Medical Informatics Analyst, Consultant

Blue Shield of California•El Dorado, AR

3d•Hybrid

About The Position

The Healthcare Quality Affordability Analytics team uses large healthcare datasets to identify insights that support better decisions and service, improve outcomes, and contain healthcare costs. The Medical Informatics Population Health Analyst, Consultant leads complex population health analytics and reporting solutions with minimal supervision, translates analytic results into recommendations and decision points, and supports investments and improvements in outcomes, equity, utilization, and affordability across lines of business. The position reports to the Principal Medical Informatics Population Health Analyst. The role leads complex analyses, designs reusable analytical methods, builds and enhances data systems and workflows, and analyzes healthcare data to identify trends, risks, disparities, and opportunities. It develops member archetypes and predictive insights, integrates health equity and social drivers of health into analysis, and evaluates program effectiveness, return on investment, and equity impact. The analyst advises business partners, mentors team members, supports regulatory, accreditation, and contractual measurement requirements, and contributes to population health workgroups and governance forums. This role follows a hybrid workplace model. Most teams are in the office two days each week; employees who live more than 50 miles from an office location will work with their manager to determine in-office time based on business need.

Requirements

Bachelor’s degree, or a high school diploma/GED and four years of additional relevant experience in lieu of a degree.
Seven years of relevant experience delivering healthcare analytics, including cost, quality, utilization, and/or outcomes analytics.
Experience leading high-complexity analyses using five or more data sources and multivariate methods, and coordinating analytical approaches across departments.
Demonstrated proficiency in six or more domains, including two or more clinical or health domains such as clinical coding/treatment, health databases, epidemiology/health services, econometrics, quality measurement, modeling, statistical graphics, or health insurance/finance.
Experience developing and maintaining production code using SQL/PL-SQL and SAS Base, Stat, or Graph, and creating repeatable reporting outputs in Excel and Access with minimal supervision.
Experience building reusable SAS Macro and PL/SQL programs for routine reporting.
Experience using R Studio, Python, SAS, or other relevant statistical software to calculate multivariate statistics, produce complex statistical graphics, and support applied clinical study designs such as risk adjustment or provider profiling.
Ability to function independently and produce results that meet standards of quality, timeliness, and acceptability.
Ability to thrive in ambiguous situations and balance analytical problem-solving with practical business judgment.
Excellent verbal and written communication skills, including the ability to interact professionally with executives, directors, managers, and subject matter experts.
Ability to establish and maintain effective, collaborative relationships with key stakeholders.
Advanced skills using Microsoft Excel, Word, Visio, and PowerPoint to prepare materials and present to various levels of management.
Extensive knowledge of CPT, HCPCS, ICD-10, and other related industry codes.

Responsibilities

Lead complex analyses and reporting solutions for population health priorities with minimal supervision.
Design reusable analytical methods and frameworks for population segmentation, risk stratification, program evaluation, and targeted outreach.
Build and enhance data systems, reporting processes, and analytic workflows that meet complex business and population health reporting requirements.
Analyze large healthcare datasets, including claims, enrollment, pharmacy, demographic, and community-level data, to identify trends, risks, disparities, and opportunities at scale.
Develop member archetypes, clusters, and predictive insights to support targeted interventions, care management, and outreach strategies.
Integrate health equity and social drivers of health into analytic approaches to identify and address disparities and underserved populations.
Establish evaluation strategies to assess the effectiveness, ROI, and equity impact of population health programs and interventions.
Interpret results for business partners, develop executive-ready narratives, and recommend clear actions and decision points.
Mentor and train team members and provide consultative guidance on analytic standards and best practices.
Mitigate business and analytical risk through peer review, quality controls, stakeholder communication, and clear documentation of methods and assumptions.
Support regulatory, accreditation, and contractual population health requirements through evidence-based measurement.
Contribute to multidisciplinary workgroups and governance forums focused on population health improvement.