Your Work In this role, you will Be responsible for analytic work required to convert pricing and financial goals at the line of business and region level into specific action plans at the provider level that the Network team can execute Build and update models that allow the actuarial team to quantify financial gaps and opportunities at a provider level Conduct and devel

Your Work In this role, you will Be responsible for converting pricing and financial goals at the line of business and region level into specific action plans at the provider level that the Network team can execute Create value for the Growth team General Managers by ensuring they have a voice when it comes to key network decisions and network strategy Create value for th

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 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 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 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

Your Role This position is located in our El Monte Community Resource Center Location & require employee to work 5 days per week in the El Monte 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 Angeles County with L.

Your Role This position is located in our Wilmington Community Resource Center Location & require employee to work 5 days per week in the Wilmington 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 Angeles County wit

Your Role Blue Shield of California is looking for a principal level Application Developer to join our IT Application Services team. The candidate will be the subject matter expert for the Operations portfolio responsible for the definition & ownership of our real time streaming claim event processing services & cloud integration platform. The Salesforce Principal Develop

Your Role The Federal Employee Program team is responsible for Federal Employee Health Benefits and serves all federal employee is the state of California. The Account Manager Federal Employee Program, Senior Central Valley will report to the Senior Manager, Account Management, FEP. In this role you will be primarily responsible for the sales, retention, and support of go

Your Role The People & Engagement HR Connect team is a critical part of Human Resources service delivery for all of Blue Shield of California (BSC) The team provides first level support to all BSC employees on a daily basis for both daily operations and employee facing initiatives. The HR Specialist, Advanced will report to the Manager, HR Connect. In this role you will b

Your Role The Medical Care Solutions team manages the clinical operations including utilization management, care management and clinical programs. The Product Manager will initially report to the Vice President of Medical Care Solutions. In this role you will be responsible for setting product vision and strategy via understanding of customer needs and organizational prio

Your Role The Strategic Partnerships team is responsible for building and implementing stakeholder engagement strategies for Blue Shield Promise. The Outreach Manager, Senior, will report to the Director of Strategic Partnerships. In this role you will be responsible for supporting Blue Shield Promise's growth and retention goals by 1) building relationships and serving a

Your Role The IT Development Center Of Excellence team at Blue Shield is tasked with establishing best practices and standards as we rapidly transform ourselves to be a digital first company. The DevSecOps Engineer, Principal will report to the Sr Manager, IT Development Centers Of Excellence. As a DevSecOps Engineer, you will play a critical role in assessing our current