Job Description

Your Role

The Healthcare Quality Affordability (HQA) Analytics team plays a key role in discovering information hidden in vast amounts of data that can lead to smarter decisions and deliver better service for our customers and contain the rising cost of healthcare. The Population Health Senior Manager, will report to the Director of HQA Analytics. Your focus will be leading a team of population health and behavioral health analysts while also contributing directly to complex, high-impact analytics initiatives. This role is responsible for translating business and clinical priorities into actionable analytic strategies, developing team capabilities, and delivering insights that inform population health investments, executive decision-making, and improvements in outcomes, utilization, equity, and affordability across lines of business.

Responsibilities

Your Work

In this role, you will:

• Manage a small to mid-sized team consisting of experienced population health analysts as well as behavioral health analysts
• Oversee the analysis and reporting as well as the design and development of systems based on business requirements and needs
• Own the design and execution of complex population level analytic agendas addressing high priority organizational questions (e.g., cost drivers, utilization patterns, disparities, program impact).
• Define analytic frameworks and methodologies for population segmentation, risk stratification, and evaluation goals that are reusable, scalable, and aligned with enterprise population health strategy.
• Serve as a subject matter expert in population health analytics, advising senior leaders on interpretation of findings and strategic implications.
• Lead analyses across large, complex healthcare datasets (claims, enrollment, pharmacy, demographic, and community level data) to identify trends, risks, and opportunities at scale.
• Develop and oversee 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 ensure insights address disparities and underserved populations
• Assess business risks associated with analytical processes and data systems and proactively implements solutions to mitigate risks
• Oversee the reliability of data and the validity and accuracy of analytical results
• Describe the significance of analytic results for business decision-making and makes recommendations to senior management and external entities

Qualifications

Your Knowledge and Experience

• Requires a college degree or equivalent
• Requires 10 years of experience in Health Care (managed care, academic, or government payer) including 4 years of management experience
• Proficient in Python or R for healthcare data analysis, statistical modeling, and visualization
• Ability to function independently and produce results that meet standards of quality, timeliness, and acceptability
• Problem-solving skills balanced between "analytical" and "intuitive"
• Ability to thrive in ambiguous situations
• Excellent verbal and written communication skills and the ability to interact professionally with a diverse group of executives, directors, managers, and subject matter experts
• Ability to establish and maintain effective and collaborative relationships with key stakeholders
• Advanced skills using Microsoft Excel, Word, Visio, and PowerPoint in preparing and making presentations to various levels of management.
• Technically proficient having broad background in problem solving tools
• Knowledge of Blue Shield of CA or similar health care organization structure
• Extensive knowledge of CPT, HCPCS, ICD-10s 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 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

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.