Business Analyst, Senior

Business Analyst, Senior

The Network Operations team works across business units to streamline workflows, support compliance, and deliver actionable insights that drive organizational success. The Business Analyst, Senior will report to the Senior Manager of Network Operations. In this role you will support and facilitate seamless mass member moves related to network terminations to ensure timeliness of moves prior to term. This work also includes providing data analytics and project support work across Network Operations to help achieve annual goals and priorities.

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.

Responsibilities

In this role, you will:

• Stay engaged and informed on planned/upcoming large-size network terms and related project meetings across all LOBs.
• Partner closely with business owners to determine business priority and execute sprint planning
• Provides analytical support through the analysis and interpretation of data in support of cross-functional business operations.
• Identifies opportunities for improvement and works cross-functionally to develop business solutions. Provides analytical support to multiple projects, establishing project plans and timelines and coordinating projects with internal and external resources.
• Develops, prepares, and analyzes reports with complex analysis and data for management review, and presents to various levels of management.
• Works cross-functionally in analyzing, designing, and developing business solutions. Provides analytical support for multiple, complex cross-functional projects simultaneously, establishes work plans and timelines, coordinates with internal and external resources.
• Other duties as assigned.

Qualifications

Your Knowledge and Experience:

• Requires a bachelor's degree or High School Diploma/GED and 4 years of additional relevant experience in lieu of a bachelor's degree
• Requires 5 years of prior relevant experience
• Requires health plan experience (managed care, government payer, academic)
• Experience using Microsoft Access required
• Advanced Excel skills required. Excel skills include, but are not limited to creating/formatting tables, pivot tables, vLookup, conditional formatting and the ability to clean, sort and filter large data sets
• Experience working with large datasets required
• SQL or Python experience is preferred
• Department of Managed Healthcare experience preferred
• Prior experience with PCP crossover and change management preferred
• Strong analytical and problem-solving skills are required
• Strong interpersonal and verbal and written communication skills
• Works independently under limited supervision
• Detail oriented and has the ability to deal with complexity, compressed timelines and shifting priorities
• Advanced proficiency with MS Office products is required, including Word, PowerPoint and Excel. Visio expertise a plus
• Advanced knowledge and ability to perform process mapping, root-cause analysis, gap analysis and requirements gathering
• Practical knowledge of project management is preferred

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 Us

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.

Please click here for further physical requirement detail.

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.