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 Core Account Service Team is responsible for the retention of existing membership and the pursuit of new business within the medium to large business segment. The Senior Account Service Representative will report to the Senior Service Manager. In this role you will be responsible for the day to day relationships within your book of business. You will also be

Your Role The Care Management team is looking for a leader with Care Management experience who can help design and lead our Population Health management (PHM) Medi Cal Care Management line of business. The Manager, Care Management will report to the Senior Manager of Care Management PHM. In this role you will act as the practice and operational leader for the care manager

Your Role The Actuarial Pricing Shared Services team is responsible for collaborating with different Finance and Actuarial teams to support enterprise financial tracking and forecasting and drive the pricing target setting and planning to meet Company's operating and growth goals. The Senior Actuarial Analyst will report to the Senior Manager of the Actuarial Pricing Shar

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 Associate Actuarial Analyst will report to the Principal of Actuarial Provider

Your Role The Information Security team is responsible for providing cyber security services to Blue Shield of California that enable secure product development and operations. The Director of Information Security will report to the Sr. Director . In this role you will you will lead a team responsible for designing, implementing, and maintaining security capabilities that

Your Role The Trust Assurance Services team drive BSC information security adherence to regulatory standards, as well as policies, standards, and controls with the goal of safeguarding company assets and maintaining confidentiality, integrity, and availability of information. The Technical Business Continuity, Principal will report to the Senior Manager, Technical Busines

Your Role The Communication Governance team supports the development and implementation of strategic communication programs to improve overall member experience, streamline operational processes, and govern member facing communications to align with company policies and regulatory requirements. The Marketing Operations Specialist, Consultant Communication Governance will

Your Role The Network Management team handles provider contracting and provider relations statewide. The Provider Contracting Specialist, Senior will report to the Director, Provider Contracting. In this role you will support Medical Group/IPA and Hospital/Facility contracting in Southern California for all Blue Shield products. You will be responsible for comprehensive m

Your Role With pharmacy benefits being an essential component of the medical benefits, Pharmacy Care Reimagined is a critical Blue Shield of California initiative along with other Health Care Reimagined initiatives. The Pharmacy Care Reimagined goal is to enable every person with safe, equitable access to sustainably affordable prescription drugs. To enable our vision, we

Your Role The Digital Enterprise Growth team is continuing to reimagine our digital broker products to make it easy for brokers to do business with Blue Shield of California. The Product Manager, Consultant will report to the Director, Digital Growth & B2B Experience. In this role, you will leverage expertise in Product Management and industry knowledge to articulate a co

Your Role The clinical services coordinator (CSC) will report directly to the supervisor of care management support operations and will serves as initial point of contact for providers and members in the medical management process by telephone or correspondence. The CSC will interact telephonically with members as per established protocol or direction to ensure that membe

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. Our data, intelligence, and actionable insights help drive quality strategy, performance improvement, and regulatory reporting. The Clinical Quality Analyst Senior will report to the Cli

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 Registered Nurse Case Manager will report to the FEP Department Ma

Your Role The Federal Employee Program (FEP) Care Management team performs integrated case management (CM) and disease management (DM) activities demonstrating clinical judgment and independent analysis, collaborating with members and those involved with their care including a multidisciplinary team and the member's treating physicians. The Registered Nurse Case Managemen