Blue Shield Of California

Medical Informatics Analyst, Consultant - Pharmacy

Blue Shield Of California$110K — $130K *
Healthcare
5 - 7 years of experience
Job Overview by Ladders

Qualifications

  • Bachelor's degree or equivalent experience in related field
  • 7 years delivering impactful analytics across healthcare
  • 5 years of pharmacy experience required
  • SAS Certified Advanced Programmer or equivalent certification
  • Strong experience with SQL and data analysis tools

Responsibilities

  • Develop and optimize complex SQL queries for data extraction and analysis
  • Utilize SAS for manipulating healthcare datasets and statistical analysis
  • Enhance underwriting tools for evaluating pharmacy trends
  • Design and automate financial reporting for pharmacy revenue monitoring
  • Perform financial reconciliations for accuracy across various data sources
  • Identify cost-saving opportunities through financial trend analysis
  • Translate complex data into actionable insights for leadership

Benefits

  • Flexible hybrid work model with defined in-office requirements
  • Collaboration opportunities with cross-functional teams
  • Access to advanced analytical tools and technologies
  • Career advancement potential within a growing organization
  • Employee support for balancing work and personal commitments
Full Job Description
Job Description

Your Role

The Pharmacy Financial Analytics team. The Medical Informatics Consultant will report 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.

Responsibilities

Your Work

In this role, you will:
  • 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.


Qualifications

Your Knowledge and Experience
  • 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)


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.

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.

About Blue Shield Of California

Blue Shield of California is a not-for-profit health plan provider that has been providing Californians with access to high-quality healthcare for over 80 years. The company offers a range of health insurance products and services to individuals, families, and employers. Blue Shield of California is committed to improving the health and wellbeing of its members and the communities it serves. The company is also committed to sustainability and has implemented a number of initiatives to reduce its environmental impact.
Learn more about Blue Shield Of California
Size
7,000 employees
Industry
Founded
1981

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