DescriptionYour Role
The HCQA team is responsible for developing analytics and supporting materials to assist and guide strategic development and maintenance of Blue Shield's network of physicians, hospitals, ambulatory surgery centers, HMO IPA's, and medical groups. Our team (Network Performance Analysis and Contracts) is part of the HCQA Division and focuses on provider network performance analysis, reporting, and consulting. The NPAC team is responsible for developing analytics and supporting materials to assist and guide strategic development and maintenance of Blue Shield's network of physicians, hospitals, ambulatory surgery centers, HMO IPA's, and medical groups. In this role you will (1) provide analysis and consultative services on new network design in support of corporate strategic roadmap; (2) manages and oversees development and production of regulatory network filing artifacts as required by regulators for all Blue Shield and Promise Health Plan Commercial, Medi-Cal and Medicare networks; (3) provides network analytics, reporting and oversight on existing networks to ensure meeting regulatory access, availability standards as defined by regulators; and (4) provides consultative and analytical support as needed to during contract negotiations, pricing activities and product/network strategy roadmap planning. The Data Analytics Consultant will report to the Manager. This role serves as a critical analytical and strategic partner to the organization, connecting network performance data with regulatory requirements and business priorities. Your ability to identify access trends, communicate meaningful insights, and collaborate across teams will help drive regulatory readiness, strengthen network performance, and support sustainable solutions for member access.
Our leadership model is about developing great leaders at all levels and creating opportunities for our people to grow – personally, professionally, and financially. We are looking for leaders that are energized by creative and critical thinking, building and sustaining high-performing teams, getting results the right way, and fostering continuous learning.
ResponsibilitiesYour Work
In this role, you will:
Lead network adequacy and Access & Availability analytics, monitoring provider access, capacity, availability, and compliance across Commercial, Medicare, and Medi-Cal networks.
(
function() {
try {
if(window.location && window.location.search && window.location.search.indexOf('capture-sitebehaviour-heatmap') !== -1) {
sessionStorage.setItem('capture-sitebehaviour-heatmap', '_');
}
var sbSiteSecret = '251f277f-b561-4b0a-b647-b48d1ec96ce7';
window.sitebehaviourTrackingSecret = sbSiteSecret;
var scriptElement = document.createElement('script');
scriptElement.defer = true;
scriptElement.id = 'site-behaviour-script-v2';
scriptElement.src = 'https://sitebehaviour-cdn.fra1.cdn.digitaloceanspaces.com/index.min.js?sitebehaviour-secret=' + sbSiteSecret;
document.head.appendChild(scriptElement);
}
catch (e) {console.error(e)}
}
)()