Data Analyst - Health, Principal
From $360/yr
Your Role The Healthcare Quality Affordability (HQA) Analytics team plays a key role in discovering information hidden in vast amounts of data that can lead to smarter decisions and deliver better service for our customers and contain the rising cost of healthcare. The Data Analyst – Health, Principal will report to the Sr. Manager, HQA Analytics. In this role you will focus on strategic partnerships with our stakeholders, reporting and business analysis of performance primarily focused on the HMO line of business (ACO, Medicare, Medi-Cal). You will collaborate with our provider performance enablement leaders, helping them understand support needs, define/drive strategy and priorities leveraging data and analytics solutions to support strategic and operational objectives. 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: * Operate at a strategic business level to ensure projects/programs are in line with Blue Shield of California strategic goals * Review IPA and Hospital performance metrics and gather insights and recommendations for our internal and external stakeholders to achieve optimal member cost and utilization outcomes * Consult with appropriate internal partners on issues and interpretations of the DOFR’s Risk assignment and fully understand the linkages between Benefits, Contracts and Claims * Work cross-functionally with Actuary, Medical Care Solutions, Data \& Analytics, Finance, Quality, Revenue Enhancement, Pharmacy and Network Management to enable a 360 review of all facets of a provider’s performance profile * Collaborate closely with the Regional Medical Directors and clinicians and recommend strategic action for improving costs and use of healthcare * Develop strong, strategic partnership with internal and external stakeholders * Utilize and recommend enhancements to existing self-service reporting solutions * Understand the data structures and sources, and the use of analytical or statistical tools to create meaningful insights that drive strategic action and results * Design, develop, and maintain interactive dashboards and data visualizations using Tableau and Power BI to support business insights and decision-making Your Knowledge and Experience * Requires a MPH, MBA, MS, MA in science, social science, public health, MIS, computer science, data science, health services research or business, or BA/BS with demonstrated equivalent work experience * Requires 10 years of experience in Health Care (managed care, academic, or government payer) * Ability to function independently and produce results that meet standards of quality, timeliness, and acceptability * Problem-solving skills balanced between “analytical” and “intuitive” * Ability to thrive in ambiguous situations * Excellent verbal and written communication skills and the ability to interact professionally with a diverse group of executives, directors, managers, and subject matter experts * Ability to establish and maintain effective and collaborative relationships with key stakeholders * Advanced skills using Microsoft Excel, Word, Visio, and PowerPoint in preparing and making presentations to various levels of management. Proficient at using MS Project * Technically proficient having broad background in problem solving tools * Knowledge of Blue Shield of CA or similar health care organization structure * Extensive knowledge of CPT, HCPCS, ICD-10s and other related industry codes 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 We believe in fostering a workplace environment that balances purposeful in-person collaboration with flexibility - providing clear expectations while respecting the diverse needs of our workforce. Our workplace model is designed around intentional in-person interaction, collaboration, connection, creativity and flexibility: * For most teams, this means coming into the office two days per week. * Employees living more than 50 miles from an office location, out of state employees, and employees in certain member-facing roles should work with their manager to determine in-office time based on business need. * 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. The Company reserves the right to require more presence in the office based on business needs, and requirements are subject to change with periodic reviews. 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. 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.