Healthcare Informatics Leader — UM Analytics & PA

Blue Shield of CA; Los Angeles (CA); Hybrid; USD 150,000 - 190,000; Full time

Job summary

Blue Shield of CA seeks a Senior Manager of Medical Informatics - Utilization Management Analytics to lead a team focused on Prior Authorization, Concurrent Review, and broader UM analytics. You will translate clinical and operational priorities into actionable analytical strategies to improve affordability, quality, and member outcomes.

The role emphasizes developing strong analytics capabilities, delivering insights for executive decisions, and ensuring data privacy and regulatory compliance

Qualifications

• Bachelor's degree or higher with 4+ years of relevant experience; graduate degree preferred.
• 8 years of prior experience in a medical informatics role in healthcare.
• 4 years of people management experience with direct reports.
• Knowledge of HIPAA and privacy requirements in data exchange.

Responsibilities

• Lead a team responsible for Prior Authorization, Concurrent Review, and broader UM analytics.
• Translate clinical and operational priorities into actionable analytical strategies.
• Deliver insights that inform operational improvement and executive decision-making.

Skills

Healthcare analytics

People management

UM concepts

Regulatory knowledge

Education

Bachelor's degree or higher

Graduate degree preferred

Job description

Blue Shield of CA seeks a Senior Manager of Medical Informatics - Utilization Management Analytics to lead a team focused on Prior Authorization, Concurrent Review, and broader UM analytics. You will translate clinical and operational priorities into actionable analytical strategies to improve affordability, quality, and member outcomes.

The role emphasizes developing strong analytics capabilities, delivering insights for executive decisions, and ensuring data privacy and regulatory compliance