Medical Informatics Analyst, Principal at Blue Shield of California

Your Role

The Data & Analytics (D&A) team partners with enterprise-wide business stakeholders to apply the power of data & analytics to deliver new insights and data-driven solutions to accelerate business outcomes.  The Pharmacy Analytics Principal will report to the Senior Manager of Pharmacy Analytics and is responsible for working with key stakeholders from Pharmacy Services and others to be the D&A partner in accelerating and achieving business objectives and operations.  This critical analytics team collaborates with other analytical and business teams and delivers analytical insights to power the business forward. This role requires not only in-depth knowledge of pharmacy claims data domain, but also a broad understanding of the business and business levers that matter.   Being able to act as a “two-in-a-box" partner with business stakeholders is critical.  

This role must be adept at "translating" the business problem and/or requirements into an analytical approach and requires not only in-depth knowledge of the pharmacy claims data domain, but also a broad understanding of the business and business levers that matter.  Being able to act as a “two-in-a-box" partner with business stakeholders is critical. Our leadership model is about developing great leaders at all levels and creating opportunities for our people to grow – personally, professionally, and financially. We are looking for leaders that are energized by creative and critical thinking, building, and sustaining high-performing teams, getting results the right way, and fostering continuous learning.

Your Work

In this role, you will:

• Partner with Pharmacy Services team as a data analytics subject matter expert to address data needs to support pharmacy operational, strategic and compliance needs.
• Design, develop and lead analytical solutions for Pharmacy Care Reimagined programs.
• Provide pharmacy and prescription drug data expertise to cloud migration teams.
• Implement data quality rules necessary to ensure timely and accurate delivery of reports.
• Provide pharmacy and prescription drug data expertise to cloud migration teams.
• Perform data exploration using a combination of statistical programming languages (including, but not limited R, Python, SQL, SAS) and deploy predictive analytics and machine learning techniques to improve risk prediction, improve reserve, trend and financial forecasting in a manner that is actuarially sound, and enable real-time results and operational efficiencies.
• Support cost of health care pharmacy analyses to assist in the development of complex cost of health care formulations leading to the recommendation of savings and budgeting. 
• Support development of budget/trend impact models and formulary strategy models for high impact pharmacy initiatives. 
• Work closely with stakeholders on report development and automation, in-depth drill down on the report reconciliations, research, and development of rebate allocation methodologies
• Lead research and development of new analyses, operation process improvement, and internal quality control and perform other analytics duties as required
• Evaluate analytic results, prepare presentation materials, and make recommendations that clearly and succinctly convey results and their business significance to appropriate audiences to inform effective decision-making.
• Review, update, and enhance existing analytic processes to improve efficiencies and quality.
• Manage large sized projects (or multiple projects) spanning across business areas
• Oversee projects and provide training and mentoring for team members on best practices for analysis and reporting.
• Consults and makes recommendations to senior management/executives on significant issues.
• Work closely with Senior Manager to drive adoption of analytical products developed.
• Perform other functions as needed. 

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 at least 10 years of prior relevant experience inclusive of at least 3 years of experience in Health Care (pharmacy, managed care, academic, government payer, or pharmacy) preferred
• Demonstrated critical-thinking, analytical, and thought leadership skills
• Experience in translating business problems into analytical approaches
• Current working knowledge of SQL and Excel strongly preferred
• SAS Certification or equivalent experience required
• Tableau experience strongly preferred
• Cloud data experience preferred
• Python experience preferred
• Experience with finance modeling preferred
• Previous program management experience preferred

Pay Range:

The pay range for this role is: $ 145970.00 to $ 218900.00 for California.

Notes:

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.