Senior Healthcare Economics & Informatics Analyst

Blue Shield of California; California; Hybrid; USD 103,000 - 154,000; Full time

Job summary

Blue Shield of California is seeking a Healthcare Economics Senior role focused on data analysis, cost modeling, and economic forecasting. You will develop insights into costs, trends, utilization, and risks to support strategic decisions.

The role involves creating financial models, collaborating with operational leaders, and presenting findings to executives. This is a hybrid workplace with in-office days to balance collaboration and flexibility.

Qualifications

• Requires a bachelor’s degree or High School Diploma/GED and 4 years of additional relevant experience in lieu of a degree
• Requires 5 years of prior relevant experience
• Prefer at least 5 years of experience in Health Care (managed care, academic, or gov't payer)
• Requires advanced knowledge of healthcare data and managed health plan operations
• Requires strong analytic and problem-solving skills with proficiency in data analysis tools
• Requires excellent communication and presentation skills with the ability to convey complex information to executive leadership and other stakeholders
• Requires ability to deliver moderate-complexity analyses using 3–4 data sources across 3–4 clinical areas, including univariate methods and standard statistical graphics
• Requires experience supporting high-complexity analyses using 5 or more data sources and multivariate methods with cross-department coordination
• Requires the ability to develop production code in SQL/PL-SQL and SAS Base (or equivalent) and produce repeatable reporting outputs in Excel and/or Power BI
• Requires experience using AI to summarize and analyze data, gather insights into data, and create reporting and presentations

Responsibilities

• Collect and evaluate data, develop and maintain financial models, analyze results and conduct scenario analyses to estimate cost of healthcare savings and to support cost /benefit analyses to understand the relative benefits of alternative courses of action
• Reconcile data results from different sources and combine them into integrated reports spanning cost, quality, utilization, and risk profile metrics
• Participate in internal workgroups and committees to provide analytical insight and support for the implementation and enhancement of new programs, products, and services
• Collaborate with key operational leaders to establish credible assumptions to support modeling of proposed initiatives to mitigate cost of healthcare trend while maintaining/improving the quality of care
• Analyze data to identify opportunities to improve healthcare quality, reduce costs and enhance member outcomes
• Use AI to gain efficiency around analyzing data, getting insights and creating reporting and presentations
• Present complex actuarial and economic insights to executive leadership and key stakeholders in a clear, actionable manner
• Use deep understanding of underlying business requirements to conceptualize and develop analytical systems that meet important business needs
• Coordinate activities with other internal departments to maximize overall efficiency and resolve conflicts
• Communicate project status, progress, and outcomes to executive management

Education

Bachelor’s degree or High School Diploma/GED with 4 years of additional relevant experience

Tools

SQL/PL-SQL

SAS Base

Job description

Blue Shield of California is seeking a Healthcare Economics Senior role focused on data analysis, cost modeling, and economic forecasting. You will develop insights into costs, trends, utilization, and risks to support strategic decisions.

The role involves creating financial models, collaborating with operational leaders, and presenting findings to executives. This is a hybrid workplace with in-office days to balance collaboration and flexibility.