Your Role
The Actuarial Provider Strategies team support the design and analytical operations of Blue Shield of California’s value-based care strategy. The Medical Informatics Analyst, Principal will report to the Senior Director of Actuarial Provider Strategies. In this role you will have responsibility evaluating the performance of Blue Shield of California’s value-based care models, including cost, utilization and quality assessment.
Your Work
In this role, you will:
- Understand the core principles and functionality underlying decision, descriptive, predictive, and prescriptive advanced analytic methods
- Perform data evaluation using a combination of statistical programming languages (including, but not limited R, Python, SQL, SAS)
- Lead the evaluation studies, from planning, alignment with stakeholders, data gathering, analysis, review, communication, to write-up.
- Have overall responsibility and accountability for completion of sound evaluation studies that review important aspects of value-based care with organized and clear data insights and leading and managing the day- to-day work related to data gathering, deploying statistical methodology for outcome assessment, and the deliverables.
- Be responsible for establishing and maintaining relationships with internal stakeholders and external partners to deliver aligned and clear deliverable outcomes.
- Deeply partner with internal and external value-based care SMEs to understand the principals of value-based care, the details of model designs, and the objectives and goals of the models.
- Have accountability to produce final evaluation deliverables encompassing cost, utilization and quality assessment and synthesize the results for general audience’s understanding for all of Blue Shield of California’s value-based care models. This can be done via presentations, memos, external publications, or all of the above.
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 proficiency in statistical and actuarial risk normalization methods
- Requires experience working with quality data and assessment preferable
- Requires strong writing skills to summarize the results of the evaluation studies concisely for both internal and external audience
- Requires strong ability to communicate complex technical subjects to non-technical audiences
- Requires strong project management skills
- Requires strong problem-solving skills, self-motivation, detail orientation and critical thinking skills
- Experience related to value-based care or evaluation analytics preferable