Blue Shield of California Jobs in El Dorado Hills
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Search Results - Blue Shield of California Jobs in El Dorado Hills
Blue Shield of California-El Dorado Hills
Your Role
The Clinical Services Coordinator (CSC) will report directly to the Supervisor of Promise Medi-Cal Care Management. This individual will interact telephonically and electronically with members and providers as per established protocol or...
Blue Shield of California-El Dorado Hills
Your Role
Utilization and Medical Review - Ensures accurate and timely prior authorization of designated healthcare services, concurrent review activity, and retrospective review activity. Utilization Management Nurse - Performs prospective,...
Blue Shield of California-El Dorado Hills
Your Role
The Behavioral Health Utilization Management team performs prospective, concurrent, retrospective utilization reviews and first level determination approvals for members using BSC evidenced based guidelines, policies, and nationally...
Blue Shield of California-El Dorado Hills
Your Role
The Clinical Services Coordinator (CSC) will report directly to the Supervisor of Promise Medi-Cal Care Management. This individual will interact telephonically and electronically with members and providers as per established protocol or...
Blue Shield of California-Rancho Cordova, 13 mi from El Dorado Hills
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-Rancho Cordova, 13 mi from El Dorado Hills
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-Rancho Cordova, 13 mi from El Dorado Hills
Your Role
The Utilization Management team reviews the inpatient stays for our members and correctly applies the guidelines for nationally recognized levels of care. The Utilization Management Nurse will report to the Utilization Management Nurse...
Blue Shield of California-Rancho Cordova, 13 mi from El Dorado Hills
Your Role
The Medicare and Medical Appeals and Grievances team is responsible for clinically reviewing member appeals and grievances that are the result of either a preservice, post service or claim denial. The Medicare Appeals and Grievances RN...
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