The Pharmacy Financial Analytics team. The Medical Informatics Consultant will report to the Sr. Principal Medical Informatics Analyst of Pharmacy Financial Analytics. In this role, you will play a key part in advancing our organization''s analytical capabilities by supporting network and rebate reporting, reconciliation processes, model development, and automation initiatives. Your work will directly empower leadership with the tools, insights, and data needed to make informed strategic decisions, drive operational excellence, and support the continued growth and success of the organization through innovative, data-driven solutions.
Your Knowledge and Experience
Requires a bachelor's degree or High School Diploma/GED and 4 years of additional relevant experience in lieu of a degree
Requires 7 years of relevant experience delivering analytics (cost, quality, utilization, and/or outcomes) with enterprise impact
Requires 5 years of prior pharmacy experience
Requires SAS Certified Advanced Programmer credential (or equivalent) or advanced analytics certification (e.g., R, Python)
Hybrid
This role requires employees to be in-office based on our hybrid workplace model, balancing purposeful in-person collaboration with flexibility. For most teams, this means coming into the office two days each week.
Employees living more than 50 miles from an office location will work with their manager to determine in-office time based on business need.
Your Work
In this role, you will:
Develop, optimize, and maintain complex SQL queries to extract, transform, and analyze pharmacy, claims, financial, and operational data.
Use SAS and other analytical tools to manipulate large healthcare datasets, support statistical analysis, and contribute to predictive model development.
Support the design, maintenance, and enhancement of underwriting tools used to evaluate pharmacy cost, utilization, revenue, and performance trends.
Design, automate, and maintain financial reporting to monitor pharmacy revenue streams, dispensing margins, rebate activity, billing accuracy, and key performance indicators.
Perform financial reconciliations across pharmacy claims, rebate, inventory, operational, and general ledger data to ensure accuracy, identify variances, and support issue resolution.
Analyze financial and operational trends to identify cost-saving opportunities, revenue impacts, process gaps, and business performance drivers.
Translate complex pharmacy and financial data into clear insights, recommendations, and presentations for business leaders and cross-functional partners.
Partner with Pharmacy, Finance, Underwriting, Actuarial, and operational teams to support strategic initiatives, improve reporting capabilities, and drive data-informed decision-making.
Your Work
In this role, you will:
Develop, optimize, and maintain complex SQL queries to extract, transform, and analyze pharmacy, claims, financial, and operational data.
Use SAS and other analytical tools to manipulate large healthcare datasets, support statistical analysis, and contribute to predictive model development.
Support the design, maintenance, and enhancement of underwriting tools used to evaluate pharmacy cost, utilization, revenue, and performance trends.
Design, automate, and maintain financial reporting to monitor pharmacy revenue streams, dispensing margins, rebate activity, billing accuracy, and key performance indicators.
Perform financial reconciliations across pharmacy claims, rebate, inventory, operational, and general ledger data to ensure accuracy, identify variances, and support issue resolution.
Analyze financial and operational trends to identify cost-saving opportunities, revenue impacts, process gaps, and business performance drivers.
Translate complex pharmacy and financial data into clear insights, recommendations, and presentations for business leaders and cross-functional partners.
Partner with Pharmacy, Finance, Underwriting, Actuarial, and operational teams to support strategic initiatives, improve reporting capabilities, and drive data-informed decision-making.
Numbers & Facts
Location
Oakland, CA
Industry
Insurance
Company Size
2,000 to 2,499 employees
Website
https://www.bcbs.com/about-us/careers
About Company
At the Blue Cross and Blue Shield Association (BCBSA), we provide business strategy, technical support and consulting expertise to 36 Blue Cross and Blue Shield companies across the nation, employing more than 1,000 of the best strategic thinkers in the industry. We are a Brand manager that sets quality control standards for the 36 independent companies that use the Blue Cross and Blue Shield Brands, and we serve as a trade association that represents these Blue companies. It is through our involvement that the Blues companies share a united vision and strategy while also benefiting from the local strength of all member companies.
Skills
Actuarial Skillsunmatched
Analysis Skillsunmatched
Automationunmatched
Billingunmatched
Consultingunmatched
Cost Controlunmatched
Cross-Functionalunmatched
Financeunmatched
Financial Analysisunmatched
Financial Operationsunmatched
Financial Trend Analysisunmatched
General Ledger Accountingunmatched
Health Informaticsunmatched
Healthcareunmatched
High School Diplomaunmatched
Leadershipunmatched
Network Supportunmatched
Operational Auditunmatched
Operational Supportunmatched
Performance Metricsunmatched
Pharmacyunmatched
Predictive Modelingunmatched
Problem Solving Skillsunmatched
Process Modelingunmatched
Reconciliationunmatched
Reporting Skillsunmatched
SQL (Structured Query Language)unmatched
Statistical Analysis System (SAS)unmatched
Statisticsunmatched
Strategic Planningunmatched
Training Data Setsunmatched
Trend Analysisunmatched
Underwritingunmatched
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