Claims Processor Intermediate The ITS Host and Home Claims teams process claims and adjustments for out of state Blue Cross Blue Shield members that receive services in California and for our Blue Shield of California members
Job Description Your Role The Commercial CMO Team provides clinical oversight for programs and processes that support members health care, reduce costs, and improve quality. The Program Manager Clinical, Consultant reports to the Director of Program
Job Description The Commercial Care Management team performs integrated case management (CM) and disease management (DM) activities demonstrating clinical judgment and independent analysis by collaborating with members and those involved with their care including a multidisciplinary
Clinical Support Coordinator The Medical Care Solutions Federal Employee Program team provides prior authorization and utilization management services to our members. The Clinical Support Coordinator will report to the Operations Management Supervisor. In this role you
Care Management Team Member The Care Management team independently manages complex and high-risk care management cases by applying advanced clinical judgment to assess medical necessity, develop cost-effective care plans, and support quality outcomes aligned with benefit