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 Actuarial Provider Strategies team is responsible for the financial oversight, forecasting, and development of payment models and fee schedules for Blue Shield's provider partners. The Executive Assistant, Experienced will report to the Vice President of Actuarial Provider Strategies. In this role you will be responsible for the planning and implementing of

Your Role The Enterprise Finance Consolidations and Business System team is responsible for the Company's consolidated financial statements, forecasting and reporting activities, business systems and administrative expense allocations. The team manages financial forecast and annual planning activities, provide monthly, quarterly, and annual consolidated financial reportin

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 Senior level Developer of the Client Personalization team is responsible for application service level achievement and customer satisfaction of Blue Shield of California's Salesforce Health Cloud capabilities. This developer creates, configures, and manages Salesforce applications and related components and will be accountable for delivering BSC's desired bu

Your Role The Corporate Services Finance team ensures financial stewardship of the Corporate Services administrative budget and serves as the trusted financial advisor to executive leadership. Our team is looking for a Financial Analyst, Consultant to steer financial performance toward Blue Shield goals. The position will support annual planning, monthly forecasting, mont

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 As a DevSecOps Engineer in IT Quality Engineering Organization, you will play a crucial role in ensuring the security and quality of software products. As part of a Center of Excellence, your primary responsibility will be to establish best practices and standards for DevSecOps methodologies, ensuring a secure and seamless transition to the cloud environment. Yo

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