Medical Informatics Analyst, Consultant - Pharmacy

Blue Shield of California • Oakland, CA

12d • $123,090 - $208,320 • Hybrid

About The Position

The Pharmacy Financial Analytics team is seeking a Medical Informatics Consultant. This role reports to the Sr. Principal Medical Informatics Analyst of Pharmacy Financial Analytics. In this role, you will play a key part in advancing our organization's analytical capabilities by supporting network and rebate reporting, reconciliation processes, model development, and automation initiatives. Your work will directly empower leadership with the tools, insights, and data needed to make informed strategic decisions, drive operational excellence, and support the continued growth and success of the organization through innovative, data-driven solutions.

Requirements

• Requires a bachelor’s degree or High School Diploma/GED and 4 years of additional relevant experience in lieu of a degree
• Requires 7 years of relevant experience delivering analytics (cost, quality, utilization, and/or outcomes) with enterprise impact
• Requires 5 years of prior pharmacy experience
• Requires SAS Certified Advanced Programmer credential (or equivalent) or advanced analytics certification (e.g., R, Python)

Responsibilities

• Develop, optimize, and maintain complex SQL queries to extract, transform, and analyze pharmacy, claims, financial, and operational data.
• Use SAS and other analytical tools to manipulate large healthcare datasets, support statistical analysis, and contribute to predictive model development.
• Support the design, maintenance, and enhancement of underwriting tools used to evaluate pharmacy cost, utilization, revenue, and performance trends.
• Design, automate, and maintain financial reporting to monitor pharmacy revenue streams, dispensing margins, rebate activity, billing accuracy, and key performance indicators.
• Perform financial reconciliations across pharmacy claims, rebate, inventory, operational, and general ledger data to ensure accuracy, identify variances, and support issue resolution.
• Analyze financial and operational trends to identify cost-saving opportunities, revenue impacts, process gaps, and business performance drivers.
• Translate complex pharmacy and financial data into clear insights, recommendations, and presentations for business leaders and cross-functional partners.
• Partner with Pharmacy, Finance, Underwriting, Actuarial, and operational teams to support strategic initiatives, improve reporting capabilities, and drive data-informed decision-making.

What This Job Offers

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