Job Description

Your Role

The Healthcare Quality Affordability (HQA) Analytics team plays a key role in discovering insights from large healthcare datasets that can lead to smarter decisions, deliver better service for customers, and contain the rising cost of healthcare. The Medical Informatics Population Health Analyst, Consultant will report to the Principal Medical Informatics Population Health Analyst. In this role you will lead complex population health analytics and reporting solutions with minimal supervision, translate analytic results into clear recommendations and decision points, and support population health investments and improvements in outcomes, equity, utilization, and affordability across lines of business.

Responsibilities

Your Work

In this role, you will:

• 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 that support targeted interventions, care management, and outreach strategies.
• Integrate health equity and social drivers of health into analytic approaches to help identify and address disparities and underserved populations.
• Establish evaluation strategies to assess the effectiveness, ROI, and equity impact of population health programs and interventions.
• Advise business partners by interpreting results, developing executive-ready narratives, and recommending 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.

Qualifications

Your Knowledge and Experience

• 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 healthcare analytics, including cost, quality, utilization, and/or outcomes analytics.
• Experience leading high-complexity analyses using 5 or more data sources and multivariate methods, with coordination of analytical approaches across departments.
• Demonstrated proficiency in 6 or more domains, including 2 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 for calculating multivariate statistics, producing complex statistical graphics, and supporting 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.

Hybrid

This role requires employees to be in-office based on our hybrid workplace model, balancing purposeful in-person collaboration with flexibility. For most teams, this means coming into the office two days each week.

Employees living more than 50 miles from an office location will work with their manager to determine in-office time based on business need.

About the Team

About Blue Shield of California

As of January 2025, Blue Shield of California became a subsidiary of Ascendiun. Ascendiun is a nonprofit corporate entity that is the parent to a family of organizations including Blue Shield of California and its subsidiary, Blue Shield of California Promise Health Plan; Altais, a clinical services company; and Stellarus, a company designed to scale healthcare solutions. Together, these organizations are referred to as the Ascendiun Family of Companies.

At Blue Shield of California, our mission is to create a healthcare system worthy of our family and friends and sustainably affordable. We are transforming health care in a way that genuinely serves our nonprofit mission by lowering costs, improving quality, and enhancing the member and physician experience.

To achieve our mission, we foster an environment where all employees can thrive and contribute fully to address the needs of the various communities we serve. We are committed to creating and maintaining a supportive workplace that upholds our values and advances our goals.

Blue Shield is a U.S. News Best Company to work for, a Deloitte U.S. Best Managed Company and a Top 100 Inspiring Workplace. We were recognized by Fair360 as a Top Regional Company, and one of the 50 most community-minded companies in the United States by Points of Light. Here at Blue Shield, we strive to make a positive change across our industry and communities - join us!

Our Values:

• Honest. We hold ourselves to the highest ethical and integrity standards. We build trust by doing what we say we're going to do and by acknowledging and correcting where we fall short.
• Human. We strive to listen and communicate effectively, showing empathy by understanding others' perspectives.
• Courageous. We stand up for what we believe in and are committed to the hard work necessary to achieve our ambitious goals.

Our Workplace Model

We believe in fostering a workplace environment that balances purposeful in-person collaboration with flexibility - providing clear expectations while respecting the diverse needs of our workforce. Our workplace model is designed around intentional in-person interaction, collaboration, connection, creativity and flexibility:

• For most teams, this means coming into the office two days per week.
• Employees living more than 50 miles from an office location, out of state employees, and employees in certain member-facing roles should work with their manager to determine in-office time based on business need.
• For employees with medical conditions that may impact their ability to work in-office, we are committed to engaging in an interactive process and providing reasonable accommodations to ensure their work environment is conducive to their success and well-being.

The Company reserves the right to require more presence in the office based on business needs, and requirements are subject to change with periodic reviews.

Physical Requirements:

Office Environment - roles involving part to full time schedule in Office Environment. Based in our physical offices and work from home office/deskwork - Activity level: Sedentary, frequency most of work day.

Please click here for further physical requirement detail.