Hybrid Pharmacy Quality & Member Analytics Analyst

Blue Shield of CA; San Diego (CA); Hybrid; USD 100,000 - 150,000; Full time

Job summary

Blue Shield of CA seeks a Business Analyst, Consultant, Rx Quality Performance to support development, measurement, and continuous improvement of Pharmacy initiatives across Commercial and Medicare lines of business.

This role combines performance analytics, program management, and member experience insights to identify opportunities, measure outcomes, and drive member-centered improvements.

Qualifications

• Requires a bachelor's degree or equivalent experience.
• Requires at least 7 years of prior relevant experience.
• A minimum of 3 years' experience in managed care is preferred.
• Requires strong analytic and problem-solving skills with intermediate to advanced knowledge of pharmacy data elements and related technical standards/concepts (e.g. claims, e-prescriptions, e-prior authorization, real time pharmacy benefits, etc.)
• Experience with HEDIS, CAHPS, NPS and Medicare Stars data preferred.
• Requires advanced proficiency in Microsoft applications including Word, Excel, Power Point, OneNote, SharePoint
• Requires excellent written, verbal, and interpersonal communication skills
• Requires experience working independently in a fast-paced environment

Skills

Analytical skills

Problem solving

Communication

Independent work

Education

Bachelor's degree or equivalent

Tools

Word

Excel

PowerPoint

OneNote

SharePoint

Job description

Blue Shield of CA seeks a Business Analyst, Consultant, Rx Quality Performance to support development, measurement, and continuous improvement of Pharmacy initiatives across Commercial and Medicare lines of business.

This role combines performance analytics, program management, and member experience insights to identify opportunities, measure outcomes, and drive member-centered improvements.