Blue Shield Of California Jobs in Sacramento, CA 95899

Your Role The Medical Director provides clinical leadership within the Office of the CMO for Blue Shield Promise Health Plan, which includes management of the physician processes in support of utilization management and transactional functions. These functions include... Read More

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 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 Nurse Consultant will report to the Manager of Care Management for the... Read More

Your Role The Care Management team is looking for a leader with Care Management experience who can help design and lead our Population Health management (PHM) Medi-Cal Care Management line of business. The Manager, Care Management will report to the Senior Manager of... Read More

Your Role The Care Management Clinical Social Work team helps Blue Shield members with complex social determinants of health by conducting psychosocial assessments, developing care plans, and providing intensive interventions. The Care Management Social Worker will... Read More

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 Provider Operations Solution Support team is accountable for provider operational governance and provider data monitoring, provider data steward activities and complex configuration of provider applications and tools. The Configuration Analyst, Principal... Read More

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... Read More

Your Role The Command Control Center (BSOC) team is responsible for executing and monitoring batch operations and Network Operations Center (NOC) events to assure successful execution and completion within required timelines. The IT NOC/Batch Operator, Experienced will... Read More