Data Analyst - Health, Senior

Your Role 

The Healthcare Quality and Affordability (HQA) division is responsible for developing analytics and supporting materials to assist and guide strategic development and maintenance of the Blue Shield of California (BSC) network of physicians, hospitals, ambulatory surgery centers, HMO IPA's, and medical groups. Our team, Network Performance Analysis and Contracts (NPAC) is part of the HQA division and focuses on provider network performance analysis, reporting, and consulting.

The Data Analyst – Health, Senior will report to the Manager, Provider Services – Network. In this role you will provide analysis and consultative services across network design, contracting, pricing activities and product planning in alignment with the corporate and network strategy roadmaps. Additionally, you will manage and oversee development and production of regulatory network filing artifacts as required by regulators for all BSC and Promise Health Plan Commercial, Medi-Cal, and Medicare networks. This role delivers network analytics, reporting and oversight on existing networks to ensure meeting regulatory access and availability standards. 

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: 

• Develop and conduct evaluations and studies within limited time frames and produce analyses that are easy for non-technical persons to understand
• 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 in 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
• Independently summarize findings and present data in formats such as Excel pivots, PowerPoint, reports, grids and tables
• Lead and manage projects that may involve coordinating a team and working with different stakeholders
• Manage creation, collection, tracking, and compilation of evidence from internal teams into regulator reports
• Analyze data using a variety of software, provide recommendations based on the results, and present to internal stakeholders
• Adapt to and incorporate state and federal regulatory updates into existing policies, procedures, and assessments
• Maintain and enhance Behavioral Health (BH) network analytics models and tools to support regulatory filings and strategic analyses, ensuring data accuracy and reliability
• Conduct BH network adequacy analyses (time/distance, ratios, access gap identification) and provide insights that guide contracting, network design, and compliance decisions
• Prepare and validate BH data for regulatory submissions, including DHCS, DMHC, CMS, CDI and NCQA required reporting/filings
• Develop dashboards and deliver executive-level insights on BH access, capacity, utilization, claims trends, grievances, and operational stability, supporting governance committees and leadership
   

Your Knowledge and Experience 

• Requires an MPH, MBA, MS, MA in science, social science, public health, health services research or business, or BA/BS with demonstrated equivalent work experience
• Requires 5 years of experience in Health Care (managed care, academic, or government payer)
• Intermediate to Advanced knowledge of MS Excel (able to model, use formula), Access (link tables, run queries)
• Experience with SQL/PL-SQL, SAS is preferred
• Good business acumen, ability to work in a team environment 
• Good math, analytical and problem-solving skills
• Excellent communication (written and verbal) and presentation skills, previous experience in presenting to leaders
• Strong analytical and problem-solving skills 
• Strong presentation skills
• Ability to work independently, proactively, and with little direction

Hybrid

This role requires employees to be in-office based on our hybrid workplace model, balancing purposeful in-person collaboration with flexibility. For most teams, this means coming into office two days each week. Employees living more than 50 miles from an office location will work with their manager to determine in-office time based on business