Data Analyst

Blue Shield of California; Los Angeles (CA); Hybrid; USD 112,000 - 167,000; Full time

Job summary

Blue Shield of California is seeking a Data Analytics Consultant in the HCQA Division to lead network performance analytics and translate regulatory requirements into practical strategies. You will build executive-ready reporting and collaborate across Commercial, Medicare, and Medi-Cal to strengthen member access.

The role emphasizes data-driven insights, rigorous validation, and presentation of complex results to non-technical audiences.

Qualifications

• Bachelor's degree or equivalent in a health, data science, or related field.
• 7+ years in Health Care with data analytics and regulatory reporting.
• Experience developing SAS programs and SQL scripts to improve efficiency.
• Strong MS Office skills, including Excel and Access; Unix and SQL/PL-SQL familiarity.
• Experience with data visualization tools such as Tableau or Power BI.

Responsibilities

• Lead network adequacy and Access & Availability analytics across Commercial, Medicare, and Medi-Cal.
• Translate state and federal requirements into policies, analyses, and compliance assessments.
• Perform complex network analyses to inform strategy, remediation, and expansion.
• Prepare data for regulatory reporting and filings with DMHC, CMS, DHCS, CDI, and NCQA.
• Develop dashboards and executive insights on performance, trends, and compliance risk.
• Collaborate with stakeholders to assess regulatory changes and risk, and implement data-driven solutions.
• Present findings to committees and leadership using Excel, PowerPoint, and visuals.

Skills

Data analysis

Regulatory reporting

Presentation skills

Project management

Stakeholder collaboration

Education

Bachelor's degree in health/related field

MBA / MPH / MS preferred

Tools

SQL

SAS

Power BI

Tableau

Excel

Access

Unix

SQL/PL-SQL

MS Office

Job description

As part of Blue Shield of California’s HCQA Division focused on Network Performance Analysis and Contracts, this role supports regulatory network readiness and member access through data-driven analytics and consultative guidance. The Data Analytics Consultant leads network performance analysis, builds executive-ready reporting, and helps translate state and federal requirements into practical compliance and network strategy.

What you’ll do

• Lead network adequacy and Access & Availability analytics by monitoring provider access, capacity, availability, and compliance across Commercial, Medicare, and Medi-Cal networks.
• Interpret and incorporate state and federal regulatory requirements into network policies, procedures, analytical methodologies, and compliance assessment.
• Perform complex network analyses, including geographic access, provider-to-member ratios, panel status, and access gaps, to inform network strategy, remediation, and expansion efforts.
• Prepare, validate, and oversee data used for regulatory reporting and filings, supporting compliance with DMHC, CMS, DHCS, CDI, and NCQA requirements.
• Develop dashboards, reports, and executive-level insights that convert complex datasets into actionable information on network performance, access trends, compliance risk, and regulatory readiness.
• Collaborate with internal and external stakeholders to assess regulatory changes, identify network and compliance risks, and implement data-driven solutions that strengthen member access.
• Present complex analytical findings clearly to internal and external audiences using Excel pivot tables, PowerPoint presentations, report grids, tables, and other visual formats.
• Use advanced analytics tools including SQL, SAS, Power BI, Tableau, and Excel to identify trends, anomalies, and opportunities for operational improvement.
• Perform data validation, reconciliation, and quality assurance to support accuracy and audit readiness of regulatory submissions and executive reporting.
• Develop and identify trends through scenario-based analyses to evaluate network performance, regulatory impacts, and emerging access risks.
• Translate technical results into clear business insights and recommendations for committees, executive leadership, and non-technical stakeholders.

Required qualifications

• Bachelor’s degree or High School Diploma/GED with 4 years of relevant experience in lieu of a degree.
• At least 7 years of experience in Health Care (managed care, academic, or government payer).
• Ability to develop new SAS programs and SQL scripts to improve the efficiency of others’ work.
• Broad knowledge of project management.
• Experience with MS Office, especially Excel and Access, plus Unix, SQL/PL-SQL, and SAS.
• Familiarity with visualization tools such as Tableau.
• Strong analytics, problem-solving, and presentation skills.
• Excellent time management and organizational skills to manage multiple complex projects simultaneously.

Preferred qualifications

• MPH, MBA, MS, or MA.

Tools and technologies

• SQL, SAS, Power BI, Tableau, Excel, Excel pivot tables, PowerPoint, Unix, SQL/PL-SQL, MS Office, Access

Location and work model

• Woodland Hills, CA (hybrid)
• This role requires in-office time under a hybrid workplace model, with most teams 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.

Background check and equal opportunity

• External hires must pass a background check and drug screen.
• Qualified applicants with arrest and/or conviction records will be considered in accordance with federal, state, and local laws, including the San Francisco Fair Chance Ordinance.
• All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, protected veteran status, disability status, or any other protected classification under applicable laws.

Compensation: USD 111,540 - 167,420 per year.

Minimum experience: 7 years.