|
|
|
|
Health Data Analysis Senior, Rx Reporting Job
|
 |
If this is a scam, MLM, or Home Based "Opportunity" then Mark as SPAM
|
 |
Thank you for helping! This job will be reviewed by us shortly. Undo
|
| Employer Name: |
SpiderID: 13981512 |
| Location: San Francisco, California |
Date Posted: 4/19/2025 |
| Wage: Negotiable |
Category: Insurance |
| Job Code: 170024N-2191 |
|
Job Description:
 Looking for a chance to do meaningful work that touches millions? Come join the hardest working, nonprofit health plan in California and help us shape the future of health care. Blue Shield of California's Mission is to ensure all Californians have access to high-quality care at an affordable price. Blue Shield is focused on improving health care delivery by working closely with providers and making it more accessible, affordable and customer-centric. Being a mission-driven organization means we do much more than serve our 4 million members: we were the first health plan in the nation to limit our annual net income to 2 percent of revenue and return the difference to our customers and the community, and since 2005 we have contributed more than $325 million to the Blue Shield of California Foundation to improve community health and end domestic violence. We also believe that a healthier California begins with our employees, so we provide them with resources to develop and maintain a healthy lifestyle through our award-winning wellness program, Wellvolution.
We're hiring smart thinkers and doers who want to work for a leader and innovator in the challenging, ever-changing healthcare space. Come and help us make health care better for everyone.
Description:
Job Description:
The Senior Health Data Analyst will be a key analyst within the Pharmacy Analytics and Reporting team to design, develop, maintain, and implement internal data management processes, custom reports and analytic tools/applications to support Blue Shield pharmacy benefit and claims implementation and claims quality processes. The Senior Health Data Analyst will also work with other analysts within the Pharmacy Analytics and Reporting team and cross functionally to meet the business objectives.
Business Unit Overview
Provide an overview of the business unit and describe the purpose of the unit: Describe the context of the role and how it operates within the unit.
The purpose of the Pharmacy Analytics and Reporting team is to develop consultative analytic methods to transform pharmacy data into accurate and meaningful information to meet client requirements, facilitate performance monitoring, and assist with business strategy planning.
Key Pharmacy Analytics & Reporting accountabilities include:
1) Provide consultative analyses and RFP data to support membership growth and retention
2) Conduct trend driver analyses, outcomes reporting and benchmarking to support Cost of Health Care (COHC) trend management and forecast
3) Develop reports to support efficient operations and regulatory requirements
Develop pharmacy data and reporting methods and tools to facilitate pharmacy program and business strategy planning
Key responsibilities include:
1) Leads report development and maintenance and analytic tool development for Medicare Part D Compliance and Commercial Audits.
2) Leads report development and maintenance and analytic tool development for Formulary Strategy.
3) Supports reporting and tool development for Pharmacy Benefit & Claims team.
4) Supports reporting and tool development for Prior Authorization/Drug Utilization Review.
5) Understands the overall business and analytic objectives, recommends and develops proper analytic plan and statistical methods to support the evaluation.
6) Utilizes programming software to efficiently develop process or tools to analyze relevant data from various sources (e.g., claims, membership, operation and other ancillary data sources), interprets and presents analytic results for all ad hoc and ongoing reporting requests.
7) Serves as pharmacy data liaison to key stakeholder areas (e.g., Pharmacy Benefits & Claims, Health Information Technology, and IT/business intelligence) and supports business and strategic project planning and implementation.
8) Develops innovative analyses and reports using understanding of the business need for information. Conducts independent analysis of high complexity under minimal supervision and guidance.
Supports design, implementation and maintenance of data logic and processes to support pharmacy data integration into health data technology platform, online and mobile tools.
Reporting Structure and Job Location
Reporting to the Manager, Rx Operational Analytics, and the Senior Health Data Analyst may be based in our Woodland Hills or San Francisco office.
Qualifications:
Qualification/Education Desired:
- Requires BA/BS degree
- Requires high proficiency data analytic skils with SAS, SQL/PL-SQL, and Microsoft Office (e.g. Access and Excel including VBA).
- Must be able to develop new SAS programs and SQL scripts.
- SAS Certified Base Programmer Credential or equivalent experience required.
- Other data analytic experience is a plus (e.g. Business Objects, Crystal Reports, Unix, Tableau, SAS Visual Analytics, Power BI ).
- Experience with Python or other scripting languages a plus.
- Requires 3-5 years experience in health care (managed care, academic, or government payer).
- Prior experience and demonstrated ability to work with large datasets required.
- Prior experience with pharmacy claims data and familiarity with pharmacy data parameters available for analysis is preferred. Knowledge of medical claims data is a plus.
- Exhibits "can do" attitude and solution-oriented approach to resolve challenges.
- Produces accurate work under tight deadlines.
- Possesses strong collaboration and partnership skills in a matrix work environment.
- Possesses excellent verbal and written communication skills.
Job Criteria:
Start Date:
Position Type: Full-Time Permanent
Years of Experience Required:
Education Required:
Overnight Travel:
Vacation Time:
Contact Information:
| Contact Name: Blue Shield of California |
Company Type: |
| Company: Blue Shield of California |
|
|
|
| City: |
|
| State: |
|
| Zip: |
|
|
|
|
|
|
|