Data Analytics Specialist
6 days ago
At Blue Shield of California, we deliver best-in-class clinical quality analytics and informatics to enable high-quality, affordable member-centered care.
We use data, intelligence, and actionable insights to drive quality strategy, performance improvement, and regulatory reporting.
Your RoleThe Clinical Quality Analyst - Consultant will report to the Clinical Quality Analytics Senior Manager with day-to-day oversight provided by the CalPERS analytic lead.
In this role, you will provide data, analytic, and reporting support in partnership with the Clinical Quality Department for the BSC CalPERS HMO/PPO lines of business.
- Conduct independent analysis of high complexity under minimal supervision and guidance.
- Develop analytical methods that can be delegated for production to Clinical Quality Analysts at lower levels.
- Produce analysis of high complexity under the guidance and direction of Clinical Quality Analyst – Principal or manager.
- Develop documentation and create workplans for analyses of high complexity. Workplans may coordinate the activities of Clinical Quality Analysts at lower levels and involve collaboration with more than one team.
- Provide training and mentoring for team members on best practices for analysis and reporting. Assist in developing supplemental analytic training tools and materials. Conduct formal training sessions for lower-level analysts and analysts in other Departments.
- Conduct independent analysis of high complexity under moderate supervision and guidance. Develop novel analyses and reports.
- Collect data from various internal systems (e.g., Claims processing or membership systems) and external systems (EMR/EHR). Convert those data into actionable insights to guide business decision making for BSC populations' health management and quality of care.
- Develop, implement, and document quality assurance processes to ensure reported data is accurate and reliable.
- Conduct program evaluation, vendor assessments, performance guarantees using advanced statistical modeling.
- Partner with the HEDIS data team, Clinical Quality Analytics, and Medical Record Review teams to support HEDIS performance improvement initiatives.
- Requires a bachelor's degree in health science, quantitative social science, public health, health services research, or business or equivalent experience.
- Prefer an MPH, MBA, MS, MA, RN, or RHIA in health science, quantitative social science, public health, health services research, or business.
- Requires at least 5 years of SAS/SQL programming experience.
- Requires at least 7 years of prior operational and/or data analysis experience, experience in database structures, and standard query and reporting tools.
- Requires at least 5 years of experience in Healthcare (managed care, academic, or government payer).
- Requires at least 3 years of experience working with NCQA HEDIS quality measures.
- Requires at least 3 years of experience with NCQA Health Plan Rating, CMS Medicare Advantage Star Rating, or Medi-Cal Managed Care Accountability Sets (MCAS).
- Requires at least 5 years of programming using inpatient claims, outpatient encounters, membership, pharmacy, or laboratory data.
- Requires at least 5 years of experience with ICD codes, CPT codes, Diagnostic Related Group (DRG) codes, or Healthcare Common Procedure Coding System (HCPCS) codes.
- Proficient in MS Office – Word, Excel, and PowerPoint.
- Experience with visual management tools (e.g., Tableau, Power BI) or task management tools (e.g., JIRA, Work Front, SharePoint) or cloud data (e.g., Azure, AWS, Snowflake).
- Experience working with RDBMS: Oracle, Netezza, DB2, etc.
- Group (APR-DRG/MS-DRG) codes or HCPCS codes.
- Experience utilizing a certified HEDIS software.
The estimated salary for this role is $118,800.00 to $178,200.00 per year in California.
-
Data Analytics Lead for Quality Enhancement
1 week ago
Long Beach, California, United States Blue Shield of California Full timeJob OverviewIn this pivotal role, you will be responsible for leading data analytics efforts to enhance clinical quality performance. Your expertise in complex data analysis and reporting will drive strategic decision-making and support regulatory compliance.About the RoleThe Senior Clinical Quality Analyst plays a critical role in enhancing clinical quality...
-
Long Beach, California, United States Blue Shield of California Full timeAt 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...
-
Long Beach, California, United States Blue Shield of California Full timeClinical Quality Analytics ConsultantWe are seeking a highly skilled Clinical Quality Analytics Consultant to join our team at Blue Shield of California. As a key member of our organization, you will utilize your expertise in data analytics and informatics to enhance member-centered care.The ideal candidate will have extensive experience in healthcare...
-
Long Beach, California, United States Blue Shield of California Full timeAbout Blue Shield of CaliforniaBlue Shield of California is a leading health insurance company dedicated to delivering high-quality, affordable healthcare to its members. Our goal is to empower individuals and communities to take control of their health through innovative solutions, expert care, and personalized support.Salary RangeThe salary range for this...
-
Long Beach, California, United States Blue Shield of California Full timeJob DescriptionAs a Data Governance Architect, Business Solutions Specialist at Blue Shield of California, you will be part of the Data Services & Solutions team that provides the framework, tools, and oversight needed to standardize processes and procedures for governing data assets.About the RoleThe ideal candidate will engage in translating business...
-
Long Beach, California, United States Long Beach Unified School District Full timeAbout the RoleWe are seeking a highly skilled Business Systems Analyst, Strategic Data Specialist to join our team at the Long Beach Unified School District.This is an exciting opportunity to utilize your analytical skills and technical expertise to drive business operations and improve district-wide processes.The ideal candidate will have a strong...
-
Data Collection Specialist
3 days ago
Long Beach, California, United States U of C NORC Full timeAbout the RoleU of C NORC seeks a highly motivated Data Collection Specialist to join our team. This is an exciting opportunity to work in a dynamic environment, collecting data that drives our research.This position is classified as intermittent and offers competitive pay at $21.75 per hour, based on experience and location. As a Data Collection Specialist,...
-
Healthcare Analytics Consultant Lead
41 minutes ago
Long Beach, California, United States Blue Shield of California Full timeAbout the RoleThis is an exceptional opportunity to join Blue Shield of California as a Medical Informatics Analyst, Consultant. Reporting to the Senior Manager of Commercial Markets Analytics in Data & Analytics under Information Technology, you will fulfill reporting and analytics needs from employers and their brokers/consultants.Your Key...
-
Healthcare Data Strategist
7 days ago
Long Beach, California, United States Blue Shield of California Full timeAbout the RoleThe Commercial Markets Analytics team at Blue Shield of California provides financial reporting and utilization/clinical analytics to Commercial employers and their Brokers/Consultants. As a Medical Informatics Analyst, Consultant, you will report to the Senior Manager of Commercial Markets Analytics in Data & Analytics under Information...
-
Long Beach, California, United States Blue Shield of California Full timeAbout Blue Shield of CaliforniaAt Blue Shield of California, we strive to deliver best-in-class clinical quality analytics and informatics to enable high-quality, affordable member-centered care. Our team uses data, intelligence, and actionable insights to drive quality strategy, performance improvement, and regulatory reporting.Job SummaryWe are seeking a...
-
Chief Data Architect
1 week ago
Newport Beach, California, United States Beacon Pointe Full timeAbout Beacon PointeBeacon Pointe is a leading organization in the industry, seeking a highly skilled Chief Data Architect to join our team. This role will be instrumental in shaping our advanced analytics capabilities and driving business growth through data-driven insights.Salary: $140,000 - $180,000 per year, depending on experience.Job DescriptionThe...
-
Long Beach, California, United States Blue Shield of California Full timeAbout the RoleAs a Senior Clinical Quality Analytics Professional at Blue Shield of California, you will play a vital role in delivering high-quality clinical analytics and informatics to drive member-centered care. Our team uses data, intelligence, and actionable insights to improve quality strategy, performance, and regulatory reporting.Your Key...
-
Long Beach, California, United States Blue Shield of California Full timeJob OverviewBlue Shield of California is seeking a Clinical Quality Analytics Professional - Senior to join our team. This role plays a critical part in delivering best-in-class clinical quality analytics and informatics to enable high-quality, member-centered care.About the RoleThis position reports to the Clinical Quality Manager or Senior Manager and...
-
Healthcare Data Analyst Consultant
7 days ago
Long Beach, California, United States Blue Shield of California Full timeWe are seeking a seasoned Healthcare Data Analyst Consultant to join our team at Blue Shield of California. In this role, you will leverage your expertise in data analytics and informatics to enhance member-centered care.Job Description:The Clinical Quality Analytics Consultant utilizes data analytics and informatics to drive performance improvement and...
-
Healthcare Data Analyst Leader
1 week ago
Long Beach, California, United States Blue Shield of California Full timeAbout the RoleThis is an exciting opportunity to lead data-driven initiatives that enhance member-centered care. As a Clinical Quality Analytics Consultant, you will utilize your expertise in healthcare analytics and informatics to drive high-quality and affordable care.Key Responsibilities:Conduct complex analyses to provide actionable insights for business...
-
Healthcare Data Analyst
2 days ago
Long Beach, California, United States Blue Shield of California Full timeJob Summary">We are seeking a highly skilled Medical Informatics Analyst, Consultant to join our team at Blue Shield of California. This role requires a strong background in health science, quantitative social science, or business, with expertise in data analysis and reporting.About the Role">This position will report to the Senior Manager of Commercial...
-
EDI Process Specialist
7 days ago
Long Beach, California, United States Advanced Medical Manage Full timeJob OverviewAt Advanced Medical Manage, we are seeking an EDI Process Specialist to join our team. This is a unique opportunity to work in a fast-paced environment and make a significant impact on the organization's operations.Salary: $80,000 - $110,000 per yearAbout the RoleThe EDI Process Specialist will be responsible for managing and overseeing...
-
Long Beach, California, United States Blue Shield of California Full timeJob OverviewThe Clinical Quality Analytics Consultant is a key role at Blue Shield of California, utilizing data analytics and informatics to enhance member-centered care.
-
Healthcare Data Analyst
2 days ago
Long Beach, California, United States Blue Shield of California Full timeAbout the RoleWe are seeking an experienced Healthcare Data Analyst to join our Clinical Quality Analytics team as a Senior Consultant. In this role, you will utilize data analytics and informatics to enhance member-centered care by conducting high complexity analyses and providing actionable insights.Key Responsibilities:Develop analytical methods to...
-
Senior Clinical Data Analyst
6 days ago
Long Beach, California, United States Blue Shield of California Full timeCritical Role in Enhancing Healthcare QualityThe Senior Clinical Quality Analyst plays a vital part in elevating healthcare quality performance through intricate data analysis and reporting. This position demands the development of sophisticated data systems, the execution of high-level analyses for enhancing healthcare quality metrics, and collaboration...
