What are the responsibilities and job description for the Data Analyst - Health, Principal position at Blue Shield Of California?
Job Description
Your Role
The Clinical Quality team is accountable for the quality ratings of the organization, for improving preventive care outcomes for Blue Shield of California's Commercial members and for managing financial risks associated with Quality performance. The Health Data Analyst for Clinical Quality (Principal) will report to the Director of Clinical Quality. In this role you will drive ratings achievement strategy, build outcomes forecasts for quality interventions and regional support models, and develop the measurement strategy for five Commercial lines of Business. This includes accountability for data models, analysis and recommendations based on the National Committee for Quality Assurance (NCQA) STAR ratings, HEDIS and CAHPS measures. This role also develops predictive modeling techniques for preventive care patterns.
Responsibilities
Your Work
In this role, you will :
- Develop and conduct evaluations and studies within limited time frames and produce analyses that are easy for non-technical persons to understand
- Apply advanced statistical methods, advanced analytics and modeling techniques, visualization techniques, and advanced programming to innovate our products and services
- Identify how our customers are accessing our provider networks to make strategic decisions and generate / implement ideas to improve our services and enable decision support
- Work with cross-functional partners to engineer new services / analytics that improve member satisfaction and access to preventive care; estimate the resources needed and provide planning and support for innovation
- Conduct proof of concept using techniques that can quickly contemplate the viability of a change in service, network or quality intervention
- Manipulate large, structured and unstructured data sets to develop quality ratings and operational insights for Senior / Executive Management review
- Create predictive models with new / emerging data sets relying on input from a variety of public health and research inputs and build new analytic bridges between claims, encounter and supplemental data sources
- Work cross-functionally with utilization, pharmacy, transformation, quality, product and other cross-functional teams to support root cause analysis, quantitative data analysis and interpretation, annual strategic planning, and return-on-investment (ROI) calculations
- Use evaluations and analysis to inform quality strategy, quality operations planning, execution around process improvements for the organization, its provider networks, member and provider incentive designs, and member engagement services
- Ensure compliance with regulatory, purchaser and accreditation requirements to provide the most equitable preventive care and services offered in the market
Qualifications
Your Knowledge and Experience
Pay Range
The pay range for this role is : $ 136400.00 to $ 204600.00 for California.
Note
Please note that this range represents the pay range for this and many other positions at Blue Shield that fall into this pay grade. Blue Shield salaries are based on a variety of factors, including the candidate's experience, location (California, Bay area, or outside California), and current employee salaries for similar roles.
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About the Team
Blue Shield of California's mission is to ensure all Californians have access to high-quality health care at a sustainably affordable price. We are transforming health care in a way that genuinely serves our nonprofit mission by lowering costs, improving quality, and enhancing the member and physician experience.
To fulfill our mission, we must ensure a diverse, equitable, and inclusive environment where all employees can be their authentic selves and fully contribute to meet the needs of the multifaceted communities we serve. Our continued commitment to diversity, equity, and inclusion upholds our values and advances our goal of creating a healthcare system that is worthy of our family and friends while addressing health disparities, promoting social justice, and integrating health equity through our products, business practices, and presence as a corporate citizen.
Blue Shield has received awards and recognition for being a certified Fortune 100 Best Companies to Work, Military Friendly Employer, People Companies that Care, a Leading Disability Employer, and one of California's top companies in volunteering and giving. Here at Blue Shield, we strive to make a positive change across our industry and communities - join us!
Our Values :
Our Workplace Model :
At Blue Shield of California, we believe in fostering a workplace environment that balances purposeful in-person collaboration with flexibility. As we continue to evolve our workplace model, our focus remains on creating spaces where our people can connect with purpose - whether working in the office or through a hybrid approach - by providing clear expectations while respecting the diverse needs of our workforce.
Two Ways of Working :
Member-facing and approved out-of-state roles remain remote.
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.
Please click here for further physical requirement detail.
Equal Employment Opportunity :
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.
Salary : $136,400 - $204,600
