Blue Shield of California's mission is to ensure all Californians have access to high quality health care at a sustainably affordable price. We are transforming health care in a way that truly serves our nonprofit mission by lowering costs, improving quality, and enhancing the member and physician experience. To fulfill our mission, we must ensure a diverse, equitable, an

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 Third Party Application Solutions personnel within the Software Development Centers Of Excellence team perform hardware and software system administration as well as set quality expectations. The Senior Application Developer & System Administrator will report to the Centers Of Excellence Senior Manager. In this role you will execute hands on patching and upg

Your Work In this role, you will Carry out administrative, analytical or procedural tasks with high degree of autonomy Handle administrative matters, in the absence of, or on behalf of, the manager Provide administrative oversight of third party relationships through implementation of designated systems, routine monitoring of performance, and tracking of goods and/or serv

The Commercial Member Acquisition marketing team is looking for a dynamic marketing professional to join us as the Marketing Campaign Specialist, Senior Member Acquisition. The team are passionate marketers at heart driven to create the most compelling member experience so that Blue Shield is the health plan carrier of choice during open enrollment. The Marketing Campaign

Your Role The Blue Shield of California Finance team is responsible for providing Line of Business consolidation, reporting, and analysis support for the Growth Finance team. The Financial Analyst, Consultant will report to the Markets Planning and Analysis Finance Manager. In this role, you will work closely and collaborate with other stakeholders (actuarial, accounting,

Summer 2024 Information & Technology General Internship About Our Internships Our paid internship program is thoughtfully curated to provide students experience and exposure to the health professional industry. Interns will be given the opportunity to get hands on experience with real work projects, build meaningful relationship and connections within the organization, an

Your Role The Core Account Service Team is responsible for the retention of existing membership and the pursuit of new business within the medium to large business segment. The Senior Account Service Representative will report to the Senior Service Manager. In this role you will be responsible for the day to day relationships within your book of business. You will also be

Your Role The Trust Assurance Services team drive BSC information security adherence to regulatory standards, as well as policies, standards, and controls with the goal of safeguarding company assets and maintaining confidentiality, integrity, and availability of information. The Sr. Manager, Information Security Technical Business Continuity will report to the Director,

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 will interact telephonically with members as per established protocol or direction to ensure that membe

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 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 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