Medical Informatics Analyst, Principal

Company: Blue Shield of California
Location: Oakland
Posted on: May 10, 2025

Job Description:

Your Role The Network and Trend Analytics (NTA) team supports the Network Management team with analytical and financial modeling for provider contracting and network development activities for Blue Shield of California. The Medical Informatics Analyst, Principal will report to the Senior Director of NTA. In this role you will be responsible for the optimization of Blue Shield's provider networks. This will include making recommendations to include or exclude certain providers based on the latest competitive dynamics. We are looking for professionals that are energized by creative and critical thinking, getting results the right way, and fostering continuous learning. Your Work In this role, you will:

• Use deep understanding of underlying business requirements to conceptualize and develop analytical systems that meet important business needs
• Design and develop these systems so that they can be used by lower-level analysts thereby promoting company-wide efficiencies
• Coordinate activities with other internal departments to maximize overall efficiency and resolve conflicts
• Communicate project status, progress, and outcomes to executive management
• Fulfill a leadership role in the critical review and ongoing development of data management and analytical systems for strategically important enterprise-wide analysis and reporting
• Be able to communicate effectively with Blue Shield business leaders on network optimization recommendations
• Be responsible for maintaining the provider network relative cost database
• Be responsible for building and maintaining provider competitive intelligence from publicly available sources such as Machine-Readable Files (MRF) Transparency data
• Be responsible for the creation and maintenance of network optimization financial models
• Have 1 associate level staff reporting to directly to you and will be responsible for their training and development
  
  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 SAS Certified Base Programmer Credential or equivalent and SAS Certified Advanced Programmer Credential or equivalent
  • Requires at least 10 years of prior relevant experience
  • Requires at least 5 years of experience in Health Care (managed care, academic, or gov't payer)
  • Requires extensive knowledge of provider contracting analytics
  • Requires deep understanding of network configuration
  • Requires excellent communication skills, both written and verbal

Keywords: Blue Shield of California, Cupertino , Medical Informatics Analyst, Principal, Professions , Oakland, California