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 Management. In this role you will ensure that services are provided based on standardized procedures including coordination

Your Role The Information Security team is responsible for providing cyber security services to Blue Shield of California that enable secure product development and operations. The Director of Information Security will report to the Sr. Director . In this role you will you will lead a team responsible for designing, implementing, and maintaining security capabilities that

Your Role The Federal Employee Program (FEP) team performs integrated case management (CM) and disease management (DM) activities demonstrating clinical judgment and independent analysis, collaborating with members and those involved with members' care including clinical nurses and treating physicians . The Registered Nurse Case Manager will report to the FEP Department M

The Commercial Member Acquisition marketing team is looking for a dynamic marketing professional to join us as the Marketing Campaign Specialist, Senior Member Acquisition. The team are passionate marketers at heart driven to create the most compelling member experience so that Blue Shield is the health plan carrier of choice during open enrollment. The Marketing Campaign

Your Role The Blue Shield of California Finance team is responsible for providing Line of Business consolidation, reporting, and analysis support for the Growth Finance team. The Financial Analyst, Consultant will report to the Markets Planning and Analysis Finance Manager. In this role, you will work closely and collaborate with other stakeholders (actuarial, accounting,

Your Role The clinical services coordinator (CSC) will report directly to the supervisor of care management support operations and will serves as initial point of contact for providers and members in the medical management process by telephone or correspondence. The CSC will interact telephonically with members as per established protocol or direction to ensure that membe

Your Role The Children's Health Program (CHP) team provides identification, referrals, and care management for all Medi Cal members under 21 years old and collaborates within Promise Clinical Team. The Case Management, Senior will report to the CHP Manager. In this role you will be Perform clinical review, assessment, evaluation of medical services for the organization us

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 direction to ensure that members are effectively and efficiently managed through the outreach, engagement, and care management

Your Role The Clinical Quality team oversees and is responsible of HEDIS medical record review, pursuit, and overall HEDIS submission. The Clinical Quality Coordinator will report to the Supervisor of the HEDIS Outreach Team. In this role you will be responsible for conducting provider outreach during the HEDIS season for medical record pursuit and retrieval. Also, partic

Your Role The Network Management team handles provider contracting and provider relations statewide. The Provider Contracting Specialist, Experienced will report to the Sr Manager of Provider Contracting. In this role you will support Medical Group/IPA and Hospital/Facility contracting in Northern California for all Blue Shield products. You will be responsible for compre

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 quality strategy, performance improvement, and regulatory reporting. The Clinical Quality Analyst Senior will report to the Cli

Your Role The IT Business Operations team plays a critical role in enhancing business and IT collaboration through a Portfolio based model. The System Analyst, Consultant will report to the Senior Manager, IT Product Management. In this role you will analyze data at a team and portfolio level, in a manner to tell stories to leadership. Your Work In this role, you will For

Your Role The Network Management team handles provider contracting and provider relations statewide. The Provider Contracting Specialist, Senior will report to the Director, Provider Contracting. In this role you will support Medical Group/IPA and Hospital/Facility contracting in Southern California for all Blue Shield products. You will be responsible for comprehensive m

Your Role The Federal Employee Program (FEP) team performs integrated case management (CM) and disease management (DM) activities demonstrating clinical judgment and independent analysis, collaborating with members and those involved with members' care including clinical nurses and treating physicians . The Registered Nurse Case Manager will report to the FEP Department M

Your Role The Care Management Department, which oversees all outpatient care management for the Commercial and Medicare lines of business, is seeking a Clinical Program Manager, Principal to join our team. In this role, the candidate will provide comprehensive support and collaborate effectively with stakeholders across various departments. The ideal candidate must posses