Blue Shield of California Jobs
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Blue Shield of California-Oakland
Your Role
The Developer & Employee Experience Team serves at the direction of the Sr. Director of Technical Engineering, enabling BSC's journey to the cloud. The Platform Engineer, Consultant , will report to the Sr. Manager of Technical...
Blue Shield of California-Long Beach
Your Role
The Clinical Program Manager, Principal in collaboration with the Regional Medical Director and internal Blue Shield of California teams will be responsible for collaborating with all externally facing partners to transform the way...
Blue Shield of California-Rancho Cordova
education on core chronic conditions (Diabetes, Heart Failure, COPD, Asthma and Coronary Artery Disease). Outreach to members with HEDIS Care Gaps to assist with closure
• Apply detailed knowledge of FEP PPO and Blue Shield of California's established...
Blue Shield of California-Long Beach
Quality Department to improve Blue Shield of California and Promise Health Plan quality performance for regulatory and accreditation requirements including National Committee for Quality Assurance, Centers for Medicare and Medicaid and Department...
1 similar job: Oakland
Blue Shield of California-Long Beach
appropriate modifications in plan of care to adapt to changes occurring over time and through various settings
• Applies detailed knowledge of FEP PPO and Blue Shield of California's (BSC) established medical/departmental policies, clinical practice...
Blue Shield of California-Rancho Cordova
Your Role
Reporting to the Sr. Director, Utilization Management, the role of the Director, Commercial Utilization Management is critical to the success of Blue Shield of California and the Utilization Management department in realizing its goals...
Blue Shield of California-Long Beach
outcomes
• Initiate and implement appropriate modifications in plan of care to adapt to changes occurring over time and through various settings
• Applies detailed knowledge of FEP PPO and Blue Shield of California's (BSC) established medical...
Blue Shield of California-Oakland
Your Role
The Privacy Office develops and oversees Blue Shield’s Privacy Program. The Privacy Program ensures that Blue Shield and its affiliated covered entities, including Blue Shield of California Promise Health Plan, are in compliance...
Blue Shield of California-Oakland
Your Role
The Promise Compliance Audit Services team oversees all functions of an effective Compliance Program for Blue Shield of California Promise Health Plan. The Compliance Audit Services, Principal will report to the Senior Director...
Blue Shield of California-Rancho Cordova
Your Role
The MCS Clinical Service Intake team responsible for timely and accurate processing of Treatment Authorization Requests. The Clinical Services Coordinator (CSC), Intermediate will report to the Supervisor of Clinical Services Intake. In...
Blue Shield of California-El Dorado Hills
Your Role
The Appeals and Grievances team receives, documents, investigates, refers, and coordinates grievances, appeals and complaints. The Appeals and Grievances, Advanced Coordinator will report to the Appeals and Grievances Supervisor. In this...
Blue Shield of California-Oakland
Your Role
The Network and Provider Analytics team drives the development of an affordable provider network through data analytics and expertise. The Senior Actuarial Analyst will report to the Senior Manager. In this role you will perform financial...
Blue Shield of California-Rancho Cordova
Your Role
The UM Prior Authorization team conducts medical necessity reviews for services before they are rendered. The Sr. Manager Medical and Utilization Review will report to the Director Medical and Utilization Review. In this role you will be...
Blue Shield of California-San Diego
Your Role
The Social Services Representative, Advanced will report to the Supervisor, Social Services. In this role you will provide telephonic social services support and resource referrals for high acuity Blue Shield Promise members, in addition...
Blue Shield of California-Oakland
Your Role
The Actuarial Pricing team is responsible for forecasting costs and revenues to ensure the financial stability of the company. The Actuarial Analyst, Principle will report to the Senior Director, Select, ASO & Specialty Pricing. In this...
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