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 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 Behavioral Health Utilization Management team performs prospective utilization review for our members and correctly applies the guidelines for nationally recognized levels of care. They collaborate directly with the Member, Member's Family, and Interdisciplinary Care Team to achieve consensus and promote positive Member health outcomes through the assessment

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 Community Programs team provides high touch engagement with member and community based organizations to remove barriers to health care access, enhance population health initiatives and advance health equity. The Community Health Advocate Coordinated Entry System (CES) Liaison will report to the Community Programs Manager, Operations. In this role you will be

Compensation range for the role is listed above. Applicable salary ranges may differ across markets. Actual pay will be determined based on experience and other job related factors permitted by law. As a part of the compensation package, this role may include eligible bonuses. For more information regarding VSP Vision benefits, please. Are you an experienced professional

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 Behavioral Health Registered Nurse Case Manager will report to th

Your Role The Cost of Healthcare Trendsetters & Pharmacy Support team analyzes and provides emerging healthcare cost trend drivers. The Medical Informatics Analyst IV will report to the Actuarial Manager. Your Work In this role, you will Conduct independent analysis of high complexity under minimal supervision and guidance Develop analytical methods so that they may be su

Your Role The Director of Facilities will report to the VP Internal Audit Services. In this role you will manage the real estate, security, and facility operations for Blue Shield of California for multiple locations of over 1.2M and 7,500 employees. Our leadership model is about developing great leaders at all levels and creating opportunities for our people to grow pers

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

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 Healthcare Business Operations (HBO) team provides centers of excellence for healthcare business resolution practice. Our team is responsible for transforming how we operate throughout the enterprise and has a significant impact on our spend. The Senior Manager, Operations role will report to the Director of Provider Dispute Resolution in Healthcare Business

Your Role The Care Management Clinical Social Work team helps Blue Shield members with complex social determinants of health by conducting psychosocial assessments, developing care plans, and providing intensive interventions. The Care Management Social Worker will report to the Manager and/or Senior Manager of Care Management Clinical Social Work. In this role you will b

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 Medical Director provides clinical leadership within the Office of the CMO for Blue Shield Promise Health Plan, which includes management of the physician processes in support of utilization management and transactional functions. These functions include performance of preservice, concurrent, retrospective utilization review, Appeals and Grievances, and retr