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Quality Assurance Auditor, Specialist The Quality Review team completes audits of front-line staff to ensure alignment with department processes and regulatory compliance. Quality Assurance Auditors also provide coaching and work closely with business leaders to drive
Digital Strategic Planning, Delivery & Performance Consultant The Digital Strategic Planning, Delivery & Performance team is responsible for digital planning, project management and delivery for key initiatives, vendor support/partnership, and digital operations. The Strategic Planning &
Marketing Insights & Reporting Analyst, Consultant The Digital & Measurement team is responsible for turning Brand and Marketing strategies into digital-first experiences that deliver measurable business outcomes. The Marketing Insights & Reporting Analyst, Consultant reports to
Utilization Management Manager 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
Sr Manager Application Services The Application Services team plays a critical role in enhancing customer and technical collaboration while delivering all application development through a Platform and Technology Product Operation Model. The Sr Manager will report
Project Manager Consultant The Enterprise Mandates Delivery team is responsible for transforming new laws into audit-ready projects with defined ownership, scope, timelines, and funding, and oversees implementation through the full project lifecycle, including transition to operational
Clinical Quality Coordinator The Clinical Quality team oversees and is responsible for HEDIS medical record review, pursuit, and overall HEDIS submission. The Clinical Quality Coordinator will report to the Supervisor of the HEDIS Outreach Team. In
Product Manager, Consultant - Automation & AI Business Delivery The Product Manager, Consultant - Automation & AI Business Delivery reports to the Transformation Sr. Director. They will lead design and delivery of automation and AI-driven solutions
Job Title Business Configuration Oversight Team Platform Administrator Consultant Job Description The Business Configuration Oversight team is responsible for overseeing configuration and delivery of projects by vendor. The Platform Administrator, Consultant will report to the IT
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
Health Plan Strategy Sr. Director The Health Plan Strategy is a new team that will define and drive Blue Shields strategic position in the market. It ensures strategic recommendations translate into actionable plans aligned with our
Product Marketing Strategist, Digital GTM, Principal Your Role 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),
Senior Manager, Program and Project Management - Pharmacy Vendor Management The Pharmacy Vendor Management team supports Pharmacy Strategy and Operations in managing the vendor contracting process, vendor governance model, vendor performance, vendor escalations, and various operational
Job Description The Appeals and Grievance Department Regulatory team is responsible for responding to inquiries received directly from our state regulatory agencies. The Regulatory Complaint Coordinator, Intermediate, will report to the Regulatory Complaint Supervisor. In this
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. The Email Development Specialist, Senior will report to the
Accounting Manager The Corporate Financial Accounting and Reporting, Gross Margin team plays a critical role in ensuring the integrity of financial reporting for Blue Shield of California and its subsidiaries. Reporting to the Assistant Controller, the
Marketing Communications Principal The Communication Governance team is responsible for developing and deploying member-facing and B2B communications that are regulated and/or operational. This team also works cross-functionally to ensure all member-facing communications are compliant, on-brand, and
Population Health Senior Manager The Healthcare Quality Affordability (HQA) Analytics team plays a key role in discovering information hidden in vast amounts of data that can lead to smarter decisions and deliver better service for our
Job Title Corporate Recovery Team Accounting Operations, Advanced Job Description The Corporate Recovery team is responsible for the end-to-end lifecycle of claim overpayment recoveries including compliance and audit documentation. The Accounting Operations, Advanced will report to