Medical Informatics Analyst, Consultant

Your Role

The Blue Shield of California Growth and Servicing analytics organization is part of the centralized Data and Analytics organization and oversees Channel Analytics including Digital, Marketing, Claims, Appeals, Grievances, Disputes and Line of Business.

The role of Medical Informatics Analyst Consultant would report to the Manager of Medical Informatics and would be responsible for supporting the growth and retention of members in the Individual & Family Plan (IFP) Line of Business.

You will have a strong understanding of the various IFP products and excited about improving the member health outcomes through data & analytics as you engage directly with stakeholders to help frame business problems, participate in recommending analytic frameworks to address those problems and deliver high quality / high impact solutions.

On top of having a product-oriented mind set, the ability to influence & impact outcomes in a matrixed environment are essential to being successful in this role.

Your Work

In this role you will :

• Analytics & Modeling : Perform in-depth membership & claims analyses and models to understand and predict member behavior, changes in trends, and uncover actionable insights to improve member acquisition, engagement, health, retention, and experience.
• Data Profiling & Reporting : Utilize appropriate tools to analyze large datasets, focusing on membership, claims & revenue along dimensions such as broker & provider performance related to BSC’s Individual Market product administered through California Health Exchange (Covered California) and direct sales.
• Analyze structured and unstructured data to uncover pain points, establish causality / identify the root causes and recommend and size improvements for prioritization.
• Build reports and dashboards to empower stakeholder decision making.
• Be enthusiastic about figuring out how to attract new members, keep existing members, deepen our relationships with members, serve them efficiently, keep them healthy and ensure they have a great experience.
• Enjoy solving thorny problems and developing data-driven solutions.
• Thrive in a highly matrixed environment.

Your Knowledge and Experience

Bachelor’s degree in data science, health informatics, statistics, mathematics, economics, engineering or related quantitative fields.

Master’s degree preferred

• 7+ years working with Claims and Membership, or similar data a huge plus.
• Strongly preferred working knowledge of Snowflake, Databricks, RDBMS (Oracle, Netezza etc.)
• Advanced SAS, SQL, Python skills to interact with data,
• Tableau skills to create reports and visualization.
• Knowledge of HEDIS & experience in supporting the California Health Exchange.
• Ability to partner enthusiastically with all levels of staff and adapt quickly to shifting and / or competing priorities.

Pay Range :

The pay range for this role is : $ 118800.00 to $ 178200.00 for California.

Notes :

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.

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