Medical Informatics Analyst, Consultant - Oakland, United States - Blue Shield Of California

Description

Your RoleThe Cost of Healthcare Trendsetters & Pharmacy Support team analyzes and provides emerging healthcare cost trend drivers. The Medical Informatics Analyst IV will report to the Actuarial Manager.

Your WorkIn this role, you will:

Conduct independent analysis of high complexity under minimal supervision and guidanceDevelop analytical methods so that they may be subsequently delegated for production to Medical Informatics Analysts at lower levelsProduce analysis of high complexity under the guidance and direction of the Actuarial ManagerDevelop documentation and create and execute workplans for analyses of high complexity.

Workplans may coordinate the activities of analysts at lower levels and may involve collaboration with more than one teamProvide training and mentoring for team members on best practices for analysis and reporting; assist in the development of supplemental analytic training tools and materials; conducts formal training sessions for lower level analysts and analysts in other DepartmentsHave overall responsibility and accountability for leading and managing pharmacy support work products related to target setting, reconciliation, and reporting (internal and/or external) for Pharmacy related programs.

Lead and/or support other general program operations work, ranging from savings projection, accrual setting, addressing data issues and developing solutions, executing program renewals/conversions, iterative model design changes, improving and streamlining operations efficiencyDirect, coordinate, and/or develop evaluation and financial reporting standards for internal and external reportsLead, coordinate and/or develop strategic, market and competitive analysisEnsure team follows existing, validates, and/or develops new work-flow procedures or policiesYour Knowledge and ExperienceRequires 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 experienceRequires SAS Certified Base Programmer Credential or equivalent and SAS Certified Advanced Programmer Credential or equivalentRequires at least 7 years of prior relevant experienceRequires at least 5 years of experience in Health Care (managed care, academic, or gov't payer)

Requires health insurance data background including ICD-10 codes, utilization measurement, and service type categorizationPrior experience related to pharmacy claim data preferablePay Range:
The pay range for this role is: $ to $ 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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