Data Analyst, Consultant (Provider Operations)

Job Description

Your Role

The Provider Operations Analytics and Reporting team is an analytical function under the Provider Operations department and provides analytical support for operational performance, provider data management and data quality. The Data Analyst, Consultant will report to the Manager of Performance Analytics and Reporting. In this role you will work closely with Operations teams (Claims and Provider), Network Management, Provider Relations, Transformation, Markets, Data & Analytics, IT teams and partners. This team is the first point of contact for operational performance and metric performance reporting using a variety of analytical tools. You will use SQL, Tableau, and Excel to design, build, enhance, and manage complex data systems and analysis methods that better serve ongoing analytical and reporting requirements.


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

Your Work

In this role, you will:

• Develop and conduct evaluations and studies within limited time frames and produce analyses that are easy for non-technical persons to understand
• Lead/coordinate the design and implementation of reports that integrate data from multiple sources, including design of reporting systems and standardization of metrics and formats across departments and functional areas
• Assess business risks relating to reporting design and production; develop and implement plans to mitigate risks
• Function as facilitator and/or mentor for data reporting projects, teams, and task forces; supply consultative advice to cross-functional analytics teams and business units regarding standard business rules and algorithms
• Coordinate interaction between data analysis teams and support functions including IT and Provider Operations.
• Analyze and summarize Provider data for comparative analysis using SAS, Business Objects (BO), Tableau and Excel.
• Adhere to documentation standards and protocols to ensure sustainability of processes, reports, SQL Code, and solutions.
• Partner with IT teams to analyze, manage and support data quality in support of new and established operational controls.

Qualifications

Your Knowledge and Experience

• Requires an MPH, MBA, MS, MA in science, social science, public health, health services research or business, or BA/BS with demonstrated equivalent work experience
• Requires at least 7 years of experience in Health Care (managed care, academic, or gov't payer)
• Experience with MS Office, especially Excel and Access, Unix, SQL/PL-SQL, SAS
• Familiarity with visualization tools such as Tableau
• Excellent analytical and problem solving skills.
• Prior experience in government programs Medi-Cal and Medicare is a plus

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.

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.