Medical Informatics Analyst, Senior

Your Role 

The Health Plan Operations Analytics and Reporting team delivers trusted analytics, operational reporting, and self-service dashboard solutions that empower business partners to make informed decisions, optimize performance, reduce costs, identify growth opportunities, and improve the experience of members, providers, and brokers. The Senior Medical Informatics Analyst will report to the Senior Medical Informatics Manager. In this role, you will collaborate with business leaders and analysts across Appeals & Grievances and other operational areas to develop data-driven insights, operational reports, dashboards, and analytical solutions that enable effective decision-making, improve performance, and support key business objectives. 

Responsibilities

Your Work 

In this role you will: 

• Deliver high-complexity analyses independently and develop new analyses and reports
• Translate results into implications and recommendations for business decisions
• Develop and execute workplans and documentation for high-complexity work
• Build and enhance data systems, reports, and analytical processes to improve efficiency and quality
• Lead cross-functional analysis efforts by defining needs, coordinating work, and mentoring junior analysts
• Present findings clearly, validate data and results, and meet deadlines
• Eliminate or transition legacy business reporting solutions into automated sustainable solutions leveraging BI tools or other solutions
• Support and maintain operational reporting needs through automation and creation of self-service options
• Work with and combine large and complex data sets (both internal and external data) to evaluate, recommend, and support the implementation of business strategies or business needs
• Create and automate dashboards to replace manual reporting with visualization integration using Tableau and Power BI

Qualifications

Your Knowledge and Experience 

• Bachelor’s degree or High School Diploma/GED and 4 years of additional relevant experience in lieu of a degree
• 5 years of prior relevant experience. Healthcare and appeals and grievances experience a plus
• Experience programming in Python or equivalent strongly desired
• Advanced SQL, complex joins, subqueries, CTEs, window functions
• Experience in data visualization tools like Power BI and Tableau
• Experience with cloud-based analytics tools like Snowflake or Databricks
• Experience in statistical analytics, modeling/forecasting, machine learning, natural language processing a plus
   

Hybrid

This role requires employees to be in-office based on our hybrid workplace model, balancing purposeful in-person collaboration with flexibility. For most teams, this means coming into the office two days each week.

Employees living more than 50 miles from an office location will work with their manager to determine in-office time based on business need.

About Blue Shield of California

As of January 2025, Blue Shield of California became a subsidiary of Ascendiun. Ascendiun is a nonprofit corporate entity that is the parent to a family of organizations including Blue Shield of California and its subsidiary, Blue Shield of California Promise Health Plan; Altais, a clinical services company; and Stellarus, a company designed to scale healthcare solutions. Together, these organizations are referred to as the Ascendiun Family of Companies. 

At Blue Shield of California, our mission is to create a healthcare system worthy of our family and friends and sustainably affordable. We are transforming health care in a way that genuinely serves our nonprofit mission by lowering costs, improving quality, and enhancing the member and physician experience. 

To achieve our mission, we foster an environment where all employees can thrive and contribute fully to address the needs of the various communities we serve. We are committed to creating and maintaining a supportive workplace that upholds our values and advances our goals.

Blue Shield is a U.S. News Best Company to work for, a Deloitte U.S. Best Managed Company and a Top 100 Inspiring Workplace. We were recognized by Fair360 as a Top Regional Company, and one of the 50 most community-minded companies in the United States by Points of Light. Here at Blue Shield, we strive to make a positive change across our industry and communities – join us!  

Our Values: 

• Honest. We hold ourselves to the highest ethical and integrity standards. We build trust by doing what we say we're going to do and by acknowledging and correcting where we fall short. 
• Human. We strive to listen and communicate effectively, showing empathy by understanding others' perspectives.
• Courageous. We stand up for what we believe in and are committed to the hard work necessary to achieve our ambitious goals. 

Physical Requirements:

Office Environment - roles involving part to full time schedule in Office Environment. Based in our physical offices and work from home office/deskwork - Activity level: Sedentary, frequency most of work day.

Please click here for further physical requirement detail. 

Equal Employment Opportunity:

External hires must pass a background check/drug screen. Qualified applicants with arrest records and/or conviction records will be considered for employment in a manner consistent with Federal, State and local laws, including but not limited to the San Francisco Fair Chance Ordinance. All qualified applicants will receive consideration for employment without regards to race, color, religion, sex, national origin, sexual orientation, gender identity, protected veteran status or disability status and any other classification protected by Federal, State and local laws.