Blue Shield of California strives to create a healthcare system worthy of its family and friends that is sustainably affordable.

Blue Shield of California is a tax-paying, nonprofit, independent member of the Blue Shield Association with 4.7 million members, 7,800 employees, and $22.9 billion in annual revenue.

Founded in 1939 in San Francisco and now headquartered in Oakland, Blue Shield of California and its affiliates provide health, dental, vision, Medicaid and Medicare healthcare service plans in California.

The HCQA team is responsible for developing analytics and supporting materials to assist and guide strategic development and maintenance of Blue Shield's network of physicians, hospitals, ambulatory surgery centers, HMO IPA's, and medical groups. Our team (Network Performance Analysis and Contracts) is part of the HCQA Division and focuses on provider network performance analysis, reporting, and consulting. The NPAC team is responsible for developing analytics and supporting materials to assist and guide strategic development and maintenance of Blue Shield's network of physicians, hospitals, ambulatory surgery centers, HMO IPA's, and medical groups. In this role you will (1) provide analysis and consultative services on new network design in support of corporate strategic roadmap; (2) manages and oversees development and production of regulatory network filing artifacts as required by regulators for all Blue Shield and Promise Health Plan Commercial, Medi-Cal and Medicare networks; (3) provides network analytics, reporting and oversight on existing networks to ensure meeting regulatory access, availability standards as defined by regulators; and (4) provides consultative and analytical support as needed to during contract negotiations, pricing activities and product/network strategy roadmap planning. The Data Analyst, Senior will report to the Manager.

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
• 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
• Independently summarize findings and presents data in formats such as excel pivots, power point, reports, grids, and tables
• Lead and manage projects that may involve coordinating a team and working with different stakeholders
• Manage creation, collection, tracking, and compilation of evidence from internal teams into regulator reports
• Analyze data using a variety of software, provide recommendations based on the results, and present to internal stakeholders
• Adapt to and incorporate state and federal regulatory updates into existing policies, procedures, and assessments

Qualifications

Your Knowledge and Experience

• Requires an MPH, MBA, MS, MA in science, social science, public health, health svcs research or business, or BA/BS with demonstrated equivalent work experience
• Requires at least 5 years of prior relevant experience
• Requires at least 3 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) and SAS
• 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