Data Analyst - Health, Consultant

Blue Shield of CA; Springfield Meadows (CA); Hybrid; USD 110,000 - 150,000; Full time

Job summary

Blue Shield of California is seeking a Data Analytics Consultant within the HCQA division to support network performance analysis and regulatory readiness. You will drive analytics to inform strategic design for physician networks, hospitals, and medical groups, and oversee regulatory filing artifacts as required by regulators.

The role partners with contract negotiations, pricing activities and product/network strategy, delivering actionable insights.

Qualifications

• Bachelor's degree or equivalent with 4 years of relevant experience
• 7+ years in Health Care (managed care, academic, or gov't payer)
• Proficiency developing SAS programs and SQL scripts
• Knowledge of project management principles and practices
• Experience with Excel and Access; SQL/PL-SQL; SAS
• Familiarity with Tableau for visualization
• Strong analytics, problem-solving, and presentation skills

Responsibilities

• Provide analysis and consultative services on new network design aligning with strategic roadmap
• Oversee development and production of regulatory network filing artifacts for Commercial, Medi-Cal and Medicare networks
• Deliver network analytics, reporting and oversight to meet regulatory access and availability standards
• Support contract negotiations, pricing activities and product/network strategy planning

Skills

SQL scripting

SAS programming

Project management

Tableau

Excel

Access

Unix

Data visualization

Strong analytics

Presentation skills

Education

Bachelor's degree or equivalent

MPH

MBA

MS

Tools

Tableau

SAS

SQL/PL-SQL

MS Office

Excel

Access

Unix

Job description

Your Role

The HCQA team is responsible for developing analytics and supporting materials to assist and guide strategic development and maintenance of Blue Shield's network of physicians, hospitals, ambulatory surgery centers, HMO IPA's, and medical groups. Our team (Network Performance Analysis and Contracts) is part of the HCQA Division and focuses on provider network performance analysis, reporting, and consulting. The NPAC team is responsible for developing analytics and supporting materials to assist and guide strategic development and maintenance of Blue Shield's network of physicians, hospitals, ambulatory surgery centers, HMO IPA's, and medical groups. In this role you will (1) provide analysis and consultative services on new network design in support of corporate strategic roadmap; (2) manages and oversees development and production of regulatory network filing artifacts as required by regulators for all Blue Shield and Promise Health Plan Commercial, Medi-Cal and Medicare networks; (3) provides network analytics, reporting and oversight on existing networks to ensure meeting regulatory access, availability standards as defined by regulators; and (4) provides consultative and analytical support as needed to during contract negotiations, pricing activities and product/network strategy roadmap planning. The Data Analytics Consultant will report to the Manager. This role serves as a critical analytical and strategic partner to the organization, connecting network performance data with regulatory requirements and business priorities. Your ability to identify access trends, communicate meaningful insights, and collaborate across teams will help drive regulatory readiness, strengthen network performance, and support sustainable solutions for member access.

Your Knowledge and Experience

• Bachelor's degree or High School Diploma/GED and 4 years of relevant experience in lieu of a degree
• Requires at least 7 years' experience in Health Care (managed care, academic, or gov't payer)
• Preferred MPH, MBA, MS, MA
• Ability to develop new SAS programs and SQL scripts that improve the efficiency of the work of others
• Broad knowledge of project management
• Experience with MS Office, especially Excel and Access, Unix, SQL/PL-SQL,SAS
• Familiarity with visualization tools such as Tableau
• Strong analytics skills, strong problem-solving skills. Strong Presentation skills.
• Must possess excellent time management and organizational skills to be able to handle multiple complex projects simultaneously

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.