Principal Financial Analyst - Healthcare Data

JOB DESCRIPTION
Your Role

The Finance Cost of Healthcare team analyzes healthcare cost and utilization patterns and identifies opportunities to reduce cost. The Principal Financial Analyst - Healthcare Data will report to the Senior Manager Finance Analytics. In this role you will collect, prepare, analyze, and present healthcare utilization data, identify utilization patterns and trends, and collaborate with cross-functional teams on cost-saving initiatives.

Your Work

In this role, you will:

• Collect and evaluate data, develop and maintain financial models, analyze results and conduct scenario analyses to forecast balance sheet, cash flow and regulatory capital
• Monitor and measure cash flow and regulatory capital
• Analyze utilization patterns and monitor healthcare trends to identify potential changes in cost drivers
• Work closely with IT teams to ensure the accuracy and integrity of data
• Follow and conduct audit processes and review internal controls to ensure financial transactions are accurate, timely and comply with accounting standards, principles and company policy
• Prepare and present reports and dashboards on healthcare utilizations and costs to internal stakeholders, such as senior management, underwriting, and actuarial teams
• Reconcile data results from different sources and combine them into integrated reports spanning cost, quality, utilization, and risk profile metrics
• Participate on internal workgroups and committees to provide analytical insight and support for the implementation and enhancement of new programs, products, and services

QUALIFICATIONS
Your Knowledge and Experience

• Requires at least 10 years of prior relevant experience
• Experience with Power BI or Tableau or Qlik is preferred
• Familiarity with Healthcare Payer Administration System such as Facets, QNXT, Epic, MedHOK and NextGen Healthcare is preferred
• Requires a bachelor's degree in finance, economics, statistics, computer science or equivalent experience
• Requires at least 8 years of experience working with SQL
• Requires at least 8 years of experience working with healthcare claims, authorizations, provider networks, contracts, and membership data

Pay Range : The pay range for this role is: $136,400.00 to $204,600.00 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.

ABOUT THE TEAM
Blue Shield of California’s mission is to ensure all Californians have access to high-quality health care at a sustainably affordable price. We are transforming health care in a way that truly serves our nonprofit mission by lowering costs, improving quality, and enhancing the member and physician experience.

To fulfill our mission, we must ensure a diverse, equitable, and inclusive environment where all employees can be their authentic selves and fully contribute to meet the needs of the multifaceted communities we serve. Our comprehensive approach to diversity, equity, and inclusion combines a focus on our people, processes, and systems with a deep commitment to promoting social justice and health equity through our products, business practices, and presence as a corporate citizen.

Blue Shield has received awards and recognition for being a certified Great Place to Work, best place to work for LGBTQ equality, leading disability employer, one of the best companies for women to advance, Bay Area’s top companies in volunteering & giving, and one of the world’s most ethical companies. Here at Blue Shield of California, we are striving to make a positive change across our industry and the communities we live in – join us!

Our Values:

• Human . We strive to be our authentic selves, listening and communicating effectively, and showing empathy towards others by walking in their shoes.
• Courageous . We stand up for what we believe in and are committed to the hard work necessary to achieve our ambitious goals.
• 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.

From the earliest days of the pandemic, Blue Shield of California has been unyielding in our commitment to putting the health and safety of our people, our members and our communities first. As a health care company, Blue Shield requires all employees to be up to date with COVID-19 vaccination prior to start date as a condition of employment. Blue Shield will consider requests for medical or religious accommodation to this vaccination requirement prior to your start date.

The definition of "up to date with your COVID-19 vaccine" is when you have received all doses in the primary series and one booster when eligible. If you are unable to be up to date with your COVID-19 vaccine by your start date, your start date will need to be postponed and you will have 30 days to remedy. If you cannot fulfill the requirement nor obtain an accommodation within 30 days, your offer will be rescinded.