Medical Informatics Analyst, Principal at Blue Shield of California

Lodi, California, United States -

Full Time

Start Date

Immediate

Expiry Date

06 Jul, 26

Salary

251720.0

Posted On

07 Apr, 26

Experience

10 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Medical Informatics, Data Architecture, Risk Adjustment, Medicare Advantage, Data Analysis, Predictive Modeling, Data Governance, SAS, Facets, Pega, Salesforce, Strategic Planning, Healthcare Analytics, Member Retention, Communication, Problem-solving

Industry

Hospitals and Health Care

Description

Your Role The AI & Analytics (D&A) team sits within the enterprise Growth organization, specifically aligned to the Risk Adjustment vertical. While situated within the Risk adjustment, this is strictly an advanced Medical Informatics and data architecture role. The Principal will serve as a critical semantic bridge and analytical lead supporting multiple Government Lines of Business (LOBs), including Senior Markets (Medicare Advantage, Medicare Supplement) and Individual and Family Plans (IFP/Covered CA). Reporting to the Sr Manager of Medical Informatics, this role is responsible for working with all the key leaders and stakeholders from Medicare, Med Supp, IFP and other Lines of Business and partner with Actuarial, Finance and others to be their AI & Analytics partner in achieving their Growth-related business objectives. This role requires not only analytical prowess but also a broad understanding of the business and business levers that matter in retaining and growing members. Being able to act as "two-in-a-box" with multiple business stakeholders is critical as you will be sharing the Membership Retention & Growth goals of the LoB’s. You will work closely with business to understand & inform the BSC strategy around these goals, design & build smart analytic tools/reports to help business monitor the outcome of those strategies by leveraging current analytics capabilities & standing up new ones as needed, working with IT leaders cross-functionally. The Medical Informatics Analyst, Principal must be adept at "translating" the business problem into an analytical approach, partnering with a of analytics professionals, and bringing in other specialties from within the D&A team such as data engineering, visualization, predictive modeling, and data governance as appropriate. The success of this role will hinge on the ability to quickly build trust with business partners & other stakeholders to achieve common goals. Utilizing analytics expertise and knowledge of systems such as Facets, Pega and Salesforce, you will analyze data to identify new opportunities for member retention and growth, conduct studies to understand the needs of members, and assist in the targeting of new member acquisition. You will bring together experience feedback, cost, quality of service, and network data to help Line of Business leaders know their members better and improve member retention and growth. 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. 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. [https://www.blueshieldca.com/physical-job-requirements] 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.

Responsibilities

The Principal Medical Informatics Analyst serves as a semantic bridge and analytical lead, partnering with business stakeholders to design and build analytic tools that support member retention and growth. This role translates complex business problems into analytical approaches while leveraging data engineering, visualization, and predictive modeling to inform strategy.