What are the responsibilities and job description for the Medical Informatics Analyst, Consultant position at Blue Shield of CA?
Your Role
The Medi-Cal Analytics team supports the Medi-Cal Business Unit. The Medical Informatics Analyst - Consultant will report to the Senior Manager, Medical Informatics and will have a dotted reported line to the Special Populations Unit, that is part of the Office of the Chief Medical Officer. In this role, you will support operational, compliance & regulatory reporting, mandated projects, and clinical key indicators, partnering closely with a large set of clinical and non-clinical teams focused on Utilization Management, Enrollment, Population Health Management, Claims Network and other areas. The Special Populations Unit (SPU) ensures effective oversight and monitoring of vulnerable groups identified by CalAIM, advancing equitable access to care and improving health outcomes. Through cross-functional collaboration and data-driven strategies, we advocate for inclusive, person-centered solutions that promote the well-being of those we serve.
Your Knowledge and Experience
- Requires a BA/BS with demonstrated equivalent work experience
- Requires at least 7 years of prior relevant experience
- Requires at least 5 years of experience in Health Care (managed care, academic, or gov't payer)
- Must be able to develop and modify SQL and SAS scripts and be able to wrangle large datasets, join multiple datasets. Strong working experience in SAS.
- Ability to work with all clinical coding systems
- Insight of Managed Care, Medi-Cal/Medicaid and coordination of Care.
- Excellent verbal and written communication and presentation skills
- Prepares complex reports and studies for a variety of use cases, including cost of healthcare analysis, quality improvement, enhancing operations and addressing identified issues.
- Practical knowledge of agile and project management skill
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.
