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 Delegation Oversight Utilization Management team is responsible for the organization, tracking and data entry of IPA Utilization Management audits, issues, complaints and monitoring. Identifies root cause of the problem and maintains monthly reporting that track and compare patters of delegated entities. The Delegation Operations Nurse Auditor LVN Experience

Your Role The Innovation Analyst, Consultant is responsible for supporting the improvement and maintenance of our integrated enterprise strategy to execution process and supporting initiatives designed to provide strategic thought leadership to business leaders across the enterprise to address ambiguous problems and opportunities. This role will serve as a change agent, l

Your Role The Medical Care Solutions Clinical Service Intake team responsible for timely and accurate processing of Treatment Authorization Request. The Clinical Services Coordinator will report to the Supervisor of Clinical Services Intake. In this role you will be for supporting clinical staff day to day operations for Promise lines of business. Your Work In this role,

Your Role The Network Performance Analysis and Contracts is part of the Provider Partnerships & Network Management Division and focuses on provider network performance analysis, reporting, and consulting. The Data Analyst Health, Experienced will report to the Manager, Data Analysis. In this role you will provide analytical support through the analysis and interpretation

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 Federal Employee Program (FEP) team performs integrated case management (CM) and disease management (DM) activities in collaboration with members and those involved with members' care including registered nurse case managers, social workers, dietitians, health coaches, pharmacists, and physicians. The FEP Health Coach will report to the FEP Department Manage

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 Innovation Analyst, Principal is responsible for providing thought leadership to business leaders across the enterprise to address ambiguous problems and opportunities through internal strategy and/or innovation consulting engagements. This role will serve as a change agent, leveraging a consistent and disciplined approach to strategy and innovation to desig

Your Role The Physical Platform Engineer, Consultant will report to the Productivity Engineering Manager. In this role you will manage development, automation, and engineering delivery of the Windows platform end to end, from OS engineering, configuration down to application management and drive to an endpoint modern management vision. Your Work In this role, you will Ope

Your Role The Operations Portfolio team within Blue Shield of California provides robust solutions for our business partners, providers and members which improve the overall health care experience from claims processing to benefit enrollment. IT Product Manager, Consultant will report to the Senior Manager, Applications Services Lead in the Operations Portfolio. In this r

Your Role The Data Solution team is responsible for technical design and end to end delivery of complex data driven solutions and data products for the enterprise. The Solution Design Lead, Consultant will report to the Sr Manager, Data Solutions. In this role you will be partnering with Enterprise Architects, Portfolio, Analytics and Data engineering teams for designing

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 California. The Senior Manager, Procurement Contracting role will report to the Director, Contracting. In this role you will be responsible for the management, prioritization and execution o

Your Role The Information Security team is responsible for governance over the exchange of protected health information (PHI) and sensitive data with external entities. The Information Security Data Exchange Expert, Principal will report to the Senior Manager, Information Security Data Exchange. In this role you will be responsible for the privacy and security frameworks

Your Role The B2B Customer Experience team is responsible for supporting Blue Shield of California Providers through their servicing needs building strong relationships and ensuring ongoing loyalty to the Blue Shield brand. The Sr. Manager, Service Strategy and Operations of B2B Services will report to the Senior Director of Broker, Employer & Provider Services. In this r