Your Role

The Quality Improvement and Provider & Plan Quality Incentives (PPQI) team strives to improve the health outcomes of our members. We strategize, plan and execute programs that support provider efforts to get patients into preventive care. We work with a broad spectrum of both internal and external stakeholders to develop programs that are directly aligned to national standards for high-quality healthcare. The Business Analyst, Senior - Provider Incentives will report to the Senior Manager. In this role you will provide complex analytical support to the Provider & Plan Quality Incentives (PPQI) team, including but not limited to payout modeling, forecasting, calculation and program evaluation. You will bridge both performance and cost views across targeted populations including Commercial HMO, Covered CA HMO, Covered CA PPO, Medicare and Medi-Cal. You will support the improvement of our work and our positive impact on both providers and members.

Your Work

In this role, you will:

• Provide analytical support through the analysis and interpretation of data in support of cross-functional business operations
• Develop budgets and forecasts for existing programs; build business cases for new initiatives (cost/benefit analysis)
• Define business requirements and provide analysis of operational efficiency
• Work cross-functionally in analyzing, designing and launching business solutions
• Develop, prepare, and analyze reports with complex analysis and data for management review
• Provide analytical support for complex cross-functional projects, and coordinate with internal and external resources
• Develop communication materials for all levels of Blue Shield of California cohorts the team works with
• Create presentations and reports utilizing tools such as Microsoft PowerPoint and Excel
• Prepare meeting agendas/notes and project plans/action item tracking
• Take responsibility for the administration and organization of the team's SharePoint site that houses critical program documentation

Your Knowledge and Experience

• Requires a college degree or equivalent experience
• Requires a minimum of 5 years of prior relevant experience
• Experience in working cross-functionally in analyzing, designing, and developing business solutions is preferred
• Excellent verbal and written communication skills and the ability to interact professionally with a diverse group of executives, managers, and subject matter experts as well as external customers is preferred
• Prior experience in the health insurance industry is preferred
• Prior experience in healthcare quality is preferred
• Strong problem solver with demonstrated ability to identify root cause of low complexity issues is preferred
• Ability to function independently and produce results that meet standards of quality, timeliness, and acceptability is preferred
• Advanced skills in Microsoft Excel, Word, Visio, and PowerPoint in preparing and making presentations to various levels of management is preferred
• Prior experience in SQL is preferred

Pay Range:

The pay range for this role is: $77,990.00 to $116,930.00 for California.

Note:

Please note that this range represents the pay range for this and many other positions at Blue Shield that fall into this pay grade. Blue Shield salaries are based on a variety of factors, including the candidate's experience, location (California, Bay area, or outside California), and current employee salaries for similar roles.

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