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:
- Monitor and measure cash flow and regulatory capital
- Collect and evaluate data, develop and maintain financial models, analyze results and conduct scenario analyses to forecast balance sheet, cash flow and regulatory capital
- Reconcile data results from different sources and combine them into integrated reports spanning cost, quality, utilization, and risk profile metrics
- 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
- Participate on internal workgroups and committees to provide analytical insight and support for the implementation and enhancement of new programs, products, and services
- Prepare and present reports and dashboards on healthcare utilizations and costs to internal stakeholders, such as senior management, underwriting, and actuarial teams
- 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
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. We’re excited to share Blue Shield of California has received awards and recognition for LGBT diversity, quality improvement, most influential women in corporate America, Bay Area’s top companies in volunteering & giving, and one of the world’s most ethical companies. Here at Blue Shield of California, we’re striving to make a positive change across our industry and the communities we live in , Join us!
Your Knowledge and Experience
- Requires a bachelor’s degree in finance, economics, statistics, computer science or equivalent experience
- Requires at least 10 years of prior relevant 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
- 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
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.