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 Manager. In this role you will be assigned a list of inpatient facilities and then review clinical information provided by the f

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 Manager. In this role you will be assigned a list of inpatient facilities and then review clinical information provided by the f

Your Role The Medical Director, Commercial is a key member of the Medical Management and Operations staff within Health Care Services. This is a front line utilization management position that has core responsibilities in the areas of pre and post service utilization review, and collaboration with RN Case and disease managers.This director position will report to the Medi

Your Role The Pharmacy Prior Authorization team provides efficient and accurate responses to external customers (physicians, office staff, pharmacy providers, members, and brokers) and internal team members for all outpatient pharmacy benefit inquiries. The Pharmacy Technician, Intermediate, will report to the Operations Supervisor. In this role you will resolve outpatien

Your Role The Law Business team brings experience, expertise and solutions in technology, data management and other support services to help the Law Department continuously improve and excel in our support of BSC and its affiliates. The Business Analyst will be responsible for providing technical support to the Law Department teams and will report to the Law Business Team

Your Role The enterprise wide Data & Analytics (D&A) team is seeking to hire a Strategic Planning & Chief of Staff, Principal. This role reports directly to VP of Data & Analytics and is expected to work team wide, IT wide, and enterprise wide as a critical part of Blue Shield's data driven and mission driven journey of transforming the world of healthcare. The D&A team p

Your Role The IT Development Center Of Excellence team at Blue Shield is tasked with establishing best practices and standards as we rapidly transform ourselves to be a digital first company. The DevSecOps Engineer, Principal will report to the Sr Manager, IT Development Centers Of Excellence. As a DevSecOps Engineer, you will play a critical role in assessing our current

Your Role The Third Party Application Solutions personnel within the Software Development Centers Of Excellence team perform hardware and software system administration as well as set quality expectations. The Senior Application Developer & System Administrator will report to the Centers Of Excellence Senior Manager. In this role you will execute hands on patching and upg

Your Role With pharmacy benefits being an essential component of the medical benefits, Pharmacy Care Reimagined is a critical Blue Shield of California initiative along with other Health Care Reimagined initiatives. The Pharmacy Care Reimagined goal is to enable every person with safe, equitable access to sustainably affordable prescription drugs. To enable our vision, we

Your Role The Cloud Engineering team is a cross functional group responsible for the advancement and support of the Blue Shield multi cloud presence. The Cloud Engineer Principal will report to the Sr. Director Hybrid Cloud Engineering. In this role you will have a broad and deep impact on how Blue Shield achieves its business and technical goals by leveraging cloud techn

Your Role Join Blue Shield's dynamic Enterprise Learning organization, which develops learning solutions to ensure employees can perform their jobs effectively to further our mission. As a IT Learning Developer, Senior you will serve as a strategic partner to talent mobility through innovative learning strategies and solutions. The IT Learning Developer, Senior will repor

Your Role The Compensation team is an in house center of expertise and consulting team and provides leadership and guidance in the development and delivery of effective compensation strategies and policies that support BSC's goals, and are in alignment with enterprise values, philosophy and strategic direction.. The Senior Compensation Analyst will report to the Senior Ma

Your Role The Actuarial Provider Strategies team helps design and implement value based care (VBC) payment models, which include Accountable Care Organizations (ACOs) and other innovative alternative payment models (APMs) to improve the affordability and quality of care our members receive. The Experienced Actuarial Analyst will report to the Senior manager of Actuarial P

Your Role The Corporate Communications team supports Blue Shield of California's reputation with both internal and external audiences through employee engagement, media and executive visibility. The Senior Communications Manager will report to the Senior Director of Corporate Communications. In this role you will lead a team supporting the Chief Human Resources Officer an

Your Role The People and Engagement (P&E) Enterprise Planning, Principal will report to the Director, P&E Strategy and Planning. In this role you will support the creation, ongoing execution and reporting of P&E's enterprise impacting plans and initiatives, and maintain alignment with our people strategy and P&E annual planning efforts. This will include Blue Shield's hum