Business Analyst, Consultant

Your Role

The Population Health Management (PHM) team promotes a vision and strategy to drive differentiation in member experience and engagement, improvement in the overall health of Blue Shield of California members, and affordability and efficiency in the healthcare system. The Business Analyst, Consultant will report to the Director of Population Health Management. In this role you will lead the strategy of reporting tools and provide analytical support on technological business solutions. The Business Analyst will effectively lead the development and collaborate both internally and externally, on operational monitoring, manage performance metrics, prepare presentations to communicate results, as well as act as the department’s subject matter expert to project leaders with development of solutions and tool.

Our leadership model is about developing great leaders at all levels and creating opportunities for our people to grow – personally, professionally, and financially. We are looking for leaders that are energized by creative and critical thinking, building and sustaining high-performing teams, getting results the right way, and fostering continuous learning.

Responsibilities

Your Work

In this role, you will:

• Provide highly complex analytical support through the analysis and interpretation of data in support of cross-functional business operations
• Lead the development of annual operating plans, capital budgets and forecasts, and build business cases for new business initiatives (cost/benefit analysis)
• Develop, prepare, and analyze reports with highly complex analysis and data for management review, and presents to various levels of management
• Define business requirements and provide analysis to increase operational efficiency
• Provide analytical support for multiple, highly complex cross-functional projects simultaneously, establish work plans and timelines, coordinates with internal and external resources
• Develop and conduct evaluations and studies within limited time frames and produce analyses that are easy for non-technical persons to understand
• Assist in identifying systems and operational problems and recommend solutions and changes to streamline procedures for more effective reporting
• Interact with internal and external customers to define complex reporting needs and specifications; design and implement complex report programming according to specifications
• Present effectively to internal and external customers on analytics/reports/presentations that are critical for their business continuity and decision making
• Participate in internal and external task forces and committees to provide analytical insights and support for implementation of new programs, applications, products and services and enhancement of existing applications/systems.
• Develop root cause analyses and presentations per specs provided by team Director, or manager.
• Develops new perspectives and approaches on existing problems.
• Create and distribute routine and ad hoc reports for various departments.
• Works as a thought leader to achieve operational excellence and creating a direct impact on department results.
• Responsible for driving analytical insights, trends, improving processes, systems or products to enhance performance.
• Present / communicate clearly and effectively to internal/external customers on analytical insights/trends that are critical to business continuity and decision making.
• Lead complex analysis, reporting, forecasting, business cases, and performance measurement to deliver actionable insights and improve operational outcomes.
• Define business and reporting requirements, conduct gap and impact analyses, and translate stakeholder needs into scalable process and technology solutions.
• Lead multiple cross-functional initiatives, coordinating resources, timelines, risks, dependencies, readiness, testing, and post-implementation validation.
• Partner with internal, external, and technical stakeholders to identify root causes, streamline workflows, strengthen controls, and communicate clear recommendations to support decision-making.

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 at least 7 years of prior relevant experience
• Previous experience in Health Care (managed care, academic, or gov't payer); understanding of payor relationship and managed care principles
• Ability to develop and modify SQL scripts and be able to wrangle large datasets, join multiple datasets - preferred working experience with SAS
• Ability to create data visualizations to effectively narrate an actionable data story - preferred working experience with Tableau Desktop, Power BI, or Business Objects
• Practical knowledge of agile or project management skills preferred
• Demonstrated expertise translating complex PHM clinical and operational needs into actionable business requirements, user stories, workflows, acceptance criteria, data and KPI reporting, and technology solutions, with strong knowledge of Medi-Cal/CalAIM regulatory requirements and the ability to partner cross-functionally from requirements discovery through implementation and ongoing monitoring preferred

Hybrid Virtual Work

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 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.

Equal Employment Opportunity:

External hires must pass a background check/drug screen. Qualified applicants with arrest records and/or conviction records will be considered for employment in a manner consistent with Federal, State and local laws, including but not limited to the San Francisco Fair Chance Ordinance. All qualified applicants will receive consideration for employment without regards to race, color, religion, sex, national origin, sexual orientation, gender identity, protected veteran status or disability status and any other classification protected by Federal, State and local laws.