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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 truly 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 comprehensive approach to diversity, equity, and inclusion combines a focus on our people, processes, and systems with a deep commitment to promoting social justice and health equity through our products, business practices, and presence as a corporate citizen.
Blue Shield has received awards and recognition for being a certified Great Place to Work, best place to work for LGBTQ equality, leading disability employer, one of the best companies for women to advance, Bay Area’s top companies in volunteering & giving, and one of the world’s most ethical companies. Here at Blue Shield of California, we are striving to make a positive change across our industry and the communities we live in – join us!
Your Role
The Clinical Quality Analytics team produces analytics and reports to help drive improvement in clinical quality measures and clinical quality review for Blue Shield of California and our medical groups and hospitals. The Senior Medical Informatics Analyst will report to the Clinical Quality Analytics Supervisor. In this role you will process, analyze, and produce reports monitoring the organization’s performance on clinical quality review and measures including HEDIS.
Your Work
In this role, you will:
- Conduct independent analysis of high complexity under moderate supervision and guidance, develop novel analyses and reports
- Develop documentation and create and execute workplans for analyses of high complexity
- Produce analysis of high complexity under the guidance and direction of Medical Informatics Analyst IV/V, supervisor or manager
- Design, build, and enhance data systems and applications so that they better serve specific reporting requirements
- Identify business risks relating to report design and production
- Develop innovative analysis and reports using understanding of the business need for information
- Understand the overall business and analytic objectives, recommends and develops proper analytic plan and statistical methods to support the evaluation
- Assist in the improvement in the design, analytics and production of reports
- Seek and provide advice to analysts in other departments and business units regarding standardization of business rules and methods for analysis and reporting
- Data extraction from corporate data warehouse and data marts
Your Knowledge and Experience
- Requires an MPH, MBA, MS, MA in health science, quantitative social science, public health, health services research or business, or BA/BS with demonstrated equivalent work experience
- Requires SAS Certified Base Programmer Credential or equivalent
- Requires at least 5 years of prior relevant experience
- Requires at least 3 years of experience in Health Care (managed care, academic, or gov’t payer)
- Desired experience with Visual Analytic tools (Tableau)
- Desired experience with heath care quality measures, especially HEDIS, and/or hospital based core measures
- Mastery of at least two of the following: clinical coding, large-scale health databases, health statistics (e.g., epidemiology or health services), health insurance business principles. Must have sufficient familiarity with the technical and clinical concepts necessary to adequately perform the duties described above
- Must exhibit level-appropriate competence in Departmental competency dimensions (Communication, Agile Learning, Business Knowledge, Creativity, Critical Thinking, Customer Focus, Drive for Results)
- Capable of managing deadlines and working simultaneously on a variety of tasks
Our Values
- Honest. We hold ourselves to the highest ethical and integrity standards. We build trust by doing what we say we’re going to do and by acknowledging and correcting where we fall short
- Human. We strive to be our authentic selves, listening and communicating effectively, and showing empathy towards others by walking in their shoes
- Courageous. We stand up for what we believe in and are committed to the hard work necessary to achieve our ambitious goals