Data Analytics Consultant for Healthcare Quality Improvement
6 days ago
At Blue Shield of California, we strive to deliver best-in-class clinical quality analytics and informatics to empower high-quality and affordable member-centered care. Our team's data, intelligence, and actionable insights drive quality strategy, performance improvement, and regulatory reporting.
About the RoleThe Clinical Quality Analyst - Consultant will work closely with our Clinical Quality Department to provide data, analytic, and reporting support for the BSC CalPERS HMO/PPO lines of business. Key responsibilities include:
- Conducting independent analysis of high complexity under minimal supervision and guidance
- Developing analytical methods that can be delegated for production to Clinical Quality Analysts at lower levels
- Producing analysis of high complexity under the guidance and direction of Clinical Quality Analyst – Principal or manager
- Developing documentation and creating workplans for analyses of high complexity, coordinating activities with Clinical Quality Analysts at lower levels and collaborating with multiple teams
- Providing training and mentoring for team members on best practices for analysis and reporting, assisting in developing supplemental analytic training tools and materials, and conducting formal training sessions for lower-level analysts and analysts in other departments
We are seeking a highly skilled professional with a strong background in data analytics, healthcare quality improvement, and program evaluation. The ideal candidate will have experience working with SAS/SQL programming, database structures, and standard query and reporting tools. Additionally, they should be proficient in MS Office, visual management tools (e.g., Tableau), task management tools (e.g., JIRA), and cloud data platforms (e.g., Azure).
Requirements
- Bachelor's degree in health science, quantitative social science, public health, health services research, or business, or equivalent experience
- Minimum 5 years of SAS/SQL programming experience
- Minimum 7 years of prior operational and/or data analysis experience, experience in database structures, and standard query and reporting tools
- Minimum 5 years of experience in Health Care (managed care, academic, or gov't payer)
- Minimum 3 years of experience working with NCQA HEDIS quality measures
- Minimum 3 years of experience with NCQA Health Plan Rating, CMS Medicare Advantage Star Rating, or Medi-Cal Managed Care Accountability Sets (MCAS)
- Minimum 5 years of programming using inpatient claims, outpatient encounters, membership, pharmacy, or laboratory data
- ICD (International Classification of Diseases) codes, CPT (Current Procedural Terminology) codes, Diagnostic Related Group (APR-DRG/MS-DRG) codes, or Healthcare Common Procedure Coding System (HCPCS) codes
- RDBMS: Oracle, Netezza, DB2
Compensation Package
We offer a competitive compensation package, including an estimated annual salary range of $118,800 to $178,200 based on experience and location. This role is located in California, and we prioritize hiring professionals who share our commitment to improving healthcare quality and outcomes.
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