Data Analyst - Health, Consultant

Your Work

Blue Shield of California is seeking a Consultant Lead Analyst in HCQA Division. The Consultant Lead Analyst’s primary responsibility is to guide tactical and strategic actions using the best-in-class analyses and robust analytic tools. The Health Solutions Division is responsible for developing, maintaining, and managing the relationship with Blue Shield's network of physicians, hospitals, ambulatory surgery centers, HMO IPAs, and medical groups.

Our team (Network Performance Analysis and Contracts) is part of the Network Management and Provider Partnerships department and focuses on provider network performance analysis, reporting, and consulting.  The NPAC team is responsible for developing analytics and supporting materials to assist and guide strategic development and maintenance of Blue Shield and Promise Health Plan's (PHP) network of physicians, hospitals, ambulatory surgery centers, HMO IPAs, and medical groups. 

Our team focuses on network design, maintenance, and regulatory support. Some of our key responsibilities are (1) provide analysis and consultative services on new network design in support of corporate strategic roadmap; (2) manages and oversees development and production of regulatory network filing artifacts as required by regulators for all Blue Shield & PHP Commercial, Medi-Cal and Medicare networks; (3) provides network analytics, reporting and oversight on existing networks to ensure meeting regulatory access, availability standards as defined by regulators; and (4) provides consultative and analytical support as needed to during contract negotiations, pricing activities and product/network strategy roadmap planning. 

Your Role

In this role you will:

• Lead, facilitate, and/or drive cross-functional network strategy initiatives as it relates to the end-to-end process; scope inclusive of business, infrastructure and operational changes needed to support the effort. 
• Identify, develop, and implement processes in support of network strategy that enable optimization, efficiency, and standardized reporting/monitoring. 
• Ability to intake requests, provide overall impact assessment with summary and present to upper mgmt. for decision making or prioritization; inclusive of programming needs/code changes, downstream impacts, system/process enhancements, solutions options/scenarios, and identification of any risks/concerns/gaps.  
• Facilitate and manage the roll-out of operational process changes within the team; develop required training documentation, provide mentoring, and facilitate training sessions in support of a successful roll-out. 
• Independently manage projects that may involve coordinating a team and working with different stakeholders.
• Collect, analyze, synthesize, and translate data into insightful and actionable items for internal customers. Summarize findings and presents data in formats such as excel pivots, power point, tableau, reports, grids, and tables. 
• Conduct complete access assessment inclusive of spatial analysis and fill-the-gap producing summaries for network strategy and/or contracting efforts. 
• Participate and collaborate with cross-functional workgroups; support other internal teams such as Contracting, Provider Partnerships, Delegation Oversight, and Provider Operations in developing strategies for improving overall processes, data integrity, and new mandates/regulatory requirements impacting provider networks. 
• Support development of presentations/reports for internal and external customers 
• Ad hoc assignments as requested.

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 7 years of prior relevant experience with at least 5 years of experience in Health Care (managed care, academic, or gov't payer)
• Healthcare analytics experience preferred
• Excellent interpersonal skills, communication and presentation skills, previous experience in presenting to leaders
• Good business acumen, ability to work in a team environment 
• Good math, analytical and problem-solving skills
• Intermediate to Advanced knowledge of MS Excel (able to model, use formula) and Access (link tables, run queries) 
• Tableau and SAS experience preferred 
• Ability to work in a team environment.
• Ability to work independently, proactively and with little direction.