Data Analyst - Health, Consultant

Blue Shield of California•Los Angeles, CA

1d•$111,540 - $188,728•Hybrid

About The Position

The Data Analyst serves as an analytical and strategic partner to Blue Shield’s Health Care Quality and Affordability (HCQA) organization, supporting the performance, design, and regulatory oversight of provider networks across Commercial, Medicare, and Medi-Cal programs. The role connects network performance data with regulatory requirements and business priorities to support network strategy, regulatory readiness, and sustainable member access solutions. The position leads network adequacy and Access & Availability analytics, performs complex analyses of geographic access, provider-to-member ratios, panel status, and access gaps, and prepares data and materials for regulatory filings. It develops reporting and executive-level insights, assesses regulatory and network risks, and supports network planning, remediation, expansion, contract negotiations, pricing, and product strategy. The role collaborates with internal and external stakeholders and translates technical findings into clear recommendations for leadership, committees, and non-technical audiences. The role reports to the Manager. It follows a hybrid workplace model, typically requiring in-office work two days per week. Employees more than 50 miles from an office location work with their manager to determine in-office expectations based on business needs.

Requirements

Bachelor’s degree, or a high school diploma/GED and four years of relevant experience in lieu of a degree.
At least seven years of experience in health care, such as managed care, academic health care, or a government payer.
Ability to develop SAS programs and SQL scripts that improve work efficiency.
Broad knowledge of project management.
Experience with MS Office, especially Excel and Access, and with Unix, SQL/PL-SQL, and SAS.
Strong analytical, problem-solving, and presentation skills.
Excellent time-management and organizational skills, including the ability to handle multiple complex projects simultaneously.

Nice To Haves

Preferred MPH, MBA, MS, or MA.
Familiarity with visualization tools such as Tableau.

Responsibilities

Lead network adequacy and Access & Availability analytics, monitoring provider access, capacity, availability, and compliance across Commercial, Medicare, and Medi-Cal networks.
Interpret and incorporate state and federal regulatory requirements into network policies, procedures, analytical methodologies, and compliance assessments.
Conduct complex network analyses, including geographic access, provider-to-member ratios, panel status, and access gaps, to inform network strategy, remediation, and expansion.
Prepare, validate, and oversee data used for regulatory reporting and filings in support of DMHC, CMS, DHCS, CDI, and NCQA requirements.
Develop dashboards, reports, and executive-level insights on network performance, access trends, compliance risks, and regulatory readiness.
Collaborate with internal and external stakeholders to assess regulatory changes, identify compliance and network risks, and implement data-driven solutions to strengthen network performance and member access.
Present analytical findings and trends to internal and external audiences using Excel pivot tables, PowerPoint presentations, report grids, tables, and other data visualizations.
Use SQL, SAS, Power BI, Tableau, and Excel to identify trends, anomalies, and opportunities for operational improvement.
Perform data validation, reconciliation, and quality assurance to ensure regulatory submissions and executive reporting are accurate and audit-ready.
Develop trend and scenario-based analyses to assess network performance, regulatory impacts, and emerging access risks.
Translate technical findings into business insights and recommendations for committees, executive leadership, and non-technical stakeholders.
Provide analysis and consultative services for new network design in support of the corporate strategic roadmap.
Support contract negotiations, pricing activities, and product and network strategy planning.