The Medicare team is responsible for servicing Medicare members including Med Supp). Total Duals / D SNP (Dual Special Need Plans. The Supervisor will report to the department Manager. In this role you will manage a team of front line representatives, focusing on coaching/engagement, Quality, Inventory Management and helping evolve member experience. Our leadership model

Your Role The Claims Shared Support Services team actively engages in providing and eliciting business requirements for system enhancements, by identifying a desired future state that addresses a business problem utilizing multiple analytic methods e.g. interviewing, brainstorming, chair siding/observation, problem identification, and gap analysis. The Business Systems An

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 Behavioral Health Registered Nurse Case Manager will report to th

Your Role The Actuarial Provider Strategies team is responsible for the financial oversight, forecasting, and development of payment models and fee schedules for Blue Shield's provider partners. The Executive Assistant, Experienced will report to the Vice President of Actuarial Provider Strategies. In this role you will be responsible for the planning and implementing of

Your Role The Enterprise Finance Consolidations and Business System team is responsible for the Company's consolidated financial statements, forecasting and reporting activities, business systems and administrative expense allocations. The team manages financial forecast and annual planning activities, provide monthly, quarterly, and annual consolidated financial reportin

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 ACA Chart Program team conducts the following functions (1) identify medical records with unreported diagnosis codes, (2) retrieve those medical charts, (3) perform medical coding to convert them into risk adjustable diagnosis codes, and (4) submit to CMS via the EDGE pathway . The Risk Adjustment, Consultant will report to the Senior Manager . In this role

Your Role The Customer Experience, Digital, and Operations Analytics team is responsible for accelerating data driven value based solutions that drive out expense, generate growth while elevating experience for members, providers and brokers. The Senior Manager of Digital and Marketing Analytics will report to the Senior Director of Customer Experience, Digital, and Opera

Your Role The Transformation team is responsible for improving the lives of those we serve by making the extremely complex, absurdly simple. The Product Manager, Principal will report to the Senior Manager of End to End Provider Experience Transformation. In this role you will be responsible leading our critical strategies to drive improved quality of interactions, overal

Your Role The Senior level Developer of the Client Personalization team is responsible for application service level achievement and customer satisfaction of Blue Shield of California's Salesforce Health Cloud capabilities. This developer creates, configures, and manages Salesforce applications and related components and will be accountable for delivering BSC's desired bu

Your Role The Corporate Services Finance team ensures financial stewardship of the Corporate Services administrative budget and serves as the trusted financial advisor to executive leadership. Our team is looking for a Financial Analyst, Consultant to steer financial performance toward Blue Shield goals. The position will support annual planning, monthly forecasting, mont

Your Role The Developer and Employee Experience team is responsible for creation of the standard and automation pipelines that enable our partnering IT teams to build, release, and manage their systems. We are setting the path for how we'll migrate to the Cloud and ensure that we are guiding the movement to a more modern DevOps operating model. The Sr. Principal Enterpris

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. As part of a Center of Excellence, your primary responsibility will be to establish best practices and standards for DevSecOps methodologies, ensuring a secure and seamless transition to the cloud environment. Yo

Your Role This position is located in our South Los Angeles Community Resource Center Location & require employee to work 5 days per week in the South Los Angeles Community Resource Center The Community Resource Center (CRC) team is responsible for managing the Blue Shield Promise Health Plan Information Resource Center (IRC) and jointly operating CRCs throughout Los Ange

Your Role This position is located in our Metro Los Angeles Community Resource Center Location & require employee to work 5 days per week in the Metro Los Angeles Community Resource Center The Community Resource Center (CRC) team is responsible for managing the Blue Shield Promise Health Plan Information Resource Center (IRC) and jointly operating CRCs throughout Los Ange