December 4, 2023
About Our Company
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.
Job Description & Responsibilities
Blue Shield of California is seeking a Data Analyst – Health, Principal in HCQA Division.
The Health Solutions Division is responsible for developing, maintaining, and managing the relationship with Blue Shield's network of physicians, hospitals, ambulatory surgery centers, HMO IPAs, and medical groups.
Our team (Network Performance Analysis and Contracts) focuses on provider network performance analysis, reporting, and consulting. Some of our key responsibilities are (1) provide consultative services to Blue Shield’s key hospital contract negotiations using robust analytic tools and analyses--strategic contract roadmap, negotiation factsheets, and presentations of key market and performance indicators; (2) develop and maintain centralized databases and reports to measure network performance; (3) manage the nuts & bolts standardized Model Contracts and amendments; and (4) provide network design, maintenance, and regulatory support.
Lead Projects :
- Responsible for leading projects end-to-end. This includes planning the project, structuring the workstreams, working with the client and stakeholders, and delivering the outcomes expected of the project
- Plans and implements multiple and extremely complex projects/programs spanning across business areas.
- Interact with stakeholders, including face-to-face meetings, to gather data and information pertinent to the engagement. Consult with all levels including senior management, make recommendations, and influence decision making.
- Leverage cross-functional internal and external relationships to drive initiative forward.
- Create various levels of communication and recommendation (to peers to executive leaders)
Collaborate with various business unit as thought partner and expert:
- Works cross-functionally in analyzing, designing, and developing business solutions
- Provides analytical support for multiple, highly complex cross functional projects simultaneously, establishes work plans and timelines: coordinates with internal and external resources.
- Participate and collaborate with cross-functional workgroups; support other internal teams such as Contracting, Provider Partnerships, Delegation Oversight, and Provider Operations in developing strategies for improving overall processes, data integrity, and new mandates/regulatory requirements impacting provider networks.
Complex analysis for insight and recommendation :
- Synthesize from complex information into clear takeaways and recommendations using both qualitative and quantitative methods for management review and presents to various levels of management.
- Collect, analyze, synthesize, and translate complex data into insightful and actionable items for internal customers. Summarize findings and presents data in formats such as excel pivots, PowerPoint, tableau, reports, grids, and tables.
- Ability to determine key business issues, develop effective action plans and implement to successful conclusion.
Process improvement and change:
- Facilitate and manage the roll-out of operational process changes within the team; develop required training documentation, provide mentoring, and facilitate training sessions in support of a successful roll-out.
- Develops deliverables that are relevant and easily consumable that allow internal and external customers to receive the information intuitively; provides consultation services to customers on an ad hoc basis or in a formal presentation format.
- 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 10 years of prior relevant experience
- Requires at least 5 years of experience in Health Care (managed care, academic, or gov't payer)
- Excellent interpersonal skills, communication and presentation skills, previous experience in presenting to leaders. Communicate effectively with all audiences, including senior leaders, in a structured manner
- Ability to work effectively with diverse teams to come up with the best solution and move people and organizations to act
- Ability to influence leaders and stakeholder with no direct reporting relationship
- Requires exceptional problem-solving and analytical skills
- Good business acumen including good math, analytical and problem-solving skills
- Intermediate to Advanced knowledge of MS Excel (able to model, use formula) and Access (link tables, run queries)
- Tableau and SAS experience preferred
- Ability to work independently, proactively and with little direction
What we offer
The pay range for this role is: $ 136400.00 to $ 204600.00 for California.
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.