• Job Description

  Req#: 32748263974

  Your Work

  
  

  Blue Shield of California is seeking a Consultant Lead Analyst in HCQA Division. The Consultant Lead Analyst's primary responsibility is to guide tactical and strategic actions using the best-in-class analyses and robust analytic tools. The Health Solutions Division is responsible for developing, maintaining, and managing the relationship with Blue Shield's network of physicians, hospitals, ambulatory surgery centers, HMO IPAs, and medical groups.
  
  Our team (Network Performance Analysis and Contracts) is part of the Network Management and Provider Partnerships department and focuses on provider network performance analysis, reporting, and consulting. The NPAC team is responsible for developing analytics and supporting materials to assist and guide strategic development and maintenance of Blue Shield and Promise Health Plan's (PHP) network of physicians, hospitals, ambulatory surgery centers, HMO IPAs, and medical groups.

  
  

  
  Our team focuses on network design, maintenance, and regulatory support. Some of our key responsibilities are (1) provide analysis and consultative services on new network design in support of corporate strategic roadmap; (2) manages and oversees development and production of regulatory network filing artifacts as required by regulators for all Blue Shield & PHP Commercial, Medi-Cal and Medicare networks; (3) provides network analytics, reporting and oversight on existing networks to ensure meeting regulatory access, availability standards as defined by regulators; and (4) provides consultative and analytical support as needed to during contract negotiations, pricing activities and product/network strategy roadmap planning.

  
  

  Your Knowledge and Experience

  
  

  
  
  • Requires an MPH, MBA, MS, MA in science, social science, public health, health svcs research or business, or BA/BS with demonstrated equivalent work experience
  
  
  • Requires at least 7 years of prior relevant experience with at least 5 years of experience in Health Care (managed care, academic, or gov't payer)
  
  
  • Healthcare analytics experience preferred
  
  
  • Excellent interpersonal skills, communication and presentation skills, previous experience in presenting to leaders
  
  
  • Good business acumen, ability to work in a team environment
  
  
  • Good math, analytical and problem-solving skills
  
  
  • Intermediate to Advanced knowledge of MS Excel (able to model, use formula) and Access (link tables, run queries)
  
  
  • Tableau and SAS experience preferred
  
  
  • Ability to work in a team environment.
  
  
  • Ability to work independently, proactively and with little direction.
  
  

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• About the company

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