Your Role The People & Engagement HR Connect team is a critical part of Human Resources service delivery for all of Blue Shield of California (BSC) The team provides first level support to all BSC employees on a daily basis for both daily operations and employee facing initiatives. The HR Specialist, Advanced will report to the Manager, HR Connect. In this role you will b

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 to administrative support to the Social Services Management Team. The Social Services Representative regularly reaches out to

Your Role The Provider Education team develops learning resources for contracted providers to help them work more effectively with Blue Shield and promote member satisfaction. The Learning Systems Administrator, Experienced will report to the Sr. Program Manager, Provider Education. In this role, you will manage and execute implementation and delivery of internal and exte

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

Office Service Representative I Job Locations US CA EL DORADO HILLS Requisition ID 2024 17828 # of Openings 1 Category (Portal Searching) Customer Service/Support Position Type (Portal Searching) Regular Full Time Overview Under general supervision, is responsible for all mail, packages and interoffice correspondence handling and dispatching for all classes of mail/packag

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 The Data & Analytics team is responsible for performing detailed data analysis, source to target designs, data profiling, and metadata management in support of new development/implementation or enhancement of existing data assets. The IT Data Analyst, Consultant will report to the Manager of Data Solutions and Asset Management. In this role, you will participate