Your Role

The Medi-Cal Analytics team supports the Medi-Cal Business Unit. The Medical Informatics Analyst, Consultant will report to the Senior Manager, Medical Informatics. In this role you will support compliance & regulatory reporting, mandated projects, and clinical key indicators for Medi-Cal and Dual -Special Need Program (D-SNP).

Your Work

In this role, you will:

• Conduct independent analysis of high complexity under minimal supervision and guidance
• Develop analytical methods so that they may be subsequently delegated for production to Medical Informatics Analysts at lower levels
• Produce analysis of high complexity under the guidance and direction of Medical Informatics Analyst V, supervisor, or manager
• Develop documentation and create and execute workplans for analyses of high complexity. Workplans may coordinate the activities of Medical Informatics Analysts at lower levels and may involve collaboration with more than one team
• Provide 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 Departments
• Assist in identifying systems and operational problems and recommend solutions and changes to streamline procedures for more effective reporting
• Support design, implementation and maintenance of data logic and processes to support Medi-Cal data integration into health data technology platform
• Responible to create system QA processes and documentation
• Prepare complex reports and studies for a variety of uses including cost of health care analysis, quality improvement, enhancing operations and addressing identified issues
• Utilize programming software to efficiently develop process or tools to analyze relevant data from various sources (e.g., claims, membership, provider, financial, operation and other ancillary data sources), interpret and present analytic results for all ad hoc and ongoing reporting requests

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 7 years of prior relevant experience
• Requires at least 5 years of experience in Health Care (managed care, academic, or gov't payer)
• Ability to work with all clinical coding systems (e.g., ICD10, CPT, DRG, LOINC, RxHUB)
• Insight of Managed Care, Medi-Cal/Medicaid and coordination of Care.
• Excellent verbal and written communication and presentation skills
• Prepares complex reports and studies for a variety of use cases, including cost of health care analysis, quality improvement, enhancing operations and addressing identified issues.
• Practical knowledge of agile and project management skills
• Excellent verbal and written communication and presentation skills

Pay Range:

The pay range for this role is: $ 118800.00 to $ 178200.00 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.