Data Analyst - Health, Senior

Job Description

Your Role

The Consultative Support and Project Management team provides analytical support in preparation of contract negotiations and manages competitive intelligence data for the organization. The Data Analyst, Senior will report to the Manager of Data Analysis. In this role you will work cross functionally with teams such as Actuary, Network Compliance, and Contracting Network Managers to develop an understanding of the overall health of contracted entities. You will identify trends, investigate anomalies, and communicate your findings. You will also own the creation and distribution of reports that are critical to the future planning and financial health of the organization.

Responsibilities

Your Work

In 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
• Assist in identifying systems and operational problems and recommend solutions and changes to streamline procedures for more effective reporting
• Interact with internal and external customers to define complex reporting needs and specifications; design and implement complex report programming according to specifications
• Present effectively to internal and external customers on analytics/reports/presentations that are critical for their business continuity and decision making
• Participate on internal and external task forces and committees to provide analytical insights and support for implementation of new programs, applications, products and services and enhancement of existing applications/systems
• Develop dossiers for provider negotiations including analyses of financial, regulatory, and quality performance
• Lead and manage projects that may involve coordinating a team and working with different stakeholders
• Manage reporting and dashboards in support of SVP network planning including data validation, testing, and documentation
• Identify and implement areas for process improvement and automation

Ad hoc assignments as requested

Qualifications

Your Knowledge and Experience

• Requires an MPH, MBA, MS, MA in science, social science, public health, health services research or business, or BA/BS with demonstrated equivalent work experience
• Requires at least 5 years of experience in Health Care (managed care, academic, or gov't payer)
• Intermediate to Advanced knowledge of MS Excel (able to model, use formula) and Access (link tables, run queries)
• Experience with data visualization tools such as Tableau or Power BI
• Good business acumen, ability to work in a team environment
• Good math, analytical and problem-solving skills
• Excellent communication (written and verbal) and presentation skills, previous experience in presenting to leaders
• Ability to work independently, proactively and with little direction
• Demonstrated ability to work with all clinical coding systems (e.g., ICD10, CPT, DRG, LOINC, RxHUB).
• Experience with MS Office, especially Excel and Access, Unix, SQL/PL-SQL,SAS
• Ability to develop new SAS programs and SQL scripts that improve the efficiency of the work of others
• Familiarity with visualization tools such as Tableau
• Strong analytical and problem solving skills. Strong presentation skills
• Advanced knowledge of job area typically obtained through advanced education combined with experience.

About the Team

About Blue Shield of California

As of January 2025, Blue Shield of California became a subsidiary of Ascendiun. Ascendiun is a nonprofit corporate entity that is the parent to a family of organizations including Blue Shield of California and its subsidiary, Blue Shield of California Promise Health Plan; Altais, a clinical services company; and Stellarus, a company designed to scale healthcare solutions. Together, these organizations are referred to as the Ascendiun Family of Companies.

At Blue Shield of California, our mission is to create a healthcare system worthy of our family and friends and sustainably affordable. 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 achieve our mission, we foster an environment where all employees can thrive and contribute fully to address the needs of the various communities we serve. We are committed to creating and maintaining a supportive workplace that upholds our values and advances our goals.

Blue Shield is a U.S. News Best Company to work for, a Deloitte U.S. Best Managed Company and a Top 100 Inspiring Workplace. We were recognized by Fair360 as a Top Regional Company, and one of the 50 most community-minded companies in the United States by Points of Light. 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 listen and communicate effectively, showing empathy by understanding others' perspectives.
• 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:

At Blue Shield of California and the Ascendiun Family of Companies, we believe in fostering a workplace environment that balances purposeful in-person collaboration with flexibility. As we continue to evolve our workplace model, our focus remains on creating spaces where our people can connect with purpose - whether working in the office or through a hybrid approach - by providing clear expectations while respecting the diverse needs of our workforce.

Two Ways of Working:

• Hybrid (Default): Work from a business unit-approved office at least two (2) times per month (for roles below Director-level) or once per week (for Director-level roles and above).Exceptions:

o Member-facing and approved out-of-state roles remain remote.

o Employees living more than 50 miles from their assigned offices are expected to work with their managers on a plan for periodic office visits.

o For employees with medical conditions that may impact their ability to work in-office, we are committed to engaging in an interactive process and providing reasonable accommodations to ensure their work environment is conducive to their success and well-being.

• On-Site: Work from a business unit-approved office an average of four (4) or more days a week.

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.

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.