Medical Informatics Analyst, Senior at Blue Shield of CA in Oakland, California

Job Description:

Job Summary

Supports corporate and departmental strategies and goals for the annual HEDIS submission process. Effectively applies business knowledge and technical expertise to support the business initiatives to report clinical quality of care received by members. The analyst will collect data from various internal systems (example Claims processing or membership systems) and external systems (EMR/EHR) and converts those data to actionable insights to guide business decision making for BSC populations' health management and quality of care. This position may also be involved in providing insights for provider network design and strategies.

Responsibilities

• Conducts analysis of moderate complexity and develops reports with guidance from manager and peers.


• Communicates analytical results in graphs or summaries to various stakeholders.


• Prepares presentation materials that clearly convey information to appropriate internal and external Blue Shield audiences.


• Designs, builds, and enhances data systems and applications so that they better serve specific reporting requirements.


• Assist to develop documentation for all new and existing SAS programs.


• Reviews and revises existing analytical processes for accuracy and efficiency.


• Identifies existing inefficiencies and problems and takes action to implement solutions.


• Assists junior team members through peer review, informal training, or mentoring.


• Seeks and provides advice to analysts in other departments and business units regarding standardization of business rules and methods for analysis and reporting.


• Produces accurate results under tight deadlines.


• Continuously refines and expands the technical, clinical, and financial content knowledge required to successfully complete these duties.


• Develops, implements, and documents quality assurance (QA) processes to ensure that reported data is accurate and reliable.


• Recommends and implements solutions for identified problems/root cause pertaining to clinical data used for HEDIS reporting.


• Provide advanced analytical support for business operations in all or some of the following areas: claims, provider data, member data, clinical data, HEDIS, pharmacy, or, external reporting


• Contributes to team success by accomplishing tasks as needed.

Knowledge and Experience

• Bachelor's degree required or master's preferred.


• 5+ years of health informatics/analysis.


• Experience working with HEDIS analytics and data.


• Managed care experience strongly preferred, preferably health plan data.


• Experience working with EMR/EHR data preferred.


• Quality improvement experience preferred.


• SAS Certification preferred.


• Advance Oracle / SQL desired.


• Advanced SAS data step, SAS macro language, and other SAS procedures required.


• Superior analytical skills required.


• Experience working with Clinical Quality data.


• Experience working with RDBMS: Oracle, Netezza, DB2 etc.


• Ability to document processes. Excellent technical, interpersonal, written and oral communication skills required.


• Proficient in MS Office.


• Individual should be self-starter motivated to correctly interpret business needs, possesses strong problem-solving skills, as well as technical expertise needed to do hands-on data analysis, research and programming work.


• Experience and ability to utilize a certified HEDIS software.


• Experience developing dashboard in Tableau is a plus.

Additional Information

• About Company: At Blue Shield of California we are parents, leader, students, visionaries, heroes, and providers. Everyday we come together striving to fulfill our mission, to ensure all Californians have access to high-quality health care at a sustainably affordable price. For more than 80 years, Blue Shield of California has been dedicated to transforming health care by making it more accessible, cost-effective, and customer-centric. We are a not-for-profit, independent member of the Blue Cross Blue Shield Association with 6,800 employees, more than $20 billion in annual revenue and 4.3 million members. The company has contributed more than $500 million to Blue Shield of California Foundation since 2002 to have a positive impact on California communities. Blue Shield of California is headquartered in Oakland, California with 18 additional locations including Sacramento, Los Angeles, and San Diego. Weare excited to share Blue Shield of California has received awards and recognition for a" LGBT diversity, quality improvement, most influential women in corporate America, Bay Areaas top companies in volunteering & giving, and one of the worldas most ethical companies. Here at Blue Shield of California, weare striving to make a positive change across our industry and the communities we live in a" Join us!










• Physical Requirements: Office Environment - roles involving part to full time schedule in Office Environment. Based in our physical offices and work from home office/deskwork - Activity level: Sedentary, frequency most of work day.
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• EEO Footer: External hires must pass a background check/drug screen. Qualified applicants with arrest records and/or conviction records will be considered for employment in a manner consistent with Federal, State and local laws, including but not limited to the San Francisco Fair Chance Ordinance. All qualified applicants will receive consideration for employment without regards to race, color, religion, sex, national origin, sexual orientation, gender identity, protected veteran status or disability status and any other classification protected by Federal, State and local laws.











• Requisition ID: 210025J













• Posting Date: Jul 24, 2021











• Schedule: Full-time

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