Medical Informatics Analyst, Consultant

Your Role

The Data & Analytics (D&A) team partners with enterprise-wide business stakeholders to apply the power of data & analytics to deliver new insights and data-driven solutions to accelerate business outcomes. The Pharmacy Analytics Consultant will report to the Senior Manager of Pharmacy Analytics and is responsible for working with key stakeholders from Pharmacy Services and others to be the D&A partner in accelerating and achieving business objectives and operations. This critical analytics team collaborates with other analytical and business teams and delivers analytical insights to power the business forward.

This role requires not only in-depth knowledge of the pharmacy claims data domain, but also a broad understanding of the business and business levers that matter. Being able to act as a "two-in-a-box" partner with business stakeholders is critical. Our leadership model is about developing great leaders at all levels and creating opportunities for our people to grow - personally, professionally, and financially. We are looking for leaders that are energized by creative and critical thinking, building, and sustaining high-performing teams, getting results the right way, and fostering continuous learning.

Your Work

In this role, you will:

• Partner with Pharmacy Services team as a data analytics subject matter expert to address data needs to support pharmacy operational, strategic and compliance needs.
• Design, develop, and support analytical solutions for Pharmacy Care Reimagined programs.
• Provide pharmacy and prescription drug data expertise to cloud migration teams.
• Implement data quality rules necessary to ensure timely and accurate delivery of reports.
• Perform data exploration using a combination of statistical programming languages (including, but not limited R, Python, SQL, SAS) and deploy predictive analytics and machine learning techniques to improve risk prediction, improve reserve, trend and financial forecasting in a manner that is actuarially sound, and enable real-time results and operational efficiencies.
• Support internal and external pharmacy data needs, including but not limited to, report automation, in-depth drill down on report reconciliations, research and development of rebate allocation methodologies, cost of healthcare modeling, and customized reporting solutions.
• Effectively translate business problem and/or requirements into an analytical approach and present findings (analytical, reports, and presentations) to stakeholders critical for their business continuity and decision making.
• Assess business risks associated with analytical processes and data systems, and develop strategies to mitigate risks.
• Evaluate analytic results, prepare presentation materials, and make recommendations that clearly and succinctly convey results and their business significance to appropriate audiences to inform effective decision-making.
• Use appropriate technical, business, and financial knowledge to assess the completeness and reliability of data and the validity and accuracy of analytical results.
• Perform other functions as needed.
• Manage medium to large sized projects (or multiple projects) spanning across business areas

Your Knowledge and Experience

• Requires an MPH, MBA, MS, MA, RN, or RHIA in health science, quantitative social science, public health, health services research or business, or BA/BS with demonstrated equivalent work experience
• Requires at least 7 years of prior relevant experience
• At least 5 years of experience in Health Care (pharmacy, managed care, academic, or government payer)
• SAS certification or equivalent experience required
• Demonstrated critical-thinking, analytical, and thought leadership skills
• Experience in translating business problems into analytical approaches
• Current working knowledge of SQL and Excel strongly preferred
• Tableau experience strongly preferred
• Python experience preferred
• Previous project management experience preferred.

Pay Range:

The pay range for this role is: $ 118800.00 to $ 178200.00 for California.

Notes:

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.