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Business Analyst, Consultant

Company: Blue Shield of CA
Location: El Dorado Hills
Posted on: October 18, 2020

Job Description:

At Blue Shield of California we are parents, leader, students, visionaries, heroes, and providers. Everyday we come together striving to fulfill our mission, to ensure all Californians have access to high-quality health care at a sustainably affordable price. For more than 80 years, Blue Shield of California has been dedicated to transforming health care by making it more accessible, cost-effective, and customer-centric. We are a not-for-profit, independent member of the Blue Cross Blue Shield Association with 6,800 employees, more than $20 billion in annual revenue and 4.3 million members. The company has contributed more than $500 million to Blue Shield of California Foundation since 2002 to have a positive impact on California communities. Blue Shield of California is headquartered in Oakland, California with 18 additional locations including Sacramento, Los Angeles, and San Diego. Were excited to share Blue Shield of California has received awards and recognition for LGBT diversity, quality improvement, most influential women in corporate America, Bay Areas top companies in volunteering & giving, and one of the worlds most ethical companies. Here at Blue Shield of California, were striving to make a positive change across our industry and the communities we live in Join us!

The Senior Performance Optimization Business Analyst, Consultant will report to the Senior Manager for Performance Improvement and Program Integrity. This position is responsible driving results and management of issues and gaps within the processes for the Senior Markets team. This includes driving to conclusion any issue or gap that presents itself within the end to end business processes. The candidate will be managing daily and weekly calls for status on issues impacting operational teams along with escalated issues and system enhancements. The right candidate is results oriented, self-driven and able to create informative and actionable reporting structure which highlights the relevant business needs including trends for improvement opportunities.

The qualified candidate will communicate effectively, collaborate with various teams, be a team player, embrace diversity and inclusion, apply critical thinking, while developing creative solutions. This position requires an understanding of Medicare products, healthcare data and operations, coupled with a knowledge of data analysis, methodology and analytical tools for delivering results. This role will work closely with other business operational leadership including analysts, managers, key stakeholders, and Senior Markets leadership at various levels.

Job Responsibilities:

* Provides highly complex analytical support through the analysis and interpretation of data in support of cross-functional business operations.

* Identifies opportunities for improvements and works cross-functionally to develop business solutions.

* Develops, prepares, and analyzes reports with highly complex analyzes and data for management review, and presents to various levels of management.

* Defines business requirements and provides analysis to increase operational efficiency.

* Analyzes actual results against plan and forecast and recommends interventions where appropriate.

* Works cross-functionally in analyzing, designing, and developing business solutions to deliver an overall consistent end to end Senior Markets consumer experience

* Ensure team maintains thoughtful and efficient operational processes including all policies and procedures, service standard, laws, regulations, and contractual obligations related to the Senior Markets.

* Develop, prepare, and analyze reports and presents to various levels of management and teams

* Partners with other BSC cross functional teams to ensure services provided to our members is effective and meeting the changing needs of our customers.

* Monitors and collaborates with functional areas across the enterprise who impact the success of the Senior Markets operational plans. Functional areas include: Customer Care, Enrollment, Appeals & Grievances, Claims, Network Management, Corporate Compliance, Medical Management, Internal Audit, Finance, Actuary, Marketing, Sales, Product, Pharmacy, Legal and IT.

* Identifies opportunities for improvement in operational performance and notifies management of issues and problems requiring immediate attention.

* Creates executive and detailed presentations to various levels of management depending on audience and deliverable.

* May perform operational responsibilities.

* Other ad hoc duties pertaining to the job

The Senior Performance Optimization Business Analyst, Consultant will report to the Senior Manager for Performance Improvement and Program Integrity. This position is responsible driving results and management of issues and gaps within the processes for the Senior Markets team. This includes driving to conclusion any issue or gap that presents itself within the end to end business processes. The candidate will be managing daily and weekly calls for status on issues impacting operational teams along with escalated issues and system enhancements. The right candidate is results oriented, self-driven and able to create informative and actionable reporting structure which highlights the relevant business needs including trends for improvement opportunities.

The qualified candidate will communicate effectively, collaborate with various teams, be a team player, embrace diversity and inclusion, apply critical thinking, while developing creative solutions. This position requires an understanding of Medicare products, healthcare data and operations, coupled with a knowledge of data analysis, methodology and analytical tools for delivering results. This role will work closely with other business operational leadership including analysts, managers, key stakeholders, and Senior Markets leadership at various levels.

Job Responsibilities:

* Provides highly complex analytical support through the analysis and interpretation of data in support of cross-functional business operations.

* Identifies opportunities for improvements and works cross-functionally to develop business solutions.

* Develops, prepares, and analyzes reports with highly complex analyzes and data for management review, and presents to various levels of management.

* Defines business requirements and provides analysis to increase operational efficiency.

* Analyzes actual results against plan and forecast and recommends interventions where appropriate.

* Works cross-functionally in analyzing, designing, and developing business solutions to deliver an overall consistent end to end Senior Markets consumer experience

* Ensure team maintains thoughtful and efficient operational processes including all policies and procedures, service standard, laws, regulations, and contractual obligations related to the Senior Markets.

* Develop, prepare, and analyze reports and presents to various levels of management and teams

* Partners with other BSC cross functional teams to ensure services provided to our members is effective and meeting the changing needs of our customers.

* Monitors and collaborates with functional areas across the enterprise who impact the success of the Senior Markets operational plans.

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.

Keywords: Blue Shield of CA, Sacramento , Business Analyst, Consultant, Accounting, Auditing , El Dorado Hills, California

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