Senior Manager, Medical Informatics & UM Analytics

Blue Shield of CA; Long Beach (CA); Hybrid; USD 140.000 - 210.000; Vollzeit

Zusammenfassung

Blue Shield of California is seeking a Sr. Manager, Medical Informatics - Utilization Management Analytics to lead a team responsible for Prior Authorization, Concurrent Review, and broader UM analytics.

You will translate clinical and operational priorities into actionable analytic strategies and deliver insights that inform affordability, quality and member outcomes across lines of business. The role emphasizes developing team capabilities, fostering continuous learning, and collaborating

Qualifikationen

• Bachelor's degree or higher with 4 years of additional relevant experience in lieu of a degree, Graduate degree preferred
• 8 years of prior relevant experience in a medical informatics position in healthcare
• 4 years of people management experience with direct reports
• HIPAA and California health data privacy knowledge and experience
• Understanding of UM concepts, authorization metrics, and related performance measures
• Experience supporting UM, Prior Authorization, and Concurrent Review analytics in payer operations
• Experience analyzing California payer/provider data and outcomes measures

Aufgaben

• Lead a team responsible for Prior Authorization, Concurrent Review, and broader UM analytics
• Translate clinical and operational priorities into actionable analytical strategies
• Develop team capabilities and foster continuous learning
• Deliver insights that inform operational improvement, executive decisions, affordability, quality, and member outcomes across lines of business

Kenntnisse

Healthcare analytics

Team leadership

Regulatory compliance

UM concepts and performance measures

California payer operations knowledge

Data interpretation

Communication skills

Ausbildung

Bachelor's degree

Graduate degree (preferred)

Jobbeschreibung

Blue Shield of California is seeking a Sr. Manager, Medical Informatics - Utilization Management Analytics to lead a team responsible for Prior Authorization, Concurrent Review, and broader UM analytics.

You will translate clinical and operational priorities into actionable analytic strategies and deliver insights that inform affordability, quality and member outcomes across lines of business. The role emphasizes developing team capabilities, fostering continuous learning, and collaborating