Blue Shield of CA

 
Displaying 1 - 15 of 119 Jobs.
 
Program Manager, Change Management and Employee Engagement
Oakland, CA
Your Role The People and Engagement (P&E) Change Management and Employee Engagement team has three core impact areas lead and execute enterprise level change efforts, holistically manage...

Operations Specialist, Experienced
El Dorado Hills, CA; Oakland, CA; Long Beach, CA; Rancho Cordova, CA; San Diego, CA; Woodland Hills, CA
Your Role The Pharmacy Vendor Performance Management team supports Pharmacy Services in managing vendor relationships, tracking vendor escalations, running operational processes related...

Appeals and Grievances - RN, Senior
Rancho Cordova, CA; Oakland, CA; Long Beach, CA; El Dorado Hills, CA; San Diego, CA; Woodland Hills, CA
Your Role The Appeals and Grievances team is responsible for clinically reviewing member appeals and grievances that are the result of either a preservice, post service or claim denial....

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

Clinical Quality Reviewer - Nurse, Senior
Long Beach, CA; Oakland, CA; El Dorado Hills, CA; Rancho Cordova, CA; San Diego, CA; Woodland Hills, CA
Your Role The Clinical Quality team is responsible for reviewing and abstracting medical records to capture data and to ensure accuracy and completeness. The Clinical Quality Reviewer Nu...

Case Management - Nurse, 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 (FEP) team performs integrated case management (CM) and disease management (DM) activities demonstrating clinical judgment and independent analysis...

Enterprise Rapid Response, Senior Principal
Oakland, CA; Long Beach, CA; El Dorado Hills, CA; Rancho Cordova, CA; San Diego, CA; Woodland Hills, CA
Your Role The Enterprise Rapid Response team is an internal consulting function that supports the business in executing strategic priorities and resolving critical business issues in a s...

Enterprise Rapid Response, Senior Principal
Oakland, CA; Long Beach, CA; El Dorado Hills, CA; Rancho Cordova, CA; San Diego, CA; Woodland Hills, CA
Your Role The Enterprise Rapid Response team is an internal consulting function that supports the business in executing strategic priorities and resolving critical business issues in a s...

Program Manager, Consultant - Health Data Strategy
El Dorado Hills, CA; Oakland, CA; Long Beach, CA; Rancho Cordova, CA; San Diego, CA; Woodland Hills, CA
Your Role The Health Transformation Data & Evaluation team is committed to identifying, designing, implementing, and evaluating innovations that transform health care leveraging comprehe...

Well-being and Recognition Analyst, Senior
Oakland, CA; Long Beach, CA; El Dorado Hills, CA; Rancho Cordova, CA; San Diego, CA; Woodland Hills, CA
Your Role The Total Rewards team is responsible for designing, implementing, administering, and communicating the organization's benefits, retirement, wellbeing, and recognition programs...

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

Financial Analyst, Principal
Oakland, CA; Long Beach, CA; El Dorado Hills, CA; Rancho Cordova, CA; San Diego, CA; Woodland Hills, CA
Your Role The Finance Cost of Healthcare team analyzes healthcare cost and utilization patterns and identifies opportunities to reduce cost. The Principal Financial Analyst Healthcare Da...

People Strategy, Planning and Performance, Consultant
Oakland, CA; Long Beach, CA; El Dorado Hills, CA; Rancho Cordova, CA; San Diego, CA; Woodland Hills, CA
Your Role The People and Engagement Strategy & Planning team is responsible for (1) researching, defining and implementing our Blue Shield people strategy and how we continue to be a gre...

Clinical Services Coordinator, Intermediate
Long Beach, CA; Oakland, CA; El Dorado Hills, CA; Rancho Cordova, CA; San Diego, CA; Woodland Hills, CA
Your Role The Behavioral Health Utilization Management team provides utilization management and support for member seeking behavioral health treatment. The Clinical Services Coordinator...

Provider Contracting Specialist, Senior
Long Beach, CA; Oakland, CA; El Dorado Hills, CA; Rancho Cordova, CA; San Diego, CA; Woodland Hills, CA
Your Role The Network Management team handles provider contracting and provider relations statewide. The Provider Contracting Specialist, Senior will report to the Director, Provider Con...