Medical Informatics Analyst, Consultant

Job Description

Your Role

The Data & Analytics (D&A) team partners with enterprise-wide business stakeholders to apply the power of data & analytics to deliver new insights and data-driven solutions to accelerate business outcomes. The Pharmacy Analytics Consultant will report to the Senior Manager of Pharmacy Analytics and is responsible for working with key stakeholders from Pharmacy Services and others to be the D&A partner in accelerating and achieving business objectives and operations. This critical analytics team collaborates with other analytical and business teams and delivers analytical insights to power the business forward.

This role requires not only in-depth knowledge of the pharmacy claims data domain, but also a broad understanding of the business and business levers that matter. Being able to act as a "two-in-a-box" partner with business stakeholders is critical. Our leadership model is about developing great leaders at all levels and creating opportunities for our people to grow - personally, professionally, and financially. We are looking for leaders that are energized by creative and critical thinking, building, and sustaining high-performing teams, getting results the right way, and fostering continuous learning.

Your Work

In this role, you will:

• Partner with Pharmacy Services team as a data analytics subject matter expert to address data needs to support pharmacy operational, strategic and compliance needs.
• Design, develop, and support analytical solutions for Pharmacy Care Reimagined programs.
• Provide pharmacy and prescription drug data expertise to cloud migration teams.
• Implement data quality rules necessary to ensure timely and accurate delivery of reports.
• Perform data exploration using a combination of statistical programming languages (including, but not limited R, Python, SQL, SAS) and deploy predictive analytics and machine learning techniques to improve risk prediction, improve reserve, trend and financial forecasting in a manner that is actuarially sound, and enable real-time results and operational efficiencies.
• Support internal and external pharmacy data needs, including but not limited to, report automation, in-depth drill down on report reconciliations, research and development of rebate allocation methodologies, cost of healthcare modeling, and customized reporting solutions.
• Effectively translate business problem and/or requirements into an analytical approach and present findings (analytical, reports, and presentations) to stakeholders critical for their business continuity and decision making.
• Assess business risks associated with analytical processes and data systems, and develop strategies to mitigate risks.
• Evaluate analytic results, prepare presentation materials, and make recommendations that clearly and succinctly convey results and their business significance to appropriate audiences to inform effective decision-making.
• Use appropriate technical, business, and financial knowledge to assess the completeness and reliability of data and the validity and accuracy of analytical results.
• Perform other functions as needed.
• Manage medium to large sized projects (or multiple projects) spanning across business areas

Qualifications

Your Knowledge and Experience

• Requires an MPH, MBA, MS, MA, RN, or RHIA in health science, quantitative social science, public health, health services research or business, or BA/BS with demonstrated equivalent work experience
• Requires at least 7 years of prior relevant experience
• At least 5 years of experience in Health Care (pharmacy, managed care, academic, or government payer)
• SAS certification or equivalent experience required
• Demonstrated critical-thinking, analytical, and thought leadership skills
• Experience in translating business problems into analytical approaches
• Current working knowledge of SQL and Excel strongly preferred
• Tableau experience strongly preferred
• Python experience preferred
• Previous project management experience preferred.

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.

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.

Location: Philatelic, CA, US

Posted Date: 11/23/2024