Pharmacy Data & Analytics Architect

Blue Shield of California; California (MO); Hybrid; USD 123,000 - 185,000; Full time

Job summary

Blue Shield of California is seeking a Medical Informatics Analyst to advance pharmacy financial analytics by supporting data extraction, model development, and automation. You will partner with Pharmacy, Finance, Underwriting, and Actuarial teams to drive data‑driven decisions.

The role requires 7+ years of analytics experience with enterprise impact and 5+ years in pharmacy, plus SAS certification or equivalent. The position is hybrid, with in‑office collaboration two days weekly.

Qualifications

• Requires a bachelor’s degree or High School Diploma/GED with 4 years of additional relevant experience in lieu of a degree
• Requires 7 years of relevant experience delivering analytics (cost, quality, utilization, and/or outcomes) with enterprise impact
• Requires 5 years of prior pharmacy experience
• Requires SAS Certified Advanced Programmer credential (or equivalent) or advanced analytics certification (e.g., R, Python)

Responsibilities

• Develop, optimize, and maintain complex SQL queries to extract, transform, and analyze pharmacy, claims, financial, and operational data.
• Use SAS and other analytical tools to manipulate large healthcare datasets, support statistical analysis, and contribute to predictive model development.
• Support the design, maintenance, and enhancement of underwriting tools used to evaluate pharmacy cost, utilization, revenue, and performance trends.
• Design, automate, and maintain financial reporting to monitor pharmacy revenue streams, dispensing margins, rebate activity, billing accuracy, and key performance indicators.
• Perform financial reconciliations across pharmacy claims, rebate, inventory, operational, and general ledger data to ensure accuracy, identify variances, and support issue resolution.
• Analyze financial and operational trends to identify cost‑saving opportunities, revenue impacts, process gaps, and business performance drivers.
• Translate complex pharmacy and financial data into clear insights, recommendations, and presentations for business leaders and cross‑functional partners.
• Partner with Pharmacy, Finance, Underwriting, Actuarial, and operational teams to support strategic initiatives, improve reporting capabilities, and drive data‑informed decision‑making.

Skills

SQL querying

Data analytics

Pharmacy analytics

Education

Bachelor’s degree or equivalent experience

Tools

SAS

R/Python

Job description

Blue Shield of California is seeking a Medical Informatics Analyst to advance pharmacy financial analytics by supporting data extraction, model development, and automation. You will partner with Pharmacy, Finance, Underwriting, and Actuarial teams to drive data‑driven decisions.

The role requires 7+ years of analytics experience with enterprise impact and 5+ years in pharmacy, plus SAS certification or equivalent. The position is hybrid, with in‑office collaboration two days weekly.