Licensed Clinician, Senior
Rancho Cordova, CA; Oakland, CA; Long Beach, CA; El Dorado Hills, CA; San Diego, CA; Woodland Hills, CA
Your Role The Federal Employee Program team completes benefit and medical necessity reviews for members enrolled in the FEP PPO benefit plans. The Board Certified Behavioral Analyst (BCB...

Clinical Quality Analytics, Senior
Oakland, CA; Long Beach, CA; El Dorado Hills, CA; Rancho Cordova, CA; San Diego, CA; Woodland Hills, CA
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...

Supervisor, Operations
Woodland Hills, CA; Long Beach, CA; El Dorado Hills, CA
Your Role The Medicare Appeals and Grievances team is responsible for compliance processing of Medicare appeals and grievances. The supervisor will report to the Sr. Manager for Medicare...

Systems Analyst, Consultant
El Dorado Hills, CA; Oakland, CA; Long Beach, CA; San Diego, CA
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...

Case Management - Nurse, Senior
El Dorado Hills, CA; Oakland, CA; Long Beach, CA; Rancho Cordova, CA; San Diego, CA; Woodland Hills, CA
Your Role The Federal Employee Program (FEP) team performs integrated case management (CM) and disease management (DM) activities demonstrating clinical judgment and independent analysis...

Correspondence Phone Support, Intermediate
Redding, CA
Blue Shield is embarking on an exciting new collaborative partnership with a fellow health plan. We will play a supporting role in their day to day contact center operations by supportin...

Product Manager, Principal - Member Experience
Oakland, CA; Long Beach, CA; Phoenix, AZ; Denver, CO; Hartford, CT; Miami, FL; Atlanta, GA; Baltimore, MD; Minneapolis, MN; Las Vegas, NV; El Dorado Hills, CA; Huntington Park, CA; Lodi, CA; Palmda...
Your Role TheDigital Member Experienceteamis driving better access to healthcare for our members by reimagining our digital customer experience. The Principal Product Manager will report...

Product Manager, Consultant - Member Experience
Oakland, CA; Long Beach, CA; Phoenix, AZ; Denver, CO; Hartford, CT; Miami, FL; Atlanta, GA; Baltimore, MD; Minneapolis, MN; Las Vegas, NV; El Dorado Hills, CA; Huntington Park, CA; Lodi, CA; Palmda...
Your Role The Digital Member Experience team is reimagining our digital customer experience and leading the transformation of the healthcare industry. The Product Manager, Consultant wil...

Business Analyst, Senior
Oakland, CA; Long Beach, CA; El Dorado Hills, CA; Redding, CA; San Diego, CA; Woodland Hills, CA
Your Role The Customer Experience Insights team is responsible for all Operational Key Performance Indicator Reporting and Analysis for the Customer Experience Call Center teams. The Bus...

Case Management - Nurse, Senior
Long Beach, CA; Oakland, CA; El Dorado Hills, CA; Rancho Cordova, CA; San Diego, CA; Woodland Hills, CA
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 setti...

Contracting Specialist, Senior
Oakland, CA; Las Vegas, NV
Your Role The Global Business Services (GBS) department is responsible for delivering strategic and category supplier sourcing, contracting and governance excellence at Blue Shield of Ca...

Case Management - Nurse, Consultant
Rancho Cordova, CA; Oakland, CA; Long Beach, CA; El Dorado Hills, CA; Woodland Hills, CA
Your Role The Federal Employee Program (FEP) Care Management team performs integrated case management (CM) and disease management (DM) activities demonstrating clinical judgment and inde...

Configuration Analyst, Experienced
Rancho Cordova, CA; Oakland, CA; El Dorado Hills, CA
Your Role The QC Pricing Analytics and Contract Configuration team is responsible for performing an in line audit for all negotiated provider contacts. The QC Configuration Analyst, Expe...

Clinical Services Coordinator, Intermediate
Long Beach, CA; Oakland, CA; Rancho Cordova, CA; San Diego, CA; Woodland Hills, CA
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 Cli...

Clinical Services Coordinator, Intermediate
Long Beach, CA; Oakland, CA; Los Angeles, CA; Sacramento, CA; San Diego, CA; Woodland Hills, CA
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 electronica...