The Medi-Cal Analytics team supports the Medi-Cal Business Unit. The Medical Informatics Analyst, Consultant will report to the Senior Manager, Medical Informatics. In this role you will support compliance & regulatory reporting, mandated projects, and clinical key indicators for Medi-Cal and Dual -Special Need Program (D-SNP).
Your Work
In this role, you will:
- Conduct independent analysis of high complexity under minimal supervision and guidance
- Develop analytical methods so that they may be subsequently delegated for production to Medical Informatics Analysts at lower levels
- Produce analysis of high complexity under the guidance and direction of Medical Informatics Analyst V, supervisor, or manager
- Develop documentation and create and execute workplans for analyses of high complexity. Workplans may coordinate the activities of Medical Informatics Analysts at lower levels and may involve collaboration with more than one team
- Provide training and mentoring for team members on best practices for analysis and reporting; assist in the development of supplemental analytic training tools and materials; conducts formal training sessions for lower-level analysts and analysts in other Departments
- Assist in identifying systems and operational problems and recommend solutions and changes to streamline procedures for more effective reporting
- Support design, implementation and maintenance of data logic and processes to support Medi-Cal data integration into health data technology platform
- Responsible to create system QA processes and documentation
- Prepare complex reports and studies for a variety of uses including cost of health care analysis, quality improvement, enhancing operations and addressing identified issues
- Utilize programming software to efficiently develop process or tools to analyze relevant data from various sources (e.g., claims, membership, provider, financial, operation and other ancillary data sources), interpret and present analytic results for all ad hoc and ongoing reporting requests
Qualifications
Your Knowledge and Experience
- 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 7 years of prior relevant experience
- Requires at least 5 years of experience in Health Care (managed care, academic, or gov't payer)
- Ability to work with all clinical coding systems (e.g., ICD10, CPT, DRG, LOINC, RxHUB)
- Insight of Managed Care, Medi-Cal/Medicaid and coordination of Care.
- Excellent verbal and written communication and presentation skills
- Practical knowledge of agile and project management skills
Pay Range:
The pay range for this role is: $118800.00 to $178200.00 for California.
About Blue Shield
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.
Job Info
- Job Identification 20241843
- Job Category Business and Data Analysis
- Posting Date 10/10/2024, 12:17 AM
- Job Schedule Full time
- Locations El Dorado Hills, CA, United States CA, United States Long Beach, CA, United States Oakland, CA, United States San Diego, CA, United States Woodland Hills, CA, United States
- Role can be filled by a candidate requiring sponsorship No
#J-18808-Ljbffr
