Business Analyst Consultant

Transformation is the opportunity

Blue Shield of California is the third largest health plan in California, with about $7.5 billion in revenue. Our mission is to ensure Californian's access to high-quality health care at a reasonable price.

Join Blue Shield of California and grow your career with a leader that’s stirring up a change.


Helping make health care for Californians easy, accessible and reasonably pricedis a great calling. Knowing that your company has channeled over $100 millionback into California communities and will continue to do so is flat outuplifting. Join the hardest working, not-for-profit health plan in Californiaand be part of the solution.

The Consultant Business Analyst will play a central role in managing data andprojects related to external vendors. As the primary Blue Shield analystsupporting our Predictive Triage Engine, this position provides the uniqueopportunity to be involved with departments across the organization and to beresponsible for vital aspects of vendor relationships and data management.

This individual will be a key team member in the External Clinical Programsdepartment in Health Care Services. This team is responsible for oversight ofclinical programs administered by vendors including high risk case management,disease management, health coaching, clinical messaging and 24/7 nurse support.

RESPONSIBILITIES:

Manage data flows and ongoing operations between external partners and BSC.Document data flows and associate programming logic

Consult on the development, implementation and maintenance of informationsystems associated with the collection, retrieval, accessibility and usage ofmember claims data

Perform critical analysis and problem determination related to informationsystems and data flows between external partners and Blue Shield

Perform QA on output files to ensure data accuracy

Collect monthly and quarterly data files from a variety of formats, map files toa standard Blue Shield format, and consolidate into appropriate layout

Critically assess processes for delivering information across functions andidentify opportunities for creating efficiencies in program delivery

Work on multiple projects simultaneously; establish work plans and timelines

Review externally produced reporting critically and for validity and consistency

Communicate with internal and external stakeholders on program steps andobjectives

Notify management of issues and problems requiring immediate attention

Design, develop, document, and execute reporting that addresses cost of healthcare, quality improvement, and operational metrics.





Bachelors degree and seven years relevant experience or equivalent combinationof education and experience.

Extensive knowledge of PCs and related software applications.



Advanced technical abilities related to automated systems and operations.

Excellent interpersonal and verbal/written communication skills.

Effective presentation skills.

Good math, analytical and problem-solving skills.

Skill in planning, organizing, leading and effectively managing projects or teammembers in the performance of their duties.

Experience with tools such as MS Office, MS Access, SQL Server, Oracle, UNIX,Business Objects and/or SAS programming skills required

Advanced technical abilities related to automated systems and operations.

Excellent interpersonal and verbal/written communication skills.

Effective presentation skills.

Good math, analytical and problem-solving skills.

Skill in planning, organizing, leading and effectively managing projects or teammembers in the performance of their duties.

ADDITIONAL EXPERIENCE:

Health Plan experience preferred

Strong analytical background, familiarity with health care data and the healthcare delivery system in California

Understanding of IT issues and ability to direct resolution of potentialproblems

Ability to generate relevant reports and review vendor-produced reportscritically

Knowledge of the key components of project management (e.g., scope, time, cost,quality, human resources, communication, risk, integration) and associated toolsand methodologies

Blue Shield of Califonia is an Equal Opportunity Employer.


Our comprehensive benefits begin on your first day with medical, dental and vision coverage; 20 days PTO annually; 9 paid holidays; matching 401(k); and company pension.

Blue Shield of California is an Equal Opportunity Employer.

An Independent Member of the Blue Shield Association.

Blue Shield of California

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