Data Analyst - Health, Principal

Your Role

The Healthcare Quality Affordability (HQA) Analytics team plays a key role in discovering information hidden in vast amounts of data that can lead to smarter decisions and deliver better service for our customers and contain the rising cost of healthcare. The Data Analyst – Health, Principal will report to the Sr. Manager, HQA Analytics. In this role you will focus on strategic partnerships with our stakeholders, reporting and business analysis of performance primarily focused on the HMO line of business (ACO, Medicare, Medi-Cal). You will collaborate with our provider performance enablement leaders, helping them understand support needs, define/drive strategy and priorities leveraging data and analytics solutions to support strategic and operational objectives.

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:

• Operate at a strategic business level to ensure projects/programs are in line with Blue Shield of California strategic goals
• Review IPA and Hospital performance metrics and gather insights and recommendations for our internal and external stakeholders to achieve optimal member cost and utilization outcomes
• Consult with appropriate internal partners on issues and interpretations of the DOFR’s Risk assignment and fully understand the linkages between Benefits, Contracts and Claims
• Work cross-functionally with Actuary, Medical Care Solutions, Data & Analytics, Finance, Quality, Revenue Enhancement, Pharmacy and Network Management to enable a 360 review of all facets of a provider’s performance profile
• Collaborate closely with the Regional Medical Directors and clinicians and recommend strategic action for improving costs and use of healthcare 
• Develop strong, strategic partnership with internal and external stakeholders
• Utilize and recommend enhancements to existing self-service reporting solutions
• Understand the data structures and sources, and the use of analytical or statistical tools to create meaningful insights that drive strategic action and results
• Design, develop, and maintain interactive dashboards and data visualizations using Tableau and Power BI to support business insights and decision-making

Your Knowledge and Experience

• Requires a MPH, MBA, MS, MA in science, social science, public health, MIS, computer science, data science, health services research or business, or BA/BS with demonstrated equivalent work experience
• Requires 10 years of experience in Health Care (managed care, academic, or government payer)
• Ability to function independently and produce results that meet standards of quality, timeliness, and acceptability
• Problem-solving skills balanced between “analytical” and “intuitive” 
• Ability to thrive in ambiguous situations
• Excellent verbal and written communication skills and the ability to interact professionally with a diverse group of executives, directors, managers, and subject matter experts
• Ability to establish and maintain effective and collaborative relationships with key stakeholders
• Advanced skills using Microsoft Excel, Word, Visio, and PowerPoint in preparing and making presentations to various levels of management.  Proficient at using MS Project
• Technically proficient having broad background in problem solving tools
• Knowledge of Blue Shield of CA or similar health care organization structure
• Extensive knowledge of CPT, HCPCS, ICD-10s and other related industry codes