Blue Shield of California Jobs
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Blue Shield of California-San Jose
Your Role
The Regional Medical Director Team (Provider Performance Clinical Team) is a team of licensed medical directors and clinical program managers who are accountable for population health and utilization results for strategic partner medical...
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2 similar jobs: San Diego, Los Angeles
Blue Shield of California-Long Beach
Your Role
The Clinical Program Manager, Principal in collaboration with the Regional Medical Director and internal Blue Shield of California teams will be responsible for collaborating with all externally facing partners to transform the way...
Blue Shield of California-Oakland
an invitation to complete a Pre-Recorded Video Interview
• November - January: 2nd round interviews & offers extended
As an intern at Blue Shield of California, you will:
• Participate in impactful projects during a 10-week internship program
• Undertake a 10...
Blue Shield of California-Rancho Cordova
Your Role
The Medical Management team ensures that Blue Shield of California is on the cutting edge of medical, medication, and payment policy to accelerate the emergence of a value-based health care system in California. The Senior Medical...
Blue Shield of California-Oakland
Your Role
The Promise Compliance Audit Services team oversees all functions of an effective Compliance Program for Blue Shield of California Promise Health Plan. The Compliance Audit Services, Principal will report to the Senior Director...
Blue Shield of California-Long Beach
to appropriate internal and external Blue Shield of California audiences; produce production and ad hoc reports and analytics under tight deadlines and within data governance and privacy guidelines
• Makes oral presentations to internal and external customers...
Blue Shield of California-El Dorado Hills
Your Role
As a DevSecOps Engineer in IT Quality Engineering Organization, you will play a crucial role in ensuring the security and quality of software products. Your primary responsibility will be to establish the best practices and standards for...
Blue Shield of California-Rancho Cordova
subject matter expertise for pricing of new, zero-dollar, and other exceptional claims.
• Consult with Blue Shield of California legal to support fraud and abuse investigations, provider arbitrations, regulatory inquiries and issues, and litigation...
Blue Shield of California-Long Beach
Quality Department to improve Blue Shield of California and Promise Health Plan quality performance for regulatory and accreditation requirements including National Committee for Quality Assurance, Centers for Medicare and Medicaid and Department...
Blue Shield of California-Rancho Cordova
Your Role
Reporting to the Sr. Director, Utilization Management, the role of the Director, Medicare & Medi-Cal Utilization Management is critical to the success of Blue Shield of California and the Utilization Management department in realizing its...
Blue Shield of California-Long Beach
the Blue Shield of California Pharmacy and Therapeutics (P&T) Committee process by ensuring that evidence-based clinical decisions are implemented operationally to support safe, efficacious, and cost-effective prescribing of medications.
Our leadership...
Blue Shield of California-Rancho Cordova
education on core chronic conditions (Diabetes, Heart Failure, COPD, Asthma and Coronary Artery Disease). Outreach to members with HEDIS Care Gaps to assist with closure
• Apply detailed knowledge of FEP PPO and Blue Shield of California's established...
Blue Shield of California-Long Beach
appropriate modifications in plan of care to adapt to changes occurring over time and through various settings
• Applies detailed knowledge of FEP PPO and Blue Shield of California's (BSC) established medical/departmental policies, clinical practice...
Blue Shield of California-Rancho Cordova
Your Role
Reporting to the Sr. Director, Utilization Management, the role of the Director, Commercial Utilization Management is critical to the success of Blue Shield of California and the Utilization Management department in realizing its goals...
Blue Shield of California-Rancho Cordova
will receive an invitation to complete a Pre-Recorded Video Interview
• November - January: 2nd round interviews & offers extended
As an intern at Blue Shield of California, you will:
• Participate in impactful projects during a 10-week internship program...
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