Business Analyst, Consultant - Quality Performance

Blue Shield of California • El Dorado, AR

1d • Hybrid

About The Position

The Business Analyst, Consultant, Rx Quality Performance Management supports the development, measurement, and continuous improvement of Pharmacy initiatives across Commercial and Medicare lines of business. The role is part of the Clinical Pharmacy Programs team within Pharmacy Strategy & Operations, which develops and executes strategies addressing clinical quality, member experience, and prescription medication affordability for Blue Shield members. It combines performance analytics, program management, member experience insights, and executive reporting to identify opportunities, measure outcomes, and drive member-centered improvements. The position reports to the Senior Manager, Rx Member Experience & Quality Performance.

Requirements

• Bachelor’s degree or equivalent experience.
• At least 7 years of prior relevant experience.
• Strong analytical and problem-solving skills.
• Intermediate to advanced knowledge of pharmacy data elements and related technical standards and concepts, such as claims, e-prescriptions, e-prior authorization, and real-time pharmacy benefits.
• Advanced proficiency in Microsoft Word, Excel, PowerPoint, OneNote, and SharePoint.
• Excellent written, verbal, and interpersonal communication skills.
• Experience working independently in a fast-paced environment.

Nice To Haves

• At least 3 years of experience in managed care.
• Experience with HEDIS, CAHPS, NPS, and Medicare Stars data.

Responsibilities

• Provide highly complex analytical support through analysis and interpretation of data for cross-functional business operations.
• Lead development of annual operating plans, capital budgets, and forecasts, and build business cases for new initiatives, including cost/benefit analysis.
• Develop, prepare, and analyze reports containing highly complex analysis and data for management review, and present findings to various levels of management.
• Define business requirements and provide analysis to increase operational efficiency.
• Provide analytical support for multiple highly complex cross-functional projects simultaneously; establish work plans and timelines and coordinate internal and external resources.
• Expand subject matter expertise in performance monitoring of drug quality and member experience measures to support program improvement and enterprise goals.
• Establish and sustain collaborative relationships and an operating model with internal and external data and technology partners to support robust management of drug quality performance.
• Work independently with limited oversight to achieve goals and objectives.

What This Job Offers

• Job Type: Full-time
• Career Level: Senior