Your Role

The Pharmacy Markets, Products, Analytics and Strategies team is a critical area within Blue Shield Pharmacy Services to provide Product and Market strategies to support affordability and quality objectives. Within the team, the Pharmacy Strategic Consultative Analytics area drive consultative analytics to facilitate strategy decision and opportunity identification for critical pharmacy road map initiatives. The Principal Health Data Analyst, Pharmacy Strategic Consultative Analytics will report to the Sr. Manager, Pharmacy Strategic Consultative Analytics. In this role you will play a key role in working cross-functionally with key stakeholders across Blue Shield to perform clinical and business analyses necessary that informs consultations and strategic program recommendations. Analytic focus areas may include pharmacy benefit management vendor, manufacturer, provider and health system contracting and reimbursement strategies, specialty drug cost management, and quality programs to improve outcomes and member satisfaction for pharmacy and medical drug benefits.

Your Work

In this role, you will:

• Develop and conduct evaluations and studies within limited time frames and produce analyses that are easy for non-technical persons to understand
• Lead/coordinate the design and implementation of reports that integrate data from multiple sources, including design of reporting systems and standardization of metrics and formats across departments and functional areas
• Assess business risks relating to reporting design and production; develop and implement plans to mitigate risks
• Function as facilitator and/or mentor for data reporting projects, teams and task forces; supply consultative advice to cross-functional analytics teams and business units regarding standard business rules and algorithms
• Coordinate interaction between data analysis teams and support functions including information systems, provider relations and medical management
• Perform analyses that leverage clinical, operational, pharmacy and medical data sources to inform strategy and program design. Leverage various data sources and reports to create executive summaries and actionable plans to support performance management
• Review pharmacy cost, utilization, and finance data to identify opportunities to optimize pharmacy performance on cost and revenue. Provide pharmacy consultations and information as appropriate to support pharmacy product and pricing strategy, annual renewal, and membership growth initiatives
• Lead or collaborate with other analysts to design and develop ongoing pharmacy reports and tools to support outcomes tracking, including tracking of key performance metrics and explaining variance to plan
• Maintain and/or enhance existing advanced models and reporting to accommodate new business requirements, new metrics and drilldown, as well as improving process efficiency
• Utilizing available reports for quick assessment and benchmarking as well as provide guidance on how to expand current reports for new initiatives or outcome monitoring
• Provide input on data warehousing requirements to improve reporting capability, efficiency, and accuracy
• Support strategic initiative and innovation planning and lead select initiative implementation as assigned

Your Knowledge and Experience

• Requires an MPH, MBA, MS, MA in science, social science, public health, health svcs research or business, or BA/BS with demonstrated equivalent work experience
• Requires at least 10 years of prior relevant experience
• Requires at least 5 years of experience in Health Care (PBM, managed care, academic, or gov't payer)
• Highly proficient data analytic skills with Business Objects, Microsoft Office (e.g. Access and Excel) required. Other data analytic experience is preferred (e.g. SQL, SAS, Tableau)
• Demonstrated ability to work with pharmacy and medical claims data and familiar with pharmacy data parameters available for analysis. Prior experience and demonstrated ability to work with large datasets required
• Prior experience in pharmaceutical contracting and pricing analytics and demonstrated ability to interpret health plan benefit utilization and financial data is preferred
• Possesses strong business acumen with proven experience in thinking strategically required
• Demonstrated ability to interpret analytic results and provide recommendations to leadership team preferred
• Demonstrated ability to successfully work with other functional departments within a health plan is required.
• Possesses excellent verbal and written skills with ability to convey and understand complex ideas.
• Detail-oriented with the ability to work in a fast-paced environment.
• Exhibits "can do" attitude and solution-oriented approach to resolve challenges preferred.
• Able to work independently with minimum direction or supervision required.
• Possesses strong collaboration and partnership skills in a matrixed work environment preferred.
• Demonstrate ability to manage challenging situations in a positive and constructive manner.
• Produces accurate work under tight deadlines.

Pay Range:

The pay range for this role is: $ 136400.00 to $ 204600.00 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.