Blue Shield Of California Jobs in Folsom, CA 95630

Jobs 1 to 5 of 5

Appeals and Grievances - RN, Senior

Blue Shield of California • El Dorado Hills, CA 95762

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... Read More

Your Role The Appeals and Grievances team is responsible for clinically reviewing member appeals and grievances that are the result... Read More

Case Management - Nurse, Senior

Blue Shield of California • Rancho Cordova, CA 95741

Your Role The Care Management team will serve to support the mission of the department, which is to provide support to patients in maintaining health and wellness in the outpatient setting . The Senior Care Manager will report to the Manager of Care Management. In this... Read More

Your Role The Care Management team will serve to support the mission of the department, which is to provide support to patients in... Read More

Case Management - Nurse, Consultant

Blue Shield of California • Rancho Cordova, CA 95741

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 by collaborating with members and those involved with their care... Read More

Your Role The Federal Employee Program (FEP) Care Management team performs integrated case management (CM) and disease management... Read More

Medical Director, Operations

Blue Shield of California • Rancho Cordova, CA 95741

Your Role The Medical Director, Operations - Federal Employee Program, is a key member of the Medical Management and Operations staff within Health Care Services. This is a front-line utilization management position that has core responsibilities in the areas of... Read More

Your Role The Medical Director, Operations - Federal Employee Program, is a key member of the Medical Management and Operations... Read More

Clinical Services Coordinator, Intermediate (Bilingual)

Blue Shield of California • El Dorado Hills, CA 95762

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... Read More

Your Role The clinical services coordinator (CSC) will report directly to the supervisor of care management support operations and... Read More

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