Business and Data Analysis
Information Technology
21002RH Requisition #

Blue Shield of California’s mission is to ensure all Californians have access to high-quality health care at a sustainably affordable price. We are transforming health care in a way that truly serves our nonprofit mission by lowering costs, improving quality, and enhancing the member and physician experience.

To fulfill our mission, we must ensure a diverse, equitable, and inclusive environment where all employees can be their authentic selves and fully contribute to meet the needs of the multifaceted communities we serve. Our comprehensive approach to diversity, equity, and inclusion combines a focus on our people, processes, and systems with a deep commitment to promoting social justice and health equity through our products, business practices, and presence as a corporate citizen.

Blue Shield has received awards and recognition for being a certified Great Place to Work, best place to work for LGBTQ equality, leading disability employer, one of the best companies for women to advance, Bay Area’s top companies in volunteering & giving, and one of the world’s most ethical companies. Here at Blue Shield of California, we are striving to make a positive change across our industry and the communities we live in – join us!


Your Role

The Medical Management Analytics team supports the Utilization Management and Care Management operations with reporting tools to monitor operational performance, evaluate effectiveness of program, and regulatory reporting to demonstrate compliance. The Senior Business Analyst will report to the Senior Manager of Medical Management Analytics. In this role you will develop reporting strategy to enable the business to monitor operational performance, conduct analysis to evaluate performance, generate reports to fulfill regulatory reporting requirements, and engage in discussions with stakeholders to develop initiatives to streamline operations or implement new programs.


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

  • Assist in identifying systems and operational problems and recommend solutions and changes to streamline procedures for more effective reporting 

  • 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

  • Create process to extract data, synthesize data, conduct and interpret quantitative and qualitative analysis into actionable insights

  • Develop surveillance models to detect emerging utilization of services that deviate from evidence-based care guidelines to inform optimal cost control strategies

  • Manage and prioritize workload while meeting deliverables and expectations in a timely manner

  • Function of role requires the ability to understand broad spectrum of issues. Problems typically involve considerations of multiple dependencies including business process, data infrastructure, business rules, and general industry knowledge of healthcare administration

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)

  • Must be able to develop and modify SQL scripts and be able to wrangle large datasets, join multiple datasets. Preferred working experience with SAS

  • Must be able to create data visualizations to effectively narrate an actionable data story. Preferred working experience with Tableau Desktop, Power BI, or Business Objects.

  • Practical knowledge of agile or project management skills

  • Requires practical knowledge of job area typically obtained through advance education combined with experience within managed care

  • Understanding of payor relationship and managed care principles

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 be our authentic selves, listening and communicating effectively, and showing empathy towards others by walking in their shoes

  • Courageous. We stand up for what we believe in and are committed to the hard work necessary to achieve our ambitious goals

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