Blue Shield Of California
Business Analyst, Consultant
Blue Shield Of California, Rancho Cordova, California, us, 95741
Your RoleThe Provider Dispute Resolution (PDR) team manages and processes provider disputes across the Commercial, Medi-Cal and Medicare lines of business. The team also partners with an offshore vendor to complete provider disputes and other strategic projects. The Business Analyst, Consultant will report to the Director of PDR. In this role you will work closely with the CalPERS product and account management team as well as the Commercial PDR team to develop strategy for the CalPERS product line and Commercial line of business. This role will also convert data obtained from various internal systems into actionable insights to guide business decision making for the PDR and CalPERS teams.Your WorkIn this role, you will:
Provide highly complex analytical support through the analysis and interpretation of data in support of cross-functional business operationsLead 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 managementDefine business requirements and provide analysis to increase operational efficiencyProvide analytical support for multiple, highly complex cross-functional projects simultaneously, establish work plans and timelines, coordinates with internal and external resourcesCoordinate interaction between Data and Analytics teams and business Subject Matter Experts for clarity of requirements definitionsUse Agile methods to deliver data and reporting solutionsPresent in Operational Committees, trend top drivers of provider disputes, and work with upstream and downstream partners to reduce provider pain pointsPartner with PDR Regulatory Audit Manager and Operations managers in developing new procedures and guidelines for onshore and offshore PDR teams that are aligned with regulatory requirements
Your Knowledge and Experience
Requires a bachelor’s degree or equivalent experienceRequires at least 7 years of prior relevant experienceRequires experience validating the quality and integrity of incoming dataRequires prior experience in data analysis and reporting, including Excel, SQL, BI tools, and data visualizationRequires excellent communication, presentation, and interpersonal skills, with the ability to communicate complex technical concepts to both technical and non-technical audiencesRequires expertise in at least one of the following lines of business – Commercial, Medi-Cal and/or Medicare
Pay Range:The pay range for this role is: $ 96470.00 to $ 144760.00 for California.Note:Please note that this range represents the pay range for this and many other positions at Blue Shield that fall into this pay grade. Blue Shield salaries are based on a variety of factors, including the candidate's experience, location (California, Bay area, or outside California), and current employee salaries for similar roles.
Provide highly complex analytical support through the analysis and interpretation of data in support of cross-functional business operationsLead 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 managementDefine business requirements and provide analysis to increase operational efficiencyProvide analytical support for multiple, highly complex cross-functional projects simultaneously, establish work plans and timelines, coordinates with internal and external resourcesCoordinate interaction between Data and Analytics teams and business Subject Matter Experts for clarity of requirements definitionsUse Agile methods to deliver data and reporting solutionsPresent in Operational Committees, trend top drivers of provider disputes, and work with upstream and downstream partners to reduce provider pain pointsPartner with PDR Regulatory Audit Manager and Operations managers in developing new procedures and guidelines for onshore and offshore PDR teams that are aligned with regulatory requirements
Your Knowledge and Experience
Requires a bachelor’s degree or equivalent experienceRequires at least 7 years of prior relevant experienceRequires experience validating the quality and integrity of incoming dataRequires prior experience in data analysis and reporting, including Excel, SQL, BI tools, and data visualizationRequires excellent communication, presentation, and interpersonal skills, with the ability to communicate complex technical concepts to both technical and non-technical audiencesRequires expertise in at least one of the following lines of business – Commercial, Medi-Cal and/or Medicare
Pay Range:The pay range for this role is: $ 96470.00 to $ 144760.00 for California.Note:Please note that this range represents the pay range for this and many other positions at Blue Shield that fall into this pay grade. Blue Shield salaries are based on a variety of factors, including the candidate's experience, location (California, Bay area, or outside California), and current employee salaries for similar roles.