The State Pre-K Lead Teacher is responsible for all aspects of planning, assessing and instructing based on the needs of each child, and the requirements of the program. We want change makers who never stop being
Medical Director, Utilization Management Commercial Prior Authorization Review The Medical Management team ensures that Blue Shield of California (BSC) is on the cutting edge of utilization management reimagined to accelerate the development and sustainability of a
Job Title Operational Quality Services Specialist, Associate Job Description The Medi-Cal Operations team is responsible for ensuring claims are processed accurately and in a timely manner. In this role you will be responsible for performing audits
Job Description Your Role The Internal Auditor Consultant will report to the Internal Audit Senior Director. In this role you will be responsible for providing objective examinations of evidence for providing independent assessment to the Audit
Internal Audit Principal The Internal Audit Services team performs internal audits and advisory services to provide assurance on specific internal control objectives and emerging risk areas. The Internal Audit Principal will report to the Internal Audit
Case Management Nurse, Senior The Childrens Services Program (CSP) 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 Nurse, Senior will
Product Marketing Strategist, Digital Gtm, Principal The Product Marketing team oversees the Go-to-Market (GTM) strategy and delivery of multiple Blue Shield products enabling Marketing, Product (e.g., Digital Experience, Product Strategy, Healthcare Quality & Affordability), and Sales
Behavioral Health Business Analyst, Principal The Behavioral Health Services (BHS) team is responsible for developing and executing a best-in-class behavioral health insurance product for Blue Shield. The Behavioral Health Business Analyst, Principal will report to the
Behavioral Health Therapy Clinical Services Coordinator The Behavioral Health Utilization Management team provides utilization management and support for members seeking behavioral health treatment. The BHT Clinical Services Coordinator will report to the Supervisor of Behavioral Health
Job Description The Behavioral Health Utilization Management (UM) team performs prior authorization and concurrent reviews for members by applying evidenced based guidelines, policies, and nationally recognized clinical criteria across multiple lines of business. The Manager, Behavioral
Job Description The Commercial First Pass Claims and Rework teams are responsible for processing work in enrollment, claims, provider, or other operational areas to meet operational, financial, and service requirements including timely and proper enrollment, adjudication
Veterinary Assistant Full-time at Anderson Veterinary Clinic, Anderson, CA Compensation is negotiable based on experience and credentials, with an expected starting range of $19 $21/hour. The actual pay will carefully consider a wide range of factors
Job Title Utilization Management Team Leader Job Description The Utilization Management team independently manages complex utilization and retrospective clinical reviews across multiple lines of business, assessing medical necessity, coding accuracy, treatment plans, discharge planning, and compliance
Job Description The Utilization Management team reviews inpatient stays and prior authorization for our members and correctly applies the guidelines for nationally recognized levels of care for both our Medi-Cal and Medicare populations. The Utilization Management
Email Development Specialist, Senior The Digital and Measurement team is responsible for elevating marketing strategies into omnichannel solutions that deliver measurable business outcomes for the Markets Organization. We strive to move at the speed of retail,
Digital Personalization Product Manager The Platform Strategy & Operations team, within Blue Shield of Californias Intelligent Automation & AI organization, owns BSCs member intelligence and orchestration layerunifying member data, generating predictive insights, and activating personalized experiences
Pharmacy Market Experience Team The Pharmacy Market Experience team is responsible for the development, management and oversight of Blue Shields pharmacy-related member marketing and operational communications materials and digital experience. The Marketing Communications Specialist, Senior will
Care Management Manager 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
AI Internal Audit Consultant The Internal Audit Services team provides independent, objective assurance and advisory services to help Blue Shield of California manage risk, strengthen internal controls, and improve business processes. The AI Internal Audit Consultant
AI Internal Audit Principal The Internal Audit Services team provides independent, objective assurance and advisory services to help Blue Shield of California manage risk, strengthen internal controls, and improve business processes. The AI Internal Audit Principal