Medical Informatics Analyst, Consultant

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    "ShortDescriptionStr": "Reporting to the Sr Manager of Medical Informatics, this role is responsible for acting as an AI & Analytics partner to key leaders and cross-functional stakeholders across Medicare, Med Supp, Actuarial, and Finance to achieve their Growth-related business objectives. The successful candidate will act as \"two-in-a-box\" collaborator to share LOB Membership Retention & Growth goals, translate complex business problems into structured analytical approaches, design smart analytical tools, and leverage internal data structures",
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    "ExternalDescriptionStr": "<p><strong>Your Role</strong></p><p>The AI &amp; Analytics (AI&amp;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 Consultant will serve as a critical semantic bridge and analytical lead supporting multiple Government Lines of Business (LOBs) within Senior Markets with a distinct focus on Special Needs Plans (SNPs).</p><p>Reporting to the Sr Manager of Medical Informatics, this role is responsible for acting as an AI &amp; Analytics partner to key leaders and cross-functional stakeholders across Medicare, Med Supp, Actuarial, and Finance to achieve their Growth-related business objectives. The successful candidate will act as \"two-in-a-box\" collaborator to share LOB Membership Retention &amp; Growth goals, translate complex business problems into structured analytical approaches, design smart analytical tools, and leverage internal data structures</p>",
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    "ExternalPostedStartDate": "2026-06-11T16:27:00+00:00",
    "ExternalQualificationsStr": "<p><strong>Your Knowledge and Experience</strong></p><p>&nbsp;</p><ul><li>Requires a college degree or equivalent experience. Master’s degree preferred</li><li>Requires a minimum 7 years of prior relevant experience with 5+ years advanced experience working with complex Medical Claims, Membership and Provider data architectures.</li><li>Requires a minimum of 5 years’ experience in Health Care (managed care, academic, or gov't payer),</li><li>Requires SAS Certified Base Programmer Credential or equivalent and SAS Certified Advanced Programmer Credential or equivalent</li><li>Requires advanced coding proficiency in SQL &amp; SAS, with strong applied experience in Python and a working knowledge of modern cloud-native data stacks (Snowflake, Databricks, RDBMS etc.) for pipeline automation.</li><li>Requires familiarity with AI coding assistants (e.g. GitHub Copilot, Codex) or a strong, demonstrated willingness to quickly learn and adopt AI tooling to optimize engineering efficiency</li><li>Requires fluency with Senior Markets lines of business (MAPD, DSNP, Medicare Supplement, Medi-Cal) and CMS MARx regulatory data structures (MMR, DTRR, BEQ, etc.)</li><li>Requires high degree of fluency with PEGA, Salesforce and similar enterprise CRM/outreach applications</li><li><p>Requires proficiency in interpersonal communication, verbal/written presentations, math, analytical problem-solving, and the ability to adapt quickly to shifting or competing priorities</p><p>&nbsp;</p></li></ul>",
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    "OrganizationDescriptionStr": "<p style=\"margin:12pt 0in 0in\"></p>\n<p><b>About Blue Shield of California</b></p>\n<p>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.&nbsp;</p>\n<p>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.&nbsp;</p>\n<p>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.</p>\n<p>Blue Shield is&nbsp;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!&nbsp;&nbsp;</p>\n<p><b>Our Values:&nbsp;</b></p>\n<p style=\"margin-left:0.25in\"></p>\n<ul>\n <li><b>Honest. </b>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.<b>&nbsp;</b><b></b></li>\n <li><b>Human. </b>We strive to listen and communicate effectively, showing empathy by understanding others' perspectives.</li>\n <li><b>Courageous. </b>We stand up for what we believe in and are committed to the hard work necessary to achieve our ambitious goals.<b>&nbsp;</b></li>\n</ul>\n<div>\n <p><b>Our&nbsp;Workplace Model</b>&nbsp;</p>\n <p>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&nbsp;workplace model&nbsp;is designed around intentional in-person interaction, collaboration, connection,&nbsp;creativity&nbsp;and flexibility:</p>\n <ul>\n  <li>\n   <p>For most teams, this means coming into the office two days per week.</p></li>\n  <li>\n   <p>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.</p></li>\n  <li>\n   <p>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.</p></li>\n </ul>\n <p>The Company reserves the right to&nbsp;require&nbsp;more presence in the office based on business needs, and requirements are subject to change with periodic reviews. &nbsp;</p>\n <p></p>\n</div>\n<div>\n</div>\n<ul></ul>\n<p><b>Physical Requirements:</b></p>\n<p>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.</p>\n<p><a href=\"https://www.blueshieldca.com/physical-job-requirements\" target=\"_blank\" rel=\"nofollow\">Please click here for further physical requirement detail.</a>&nbsp;</p>\n<p><b>Equal Employment Opportunity:</b></p>\n<p>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.</p>",
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