching business solutions
• Develop, prepare, and analyze reports with complex analysis and data for management review
• Provide analytical support for complex cross-functional projects, and coordinate with internal and external resources
• Develop communication materials for all levels of Blue Shield of California cohorts the team works with
• Create presentations and reports utilizing tools such as Microsoft PowerPoint and Excel
• Prepare meeting agendas / notes and project plans / action item tracking
• Take responsibility for the administration and organization of the team’s SharePoint site that houses critical program documentation

Qualifications

Your Knowledge and Experience

• Requires a college degree or equivalent experience
• Requires a minimum of 5 years of prior relevant experience
• Experience in working cross-functionally in analyzing, designing, and developing business solutions is preferred
• Excellent verbal and written communication skills and the ability to interact professionally with a diverse group of executives, managers, and subject matter experts as well as external customers is preferred
• Prior experience in the health insurance industry is preferred
• Prior experience in healthcare quality is preferred
• Strong problem solver with demonstrated ability to identify root cause of low complexity issues is preferred
• Ability to function independently and produce results that meet standards of quality, timeliness, and acceptability is preferred
• Advanced skills in Microsoft Excel, Word, Visio, and PowerPoint in preparing and making presentations to various levels of management is preferred
• Prior experience in SQL is preferred

Pay Range :

The pay range for this role is : $77,990.00 to $116,930.00 for California.

Note :

Please note that this range represents the pay range for this and many other positions at Blue Shield that fall into this pay grade.

Blue Shield salaries are based on a variety of factors, including the candidate's experience, location (California, Bay area, or outside California), and current employee salaries for similar roles.

About The Team

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 genuinely 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 continued commitment to diversity, equity, and inclusion upholds our values and advances our goal of creating a healthcare system that is worthy of our family and friends while addressing health disparities, promoting social justice, and integrating health equity through our products, business practices, and presence as a corporate citizen.

Blue Shield has received awards and recognition for being a certified Fortune 100 Best Companies to Work, Military Friendly Employer, People Companies that Care, a Leading Disability Employer, and one of California’s top companies in volunteering and giving.

Here at Blue Shield, we strive to make a positive change across our industry and communities join us!

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.

Our Workplace Model :

Blue Shield of California is dedicated to making work-life balance a reality. Whether you prefer to work in an office or from home, we understand flexibility is more important than ever.

That’s why Blue Shield is a hybrid company, offering you the opportunity to decide where you can do your best and most meaningful work.

Two ways of working : Hybrid (our default) and office

• Hybrid In a business unit approved office a few times per year to 3 days per week, on average
• Office In a business unit approved office 4+ days a week, on average. If the role you’re applying for is deemed an Essential Role, the company has determined that the role can only be performed in a Blue Shield office or in the field and would require your to meet the office worker classification.

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.

Equal Employment Opportunity :

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.

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