Your Role The Back Office Analytics team supports back office operations stakeholders with dashboarding, analytic studies, and statistical modeling to drive a better member/provider experience while reducing both administrative and healthcare costs. The Business Data Analyst, Senior will report to the Sr. Manager of Back Office Analytics. In this role you will provide ana

Your Role The Children's Health Program (CHP) team provides identification, referrals, and care management for all Medi Cal members under 21 years old and collaborates within Promise Clinical Team. The Case Management, Senior will report to the CHP Manager. In this role you will be Perform clinical review, assessment, evaluation of medical services for the organization us

Your Role The Network Trend Analytics team is responsible for performing financial modeling and analytics for provider contract negotiations for hospitals and ambulatory surgery centers. The Associate Actuarial Analyst will report to the Senior Manager. In this role you will be applying your analytical toolset to project future unit cost trends and drive the development o

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 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 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 Supervisor of the HEDIS Outreach Team. In this role you will be responsible for conducting provider outreach during the HEDIS season for medical record pursuit and retrieval. Also, partic

Your Role The Corporate Citizenship Sustainability team sets environmental strategy, standards and targets, collects and analyzes environmental data, conducts environmental reporting (including greenhouse gas inventory and climate related risk/resilience), and oversees mitigation, adaptation and climate leadership work along Blue Shield's value chain. The Corporate Citize

Your Role The Network Management team handles provider contracting and provider relations statewide. The Provider Contracting Specialist, Experienced will report to the Sr Manager of Provider Contracting. In this role you will support Medical Group/IPA and Hospital/Facility contracting in Northern California for all Blue Shield products. You will be responsible for compre

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 IT Business Operations team plays a critical role in enhancing business and IT collaboration through a Portfolio based model. The System Analyst, Consultant will report to the Senior Manager, IT Product Management. In this role you will analyze data at a team and portfolio level, in a manner to tell stories to leadership. Your Work In this role, you will For

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 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 M

Your Role The Care Management Department, which oversees all outpatient care management for the Commercial and Medicare lines of business, is seeking a Clinical Program Manager, Principal to join our team. In this role, the candidate will provide comprehensive support and collaborate effectively with stakeholders across various departments. The ideal candidate must posses

Your Role TheDigital Member Experienceteamis driving better access to healthcare for our members by reimagining our digital customer experience. The Principal Product Manager will report to the Sr. Manager, Product Management Digital Member Experience. In this role you willleverage your expertise in product management and consumer experiences to help drive member satisfac

Your Role The Digital Member Experience team is reimagining our digital customer experience and leading the transformation of the healthcare industry. The Product Manager, Consultant will report to the Sr. Manager, Product Management Digital Member Experience. In this role you will leverage your expertise in Product Management and consumer experiences to help us define th