Medical Informatics Analyst, Senior
Blue Shield of California · Oakland, California, United States
Your Role
The healthcare economics team devises strategies and supports work to make healthcare affordable through data analysis, cost of healthcare modeling and economic forecasting in a healthcare environment. The medical informatics senior health care economics reports to the senior manager of healthcare economics. The role includes developing insights into healthcare costs, trends, utilization and risks to support strategic decision making.
Your Work
In this role, you will:
- Collect and evaluate data, develop and maintain financial models, analyze results and conduct scenario analyses to estimate cost of healthcare savings and to support cost /benefit analyses to understand the relative benefits of alternative courses of action
- Reconcile data results from different sources and combine them into integrated reports spanning cost, quality, utilization, and risk profile metrics
- Participate in internal workgroups and committees to provide analytical insight and support for the implementation and enhancement of new programs, products, and services
- Collaborate with key operational leaders to establish credible assumptions to support modeling of proposed initiatives to mitigate cost of healthcare trend while maintaining/improving the quality of care
- Analyze data to identify opportunities to improve healthcare quality, reduce costs and enhance member outcomes
- Use AI to gain efficiency around analyzing data, getting insights and creating reporting and presentations
- Present complex actuarial and economic insights to executive leadership and key stakeholders in a clear, actionable manner
- Use deep understanding of underlying business requirements to conceptualize and develop analytical systems that meet important business needs
- Coordinate activities with other internal departments to maximize overall efficiency and resolve conflicts
- Communicate project status, progress, and outcomes to executive management
Your Knowledge and Experience
- Requires a bachelor’s degree or High School Diploma/GED and 4 years of additional relevant experience in lieu of a degree
- Requires 5 years of prior relevant experience
- Prefer at least 5 years of experience in Health Care (managed care, academic, or gov't payer)
- Requires advanced knowledge of healthcare data and managed health plan operations
- Requires strong analytic and problem-solving skills with proficiency in data analysis tools
- Requires excellent communication and presentation skills with the ability to convey complex information to executive leadership and other stakeholders
- Requires ability to deliver moderate-complexity analyses using 3–4 data sources across 3–4 clinical areas, including univariate methods and standard statistical graphics
- Requires experience supporting high-complexity analyses using 5 or more data sources and multivariate methods with cross-department coordination
- Requires the ability to develop production code in SQL/PL-SQL and SAS Base (or equivalent) and produce repeatable reporting outputs in Excel and/or Power BI
- Requires experience using AI to summarize and analyze data, gather insights into data, and create reporting and presentations
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 the 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 need.