Your Role

The Back Office Analytics team supports operations stakeholders with dashboarding, analytic studies, and statistical modeling to drive a better member/provider experience while reducing both administrative and healthcare costs. The Medical Informatics Analyst, Consultant will report to the Sr. Manager of Back Office Analytics. In this role you will provide analytic support to the operations team which involves defining a business problem, developing an analytic framework, and producing analytically driven insights and solutions that support transformational initiatives improving health care operations efficiency and member experience. You will face off directly with executive leadership to understand business challenges and present your analytic findings. You will own the relationship with your executive stakeholders and be responsible for delivering on their priorities within committed timeframes.

Your Work

In this role, you will:

• Proactively and aggressively partner with business stakeholders to understand problems and provide guidance / support before you are asked
• Conduct independent analysis of highly complex domains under minimal supervision and guidance
• Develop analytical methods so that they may be subsequently delegated for production to Medical Informatics Analysts at lower levels
• Develop documentation and create / execute workplans for analyses. Workplans may coordinate the activities of Medical Informatics Analysts at lower levels and may involve collaboration with more than one team
• Provide training and mentoring for team members on best practices for analysis and reporting; assist in the development of supplemental analytic training tools and materials; conduct formal training sessions for lower-level analysts and analysts in other Departments
• Analyze structured and unstructured data to size and solve different business problems which can include uncovering pain points, performing root cause analysis, recommending, and sizing improvements for prioritization
• Build complex data sets from disparate sources with required linkages to enable analytics
• Use statistics, text mining, topic modeling, predictive modeling to answer business questions and generate insights/outcomes that relate to solving business problems
• Work directly with business stakeholders and leaders to become an "embedded" analytic partner who understands the business and is ready to contribute directly to meeting stakeholder goals
• Lead teams of full time and contract analysts to produce impactful insights in a highly matrixed and fast paced environment

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 advanced level proficiency in SAS, R, or Python (preferred) for data wrangling, automation, and creating statistical and machine learning models
• Requires at least 7 years of prior relevant experience
• Requires expert level skill with SQL, Excel, data visualization (Tableau preferred), query tuning, various database models (normalized / dimensional / data vault / etc.)
• Requires high level of curiosity, superior conceptualization, and problem-solving skills
• Requires proficiency in statistics, regression techniques, text mining, predictive modeling
• Desire at least 5 years of experience in Health Care (managed care, academic, or gov't payer)
• Desire proficiency in agile methodology, confluence, Jira, etc.
• Desire proficiency in cloud-based computing and data platforms (Azure, Google Cloud, BigQuery, Snowflake, DataBricks)
• Desire experience with medical claims payment, payment integrity, corporate recovery, provider operations/relations, provider network management, inventory management, workforce productivity measurement

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.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.