Data & Decision Analyst, Senior

Job Description

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 Medical Informatics Analyst - Senior ( Individual Family Plan) will report to the Senior Manager of Medical Informatics and play a critical role in advancing the health plan's specialty lines of business (dental, vision, and life insurance). This role is strategically designed to focus 70% on analytics and 30% on reporting, emphasizing the use of machine learning models and predictive analytics to drive member acquisition, retention, engagement, and growth, as well as identifying opportunities for cross-selling.

The successful candidate will have a robust understanding of both medical benefits, a proven ability to leverage existing analytics solutions across benefit types, and a demonstrated capacity to improve operational efficiency through data integration and actionable insights. Passionate about improving member health outcomes through data and analytics, the candidate will actively engage with stakeholders to frame business problems, recommend analytic frameworks, and deliver impactful, high-quality solutions.

A product-oriented mindset and the ability to influence outcomes in a matrixed environment are essential to excel in this role.

Responsibilities

Your Work

In this role you will:

• Integrate medical benefits data with other BSC data, creating comprehensive employer reports that identify cross-selling opportunities and improve member experiences.
• Lead the development and deployment of machine learning models to predict and enhance member acquisition, retention, engagement, and growth within the dental and vision lines of business.
• Perform predictive and prescriptive analytics to understand member behavior, identify intervention opportunities, and recommend strategies for growth and retention.
• Collaborate with Individual Family Plan Line of Business (LOB) teams to align business goals with analytics solutions and deliver data-driven recommendations.
• Support regulatory reporting and monthly employer reporting by working closely with the data services team to develop integrated data models spanning medical, dental, and vision benefits.
• Partner with data engineering teams to ensure seamless integration of claims data from multiple sources into the analytics environment.
• Analyze structured and unstructured data to uncover pain points, establish causality, and recommend prioritized solutions based on insights.
• Build intuitive reports and dashboards to empower stakeholders with data-driven decision-making tools.
• Monitor and evaluate the effectiveness of marketing campaigns, engagement strategies, and product performance using actionable insights.
• Assist in defining strategic business rules and KPIs for reporting and analytics within the specialty benefits domain.
• Be enthusiastic about solving complex challenges, improving member satisfaction, and driving health outcomes.
• Thrive in a matrixed environment, balancing priorities across teams and stakeholders.
• Approach problems with curiosity, creativity, and a solutions-driven mindset.
• Passionate about improving member outcomes while delivering value to the organization.

Qualifications

Your Knowledge and Experience

• Bachelor's degree in data science, health informatics, statistics, mathematics, economics, engineering or related quantitative fields. Master's degree preferred
• Minimum 5 years of prior relevant experience, and 3 years' experience in Health Care (managed care, academic, or gov't payer)
• 3+ years working with Claims and Membership, or similar data strongly preferred.
• Strongly preferred working knowledge of Snowflake, Databricks, RDBMS (Oracle, Netezza etc.)
• Advanced Python, SQL SAS or equivalent skills to interact with data
• Strong experience with machine learning techniques such as classification, clustering, and predictive modeling, especially in member engagement and retention contexts
• Experience with medical claims data integration and analysis.
• Proven ability to integrate and analyze medical claims data, providing actionable insights for employer groups and internal stakeholders.
• Familiarity with cross-selling strategies and member engagement techniques in the healthcare space
• Hands-on Experience with data visualization tools (e.g., Tableau, Power BI) to present insights in a clear and actionable manner.
• Excellent communication skills to effectively collaborate with the Individual Family Plan LOB team and align analytics initiatives with business strategy
• Demonstrated ability to partner across all levels of staff and adapt quickly to shifting priorities.

About the Team

About Stellarus and the Ascendiun Family of Companies

Stellarus, launched in January 2025, is designed to scale innovative healthcare solutions that support customers in creating a health care experience deserving of their family, friends, and neighbors.

Stellarus is part of a family of organizations that is overseen by a nonprofit corporate entity named Ascendiun. The Ascendiun Family of Companies also includes Blue Shield of California and its subsidiary, Blue Shield of California Promise Health Plan and Altais, a clinical services company.

Stellarus' vision is to empower its customers to create a healthcare experience that is worthy of their family, friends, and neighbors. Stellarus' objective is to offer innovative, modern, scalable solutions that challenge the health care status quo. This very closely aligns with Blue Shield of California's vision by using innovation to improve quality, affordability, and experience for members.

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.

Our Values:

At Stellarus, our core values of agility, trust, drive, courage and service shape our approach to developing innovative product offerings.

Our Workplace Model:

At Stellarus 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.