Looking for a chance to do meaningful work that touches millions? Come join the hardest working, nonprofit health plan in California and help us shape the future of health care. Blue Shield of California is focused on transforming health care by making it more accessible, affordable and customer-centric. Being a mission-driven organization means we do much more than serve our 3.5 million members: we were the first health plan in the nation to limit our annual net income to 2 percent of revenue and return the difference to our customers and the community, and since 2005 we have contributed more than million to the Blue Shield of California Foundation to improve community health and end domestic violence. We also believe that a healthier California begins with our employees, so we provide them with resources to develop and maintain a healthy lifestyle through our award-winning wellness program, Wellvolution. We're hiring smart thinkers and doers who want to work for a leader and innovator in the challenging, ever-changing healthcare space. Come and help us make health care better for everyone.
Being part of the Enterprise analytics and Informatics, we support Blue Shield of California's ability to gain insight into key analytics areas to help understand key attributes (health/performance/cost) and make business decisions. This team focuses in provider analytics and negotiation support, network assessment/analysis, cost of healthcare data reporting, financial forecasting/projections, performing financial and risk analysis in changes to provider contracts in order to help BSC meet its goals of providing low-cost healthcare and meeting earnings objectives.
Develop, interpret and implement provider cost and quality reports and metrics to support key strategic initiative such as cost of health care management, quality of care, provider network design and cost transparency program. May perform healthcare research related to provider reimbursement structures, physician reimbursement and impact of contractual agreements
• Creates, maintains and produces timely various standard analytic reports for internal and/or external use.
• Partners with internal stakeholder to create the most up to date financial outlook for the company
• Conducts analysis and risk assessment to estimate financial outcomes.
• Forecasts healthcare cost at the provider level
• Analyze product designs and its impact to members treatment cost
• Develops documentation and creates and executes work plans for both analytic and operation type of work
• Research and prepare evaluations on a variety of projects/problems (financial, statistical, operational and cost/benefit analyses).
• Other duties as assigned
• 2+ years Healthcare or Insurance experience, is preferred.
• Ability to use MS Office, esp. Excel and Access, Unix, SQL/PL-SQL, with minimal supervision and support.
• Experience with SAS is preferred.
• Ability to make major modifications to adapt computer programs and scripts developed by others for new applications and purposes.
• Passion to improve internal and external customer service
Bachelors or above in any quantitative background mathematics, statistics, actuarial science, health science, public health, business analytics, financial analytics or equivalent years of relevant experience.
What we Offer:
• Work for a company that has a clear mission: Affordable Care worthy of your family and friends
• Opportunity to experience a broad range of technologies, to work with and learn from talented people and leaders
• Challenge yourself in solving complex problems, in technical, business, and people areas
• Be part of IT modernization and be an agent of change
• Access to learning and growth programs, grow your managerial and leadership skills
• Work in an environment that value people and work/life balance
• Generous Benefits package including health and wellness benefits and 401K.
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.
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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.