Your Role
The Network Contracting and Trend Analytics (NTA) team supports the Network Management team with analytical and financial modeling for provider contracting and network development activities for Blue Shield of California. The Senior Principal, Medical Informatics of NTA will report to the Senior Director of NTA. In this role you will be responsible for behavioral health finance analytics including measurement of internal cost of healthcare and reporting, analytics supporting coordination of care opportunities, and oversight of provider contracting analytics.
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.
Your Work
In this role, you will:
- Develop the financial management and modeling best practices, specifically for Behavior Health as we move to an in-sourced environment
- Implement on-going behavior health costs analysis and trends
- Be responsible for CoHC - Behavior Health
- Be the lead on modeling the financial aspects. Example, evaluating the financial aspects of care activities such as hospital ER vs behavioral health services
- Lead all financial aspects in developing Value-Based Contracting, specifically in Behavior Health marketplace.
- Be accountable for development of the financial contractual arrangements and the implementation of these providers, which we are bringing in house
Your Knowledge and Experience
- Requires a college degree or equivalent experience
- MPH, MBA, MS, MA, RN, or RHIA preferred
- Requires 10 years of relative experience
- Requires a minimum of 5 years' experience in Health Care (managed care, academic, or gov't payer)
- Requires contracting in healthcare with a behavioral health specialty
- Requires experience developing programs that will translate into CoHC savings specifically in extensive vendor knowledge of financial healthcare within behavioral health
- Requires experience with behavioral health financial reporting and modeling
- Requires one to be comfortable with an ever changing business model that is continually seeking the optimal solution in the behavioral health space
- Requires a SAS Certified Base Programmer Credential or equivalent or a SAS Certified Advanced Programmer Credential or equivalent