What are the responsibilities and job description for the Medical Informatics Analyst, Consultant position at Blue Shield of CA?
Your Role
The Blue Shield of California Growth and Servicing analytics organization is part of the centralized Data and Analytics organization and oversees Channel Analytics including Digital, Marketing, Claims, Appeals, Grievances, Disputes and Line of Business. The Medical Informatics Analyst - Consultant (Medical Specialty Integration) will report to the Senior Manager of Medical Informatics and play a critical role in advancing the health plan's specialty lines of business (dental, vision, and life insurance). This role is strategically designed to focus 70% on analytics and 30% on reporting, emphasizing the use of machine learning models and predictive analytics to drive member acquisition, retention, engagement, and growth, as well as identifying opportunities for cross-selling.
The successful candidate will have a robust understanding of both medical and specialty benefits, a proven ability to leverage existing analytics solutions across benefit types, and a demonstrated capacity to improve operational efficiency through data integration and actionable insights. Passionate about improving member health outcomes through data and analytics, the candidate will actively engage with stakeholders to frame business problems, recommend analytic frameworks, and deliver impactful, high-quality solutions.
A product-oriented mindset and the ability to influence outcomes in a matrixed environment are essential to excel in this role.
Your Knowledge and Experience
- Bachelor's degree in data science, health informatics, statistics, mathematics, economics, engineering or related quantitative fields. Master's degree preferred
- Minimum 7 years of prior relevant experience, and 5 years' experience in Health Care (managed care, academic, or gov't payer)
- 5 years working with Claims and Membership, or similar data strongly preferred.
- Strongly preferred working knowledge of Snowflake, Databricks, RDBMS (Oracle, Netezza etc.)
- Advanced Python, SQL SAS or equivalent skills to interact with data
- Strong experience with machine learning techniques such as classification, clustering, and predictive modeling, especially in member engagement and retention contexts
- Experience with dental, vision, and medical claims data integration and analysis.
- Proven ability to integrate and analyze dental, vision, and medical claims data, providing actionable insights for employer groups and internal stakeholders.
- Familiarity with cross-selling strategies and member engagement techniques in the healthcare space
- Hands-on Experience with data visualization tools (e.g., Tableau, Power BI) to present insights in a clear and actionable manner.
- Excellent communication skills to effectively collaborate with the Specialty LOB team and align analytics initiatives with business strategy
- Demonstrated ability to partner across all levels of staff and adapt quickly to shifting priorities.
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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.
