Blue Shield of California Jobs in Long Beach
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Search Results - Blue Shield of California Jobs in Long Beach
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-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-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...
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-Long Beach
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-Long Beach
Your Role
The Care Management team will serve to support the mission of the department, which is to provide support to patients in maintaining health and wellness in the outpatient setting. The Senior Care Manager will report to the Manager of Care...
Blue Shield of California-Long Beach
Your Role
The Facility Compliance Review team reviews post service prepayment facility claims for contract compliance, industry billing standards, medical necessity and hospital acquired conditions/never events. The Utilization Management Nurse,...
Blue Shield of California-Long Beach
Your Role
The Pharmacist, Consultant (Quality Assurance Pharmacist) is responsible for the design, development, maintenance, and delivery of audit programs for the Prior Authorization/Drug Utilization program. Reporting to the Sr. Manager,...
Blue Shield of California-Long Beach
Your Role
The Clinical Quality Analytics and Informatics team delivers best-in-class clinical quality analytics and informatics to enable high quality and affordable member-centered care. Our data, intelligence, and actionable insights help drive...
Blue Shield of California-Long Beach
Your Role
The Care Management team will serve to support the mission of the department, which is to provide support to patients in maintaining health and wellness in the outpatient setting. The Senior LVN, Care Manager will report to the Manager of...
Blue Shield of California-Long Beach
the Blue Shield of California Pharmacy and Therapeutics (P&T) Committee process by ensuring that evidence-based clinical decisions are implemented operationally to support safe, efficacious, and cost-effective prescribing of medications.
Our leadership...
Blue Shield of California-Long Beach
Your Role
The Clinical Services Coordinator (CSC) will report directly to the supervisor of care management support operations and will serve as an initial point of contact for providers and members in the medical management process by telephone or...
Blue Shield of California-Long Beach
Your Role
*This position is located at our Wilmington Community Resource Center Location & require employee to work 5 days per week in the Wilmington Community Resource Center*
The Community Resource Center (CRC) team is responsible for managing...
Blue Shield of California-Long Beach
Your Role
*This position is located at our Norwalk Community Resource Center Location & require employee to work 5 days per week in the Norwalk Community Resource Center*
The Community Resource Center (CRC) team is responsible for managing the...
Blue Shield of California-Long Beach
Your Role
The Risk Adjustment Provider Partnership team supports all functions within the risk adjustment program, working with cross-functional teams at Blue Shield and Provider Groups. The Risk Adjustment Consultant, reporting to the Manager, will...
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