Pharmacy Medical Informatics Analyst, Principal

1 week ago

Oakland, California, United States Blue Shield Of California Full time
About the Role

The Pharmacy Medical Informatics Analyst, Principal will play a critical role in supporting the Pharmacy Reimagined strategy and traditional actuarial functions of claim reserves and cost trends.

Key Responsibilities
  • Develop analytical systems that meet important business needs, leveraging deep understanding of underlying business requirements.
  • Design and develop systems that promote company-wide efficiencies, coordinating activities with other internal departments.
  • Communicate project status, progress, and outcomes to executive management, fulfilling a leadership role in critical review and ongoing development of data management and analytical systems.
  • Support vendor financial contract performance evaluation, forecast, and negotiation, as well as development of budget/trend impact models and formulary strategy models.
  • Provide Rx data support and participate in product governance/value assessment committee on Rx benefit and formulary strategy.
  • Support ASO product strategy evaluation and coordinate with UW and Actuarial Trend teams as needed.
Requirements
  • Requires an MPH, MBA, MS, MA, RN, or RHIA in health science, quantitative social science, public health, health services research, or business, or BA/BS with demonstrated equivalent work experience.
  • Requires SAS Certified Base Programmer Credential or equivalent and SAS Certified Advanced Programmer Credential or equivalent.
  • Requires at least 10 years of prior relevant experience.
  • Requires at least 5 years of experience in Health Care (managed care, academic, or gov't payer).
  • Requires experience at a Pharmacy Benefit Manager (PBM).
About Blue Shield of California

Blue Shield of California's mission is to ensure all Californians have access to high-quality health care at a sustainably affordable price.

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 fulfill our mission, we must ensure a diverse, equitable, and inclusive environment where all employees can be their authentic selves and fully contribute to meet the needs of the multifaceted communities we serve.

Our continued commitment to diversity, equity, and inclusion upholds our values and advances our goal of creating a healthcare system that is worthy of our family and friends while addressing health disparities, promoting social justice, and integrating health equity through our products, business practices, and presence as a corporate citizen.

Blue Shield has received awards and recognition for being a certified Fortune 100 Best Companies to Work, Military Friendly Employer, People Companies that Care, a Leading Disability Employer, and one of California's top companies in volunteering and giving.

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