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Blue Shield of CA
- Oakland, CA / Long Beach, CA / El Dorado Hills, CA / 4 more...
Your Role The Law Business team brings experience, expertise and solutions in technology, data management and other support services to help the Law Department continuously improve and excel in our support of BSC and its affiliates. The Business Analyst will be responsible for providing technical support to the Law Department teams and will report to the Law Business Team
Posted Today
Blue Shield of CA
- Oakland, CA / Long Beach, CA / El Dorado Hills, CA / 2 more...
Your Role This role resides within the IT Applications' Transformation, Operations & Customer Experience team. The candidate will report to the IT Director, Solution & Delivery Lead in the Portfolio. In this role you will be responsible for leading, facilitating, and driving continuous improvement of Agile practices for the team or teams that you'll be supporting. The Por
Posted 1 day ago
Blue Shield of CA
- Oakland, CA / El Dorado Hills, CA
Your Role The Data & Analytics team is responsible for performing detailed data analysis, source to target designs, data profiling, and metadata management in support of new development/implementation or enhancement of existing data assets. The IT Data Analyst, Consultant will report to the Manager of Data Solutions and Asset Management. In this role, you will participate
Posted 1 day ago
Blue Shield of CA
- Oakland, CA / El Dorado Hills, CA
Your Role The Data and Analytics (D&A) organization focuses enterprise wide to partner with business stakeholders to apply the power of data & analytics to deliver new insights and data driven solutions to accelerate business outcomes. The Data Services & Solutions team is part of the centralized D&A organization and leads the design and implementation of data solutions a
Posted 1 day ago
Blue Shield of CA
- Rancho Cordova, CA / Oakland, CA / Long Beach, CA / 3 more...
Your Role The Population Health Management team responsible for implementing whole person integrated healthcare by engaging members, reducing disparities and gaps in care, improving quality for our members. The Product Owner (PO) will report to the Sr. Director, Population Health Management, and represents the "voice of the customer" or proxy for the business into the Agi
Posted 1 day ago
Blue Shield of CA
- Long Beach, CA / Oakland, CA / El Dorado Hills, CA / 3 more...
Your Role The Social Services Representative, Advanced will report to the Supervisor, Social Services. In this role you will provide telephonic social services support and resource referrals for high acuity Blue Shield Promise members, in addition to administrative support to the Social Services Management Team. The Social Services Representative regularly reaches out to
Posted 1 day ago
Your Role The Appeals and Grievances team receives, documents, investigates, refers, and coordinates grievances, appeals and complaints . The Appeals and Grievances Coordinator will report to the Appeals and Grievances Supervisor. In this role you will be responsible for taking incoming telephone calls, reviewing, researching, and responding to incoming appeals and grieva
Posted 1 day ago
Blue Shield of CA
- Oakland, CA / Long Beach, CA / El Dorado Hills, CA / 3 more...
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
Posted 1 day ago
Blue Shield of CA
- Oakland, CA / Long Beach, CA / El Dorado Hills, CA / 1 more...
Your Role The Centers of Excellence (COE) Systems Analyst team defines and deliver solutions that meet business objectives and will serve as a facilitator between the business and IT in understanding the business needs; leads eliciting, analyzing, validating, and managing requirements, processes, and high level solution designs; is a proactive member of an Agile product t
Posted 1 day ago
Blue Shield of CA
- Long Beach, CA / Oakland, CA / El Dorado Hills, CA / 3 more...
Your Role The Delegation Oversight Utilization Management team is responsible for the organization, tracking and data entry of IPA Utilization Management audits, issues, complaints and monitoring. Identifies root cause of the problem and maintains monthly reporting that track and compare patters of delegated entities. The Delegation Operations Nurse Auditor LVN Experience
Posted 2 days ago
Blue Shield of CA
- Oakland, CA / Long Beach, CA / El Dorado Hills, CA / 3 more...
Your Role The Innovation Analyst, Consultant is responsible for supporting the improvement and maintenance of our integrated enterprise strategy to execution process and supporting initiatives designed to provide strategic thought leadership to business leaders across the enterprise to address ambiguous problems and opportunities. This role will serve as a change agent, l
Posted 2 days ago
Blue Shield of CA
- El Dorado Hills, CA / Long Beach, CA / Oakland, CA / 3 more...
Your Role The Workforce Management team partners with operations to ensure the contact centers are staffed appropriately to meet KPI's while looking for opportunities to gain efficiency. The Workforce Optimization Analyst will report to the Sr. Manager of WFM. In this role you will analyze contact center trends, including call volumes, offline inventory, and call patterns
Posted 2 days ago
Blue Shield of CA
- Long Beach, CA / Oakland, CA / El Dorado Hills, CA / 3 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 Senior Care Manager will report to the Manager of Care Management. In this role you will ensure that services are provided based on standardized procedures including coordination
Posted 3 days ago
Blue Shield of CA
- Rancho Cordova, CA / El Dorado Hills, CA / Oakland, CA
Your Role The Reporting, Analysis and Administration team supports Blue Shield of California with design, development, and management of Verint, Genesys and Avaya platforms. We provide business support expertise and manage requirements deliverables. Currently, this includes Routing, Quality, Speech, WFM, Performance Management and Desktop Analytics modules. The Business A
Posted 3 days ago
Your Role The Managed Care Finance team administers the financial terms and conditions of our capitated contracts with IPA/Medical Groups, Hospitals, and Vendors. The Financial Analyst, Experienced will report to the Manager of Managed Care Finance. In this role you will be performing provider contract analysis, financial research, preparing financial forecasts, analyzing
Posted 3 days ago
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