Job Description

Your Role

The Healthcare Quality Affordability (HQA) Analytics team plays a key role in discovering information hidden in vast amounts of data that can lead to smarter decisions and deliver better service for our customers and contain the rising cost of healthcare. The Medical Informatics Analyst, Principal will report to the Director of HQA Analytics. Your focus will be in serving as a senior analytic and thought leader responsible for shaping population health strategy through advanced analytics and cross enterprise influence. This role owns complex, high impact analyses that inform executive decision-making, guide population health investments, and drive improvements in outcomes, equity, utilization, and affordability across lines of business.

Our leadership model is about developing great leaders at all levels and creating opportunities for our people to grow – personally, professionally, and financially. We are looking for leaders that are energized by creative and critical thinking, building and sustaining high-performing teams, getting results the right way, and fostering continuous learning.

Your Work

In this role, you will:

• Own the design and execution of complex population level analytic agendas addressing high priority organizational questions (e.g., cost drivers, utilization patterns, disparities, program impact)
• Define analytic frameworks and methodologies for population segmentation, risk stratification, and evaluation goals that are reusable, scalable, and aligned with enterprise population health strategy
• Serve as a subject matter expert in population health analytics, advising senior leaders on interpretation of findings and strategic implications
• Lead analyses across large, complex healthcare datasets (claims, enrollment, pharmacy, demographic, and community level data) to identify trends, risks, and opportunities at scale
• Develop and oversee member archetypes, clusters, and predictive insights to support targeted interventions, care management, and outreach strategies
• Integrate health equity and social drivers of health into analytic approaches to ensure insights address disparities and underserved populations
• Establish evaluation strategies to assess effectiveness, ROI, and equity impact of population health programs and interventions
• Translate analytic results into clear, executive ready narratives, recommendations, and decision points
• Support regulatory, accreditation, and contractual population health requirements through evidence-based measurement and reporting
• Partner with clinical quality, behavioral health, care management, product, and strategy teams to align analytics with operational and clinical priorities
• Lead or contribute to multidisciplinary workgroups and governance forums focused on population health improvement
• Mentor and coach analysts, setting standards for analytic rigor, storytelling, and impact

Your Knowledge and Experience

• Requires a college degree or equivalent experience
• Requires 10 years of prior relevant experience in Health Care (managed care, academic, or government payer)
• Certifications: SAS Certified Base Programmer Credential or equivalent required. SAS certified Advanced Programmer Credential or equivalent required
• Requires mastery level knowledge of health data science typically obtained through advanced education combined with experience. May have dep knowledge of project management
• Ability to function independently and produce results that meet standards of quality, timeliness, and acceptability
• Problem-solving skills balanced between “analytical” and “intuitive”
• Ability to thrive in ambiguous situations
• Excellent verbal and written communication skills and the ability to interact professionally with a diverse group of executives, directors, managers, and subject matter experts
• Ability to establish and maintain effective and collaborative relationships with key stakeholders
• Advanced skills using Microsoft Excel, Word, Visio, and PowerPoint in preparing and making presentations to various levels of management. Proficient at using MS Project
• Technically proficient having broad background in problem solving tools
• Knowledge of Blue Shield of California or similar health care organization structure
Extensive knowledge of CPT, HCPCS, ICD-10s and other related industry codes

Hybrid

This role requires employees to be in-office based on our hybrid workplace model, balancing purposeful in-person collaboration with flexibility. For most teams, this means coming into the office two days each week.

Employees living more than 50 miles from an office location will work with their manager to determine in-office time based on business need.

ABOUT THE TEAM
About Blue Shield of California

As of January 2025, Blue Shield of California became a subsidiary of Ascendiun. Ascendiun is a nonprofit corporate entity that is the parent to a family of organizations including Blue Shield of California and its subsidiary, Blue Shield of California Promise Health Plan; Altais, a clinical services company; and Stellarus, a company designed to scale healthcare solutions. Together, these organizations are referred to as the Ascendiun Family of Companies.

At Blue Shield of California, our mission is to create a healthcare system worthy of our family and friends and sustainably affordable. We are transforming health care in a way that genuinely serves our nonprofit mission by lowering costs, improving quality, and enhancing the member and physician experience.

To achieve our mission, we foster an environment where all employees can thrive and contribute fully to address the needs of the various communities we serve. We are committed to creating and maintaining a supportive workplace that upholds our values and advances our goals.

Blue Shield is a U.S. News Best Company to work for, a Deloitte U.S. Best Managed Company and a Top 100 Inspiring Workplace. We were recognized by Fair360 as a Top Regional Company, and one of the 50 most community-minded companies in the United States by Points of Light. Here at Blue Shield, we strive to make a positive change across our industry and communities – join us!

Our Values:

• Honest. We hold ourselves to the highest ethical and integrity standards. We build trust by doing what we say we're going to do and by acknowledging and correcting where we fall short.
• Human. We strive to listen and communicate effectively, showing empathy by understanding others' perspectives.
• Courageous. We stand up for what we believe in and are committed to the hard work necessary to achieve our ambitious goals.

Our Workplace Model

We believe in fostering a workplace environment that balances purposeful in-person collaboration with flexibility - providing clear expectations while respecting the diverse needs of our workforce. Our workplace model is designed around intentional in-person interaction, collaboration, connection, creativity and flexibility:

• For most teams, this means coming into the office two days per week.

• Employees living more than 50 miles from an office location, out of state employees, and employees in certain member-facing roles should work with their manager to determine in-office time based on business need.

• For employees with medical conditions that may impact their ability to work in-office, we are committed to engaging in an interactive process and providing reasonable accommodations to ensure their work environment is conducive to their success and well-being.

The Company reserves the right to require more presence in the office based on business needs, and requirements are subject to change with periodic reviews.

Physical Requirements:

Office Environment - roles involving part to full time schedule in Office Environment. Based in our physical offices and work from home office/deskwork - Activity level: Sedentary, frequency most of work day.

Equal Employment Opportunity:

External hires must pass a background check/drug screen. Qualified applicants with arrest records and/or conviction records will be considered for employment in a manner consistent with Federal, State and local laws, including but not limited to the San Francisco Fair Chance Ordinance. All qualified applicants will receive consideration for employment without regards to race, color, religion, sex, national origin, sexual orientation, gender identity, protected veteran status or disability status and any other classification protected by Federal, State and local laws.

Job Tags

Full time, Part time, Work at office, Local area, Work from home, Home office, 2 days per week

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