Your Role The Internal Auditor Consultant will report to the Internal Audit Senior Director. In this role you will be responsible for providing objective examinations of evidence for providing independent assessment to the Audit Committee, management and outside parties on the adequacy and effectiveness of governance, risk, management and control processes. Your Work In t

Your Role The Installation and Billing (I&B) team within Blue Shield of California oversees the enrollment and billing and payments process for their groups and members. This role, Product Owner Consultant, will report to the Manager of Programs and Projects and will be responsible for the development and enhancement of our Medi Cal enrollment process, as well as oversee

Your Role Clinical Quality Analytics team is looking for a Clinical Quality Analytics, Senior who has hands on experience on data analysis, research and programming using SAS from various data sources (flat files, relational databases, other SAS datasets etc.) using Base SAS. TheClinical Quality Analytics, Senior will report to the Manager, Clinical Quality Analytics. In

Your Role The Cloud Engineering team is a cross functional group responsible for the advancement and support of the Blue Shield multi cloud presence. The Cloud Engineer Principal will report to the Sr. Director Hybrid Cloud Engineering. In this role you will have a broad and deep impact on how Blue Shield achieves its business and technical goals by leveraging cloud techn

Your Role This Compensation team provides leadership and guidance in the development and delivery of effective compensation strategies and policies that support BSC's goals and are in alignment with enterprise values, philosophy, and strategic direction. The Sales Compensation Analyst, Consultant will report to the Senior Director, Compensation. In this role, you will foc

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 Manageme

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 Clinical Services Coordinator Intermediate will report to the CHP Manager. In this role you will work with clinical staff to support member needs using the established and

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 Behavioral Health Utilization Management team performs prospective utilization review for our members and correctly applies the guidelines for nationally recognized levels of care. They collaborate directly with the Member, Member's Family, and Interdisciplinary Care Team to achieve consensus and promote positive Member health outcomes through the assessment

Your Role Join Blue Shield's dynamic Enterprise Learning organization, which develops learning solutions to ensure employees can perform their jobs effectively to further our mission. As a IT Learning Developer, Senior you will serve as a strategic partner to talent mobility through innovative learning strategies and solutions. The IT Learning Developer, Senior will repor

Your Role The enterprise wide Data & Analytics (D&A) team is seeking to hire a Strategic Planning & Chief of Staff, Principal. This role reports directly to VP of Data & Analytics and is expected to work team wide, IT wide, and enterprise wide as a critical part of Blue Shield's data driven and mission driven journey of transforming the world of healthcare. The D&A team p

Your Role The Appeals and Grievances team is responsible for clinically reviewing member appeals and grievances that are the result of either a preservice, post service or claim denial. The Appeals and Grievances RN Senior will report to the Manager of the Appeals and Grievances team. In this role you will perform accurate and timely clinical review of member initiated ap

Your Role The Cost of Healthcare Trendsetters & Pharmacy Support team analyzes and provides emerging healthcare cost trend drivers. The Medical Informatics Analyst IV will report to the Actuarial Manager. Your Work In this role, you will Conduct independent analysis of high complexity under minimal supervision and guidance Develop analytical methods so that they may be su

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