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Blue Shield Of California jobs

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CLINICAL SERVICES COORDINATOR, ADVANCED

Process faxed/phoned in authorizations, UM/CM requests, special processing/case types and/or calls left on voicemail Monitor specific queues/workstreams and generates pre-defined reports to identify and resolve common errors Handl...

CompanyBlue Shield Of California
AddressRancho Cordova, CA
CategoryEducation/Training
Salary$22.69 - $31.77 an hour
Job typeFull-time
Date Posted 2 weeks ago See detail

Clinical Services Coordinator, Advanced

Blue Shield Of California

Rancho Cordova, CA

$22.69 - $31.77 an hour

Process faxed/phoned in authorizations, UM/CM requests, special processing/case types and/or calls left on voicemail Monitor specific queues/workstreams and generates pre-defined reports to identify and resolve common errors Handl...

2 weeks ago seen See more...

Claims Processor, Intermediate

Blue Shield Of California

Long Beach, CA

$18.61 - $26.06 an hour

Be experienced in back-end processing; proficient in resolving complex edits using available documents/job aids with minimum direction. Experience front-end processing and complex adjustments. Be given special processing assignmen...

2 weeks ago seen See more...

Well-being and Recognition Analyst, Senior

Blue Shield Of California

Oakland, CA

$87,230 - $130,900 a year

Analyzes and develops recognition programs and policies Researches, evaluates, and recommends needed changes or program enhancements in response to problem and opportunity areas Develops administrative procedures to monitor and re...

3 weeks ago seen See more...

DevSecOps Engineer, Consultant

Blue Shield Of California

Oakland, CA

$118,800 - $178,200 a year

Evaluate and analyze the existing IT infrastructure, identifying areas for improvement and security enhancement. Design and implement secure, scalable, and automated cloud-based solutions on Microsoft Azure to support application...

3 weeks ago seen See more...

Administrative Assistant, Specialist

Blue Shield Of California

Long Beach, CA

$31.39 - $43.94 an hour

Be responsible for providing administrative support for large team, their functional areas, directors, managers, and team members Manage and coordinate calendars for directors and team members, involving internal and external indi...

3 weeks ago seen See more...

Pharmacy Technician, Advanced

Blue Shield Of California

El Dorado Hills, CA

$22.69 - $31.77 an hour

Utilize medication policy and operational principles to make authorization determination on drug case reviews within technician extension of authority Research and collect pertinent patient and drug information to assist the pharm...

3 weeks ago seen See more...

Community Connector Health Advocate, Experienced - San Diego

Blue Shield Of California

San Diego, CA

$66,770 - $93,390 a year

Assess psychosocial and social determinants of health needs for moderate-risk members and document assessment results or augment available information in appropriate systems Consult with or refer members to licensed staff (social...

3 weeks ago seen See more...

Program Manager, Change Management and Employee Engagement

Blue Shield Of California

California, United States

$109,120 - $163,680 a year

Provide overall program leadership, guidance, and manage all aspects of a given program, including requirements gathering, business case creation, and implementation Develop resourcing strategies to ensure optimum support for proj...

4 weeks ago seen See more...

Financial Analyst, Consultant

Blue Shield Of California

El Dorado Hills, CA

$109,120 - $163,680 a year

Partner cross-functionally to effectively steer financial performance through detailed planning and analysis Develop and present financial models, annual plans, and monthly results with updated outlooks to executive leadership Ide...

4 weeks ago seen See more...

Operations Specialist, Experienced

Blue Shield Of California

El Dorado Hills, CA

$66,770 - $93,390 a year

Act as subject matter expert and review operational workflows, identifying problems and developing improvements, modifications, and enhancements Develop and evaluate tools and materials that enhance operating efficiency and accura...

a month ago seen See more...

Clinical Quality Coordinator, Entry

Blue Shield Of California

Long Beach, CA

$17.41 - $24.38 an hour

Initiate outbound calls to members and providers to collect information and provide care coordination assistance in obtaining services (schedule appointments, provider appointment reminders, coordinate transportation, etc.) Educat...

a month ago seen See more...

Licensed Clinician, Senior (Board Certified Behavioral Analyst)- Part Time

Blue Shield Of California

El Dorado Hills, CA

$87,230 - $130,900 a year

Perform prospective, concurrent and retrospective utilization reviews and first level determination approvals for members using BSC evidenced based guidelines, policies and nationally recognized clinal criteria across lines of bus...

a month ago seen See more...

Clinical Services Coordinator, Intermediate

Blue Shield Of California

Long Beach, CA

$20.47 - $28.66 an hour

Process faxed/phoned in authorization requests, UM/CM requests and/or calls left on voicemail. Select support for Case Manager such as mailings, surveys Data entry including authorization forms, high risk member information, verba...

a month ago seen See more...

Pharmacist, Consultant

Blue Shield Of California

Rancho Cordova, CA

$118,800 - $178,200 a year

Support the operational and clinical implementation of medication policies for injectable drugs covered under the medical benefit for the FEP PPO line of business Provide pharmacist support for the FEP Medical Management Pre-servi...

a month ago seen See more...

Clinical Services Coordinator, Intermediate

Blue Shield Of California

El Dorado Hills, CA

$20.47 - $28.66 an hour

Process faxed/phoned in authorizations, UM/CM requests and/or calls left on voicemail Select support for Case Manager such as mailings, surveys Data entry including authorization forms, high risk member information, verbal HIPPA a...

a month ago seen See more...

Actuarial Analyst, Consultant

Blue Shield Of California

Oakland, CA

$118,800 - $178,200 a year

Understand the core principles and functionality of decision, descriptive, predictive, and prescriptive analytic methods including forecasting, statistical and machine learning techniques Conduct and develop analysis, assess risk...

2 months ago seen See more...

Payroll Support, Intermediate

Blue Shield Of California

Oakland, CA

$21.53 - $30.16 an hour

Perform a wide variety of record keeping and payroll processing activities, including computing wage and overtime payments, calculating and recording payroll deductions, processing requests for paycheck advances, and processing te...

2 months ago seen See more...

Case Management - Nurse, Senior

Blue Shield Of California

Long Beach, CA

$85,360 - $128,040 a year

Research and design treatment /care plans to promote quality of care, cost effective health care services based on medical necessity complying with contract for each appropriate plan type Initiation of timely individualized care p...

2 months ago seen See more...

Tax Consultant

Blue Shield Of California

Oakland, CA

$96,470 - $144,760 a year

Assist in the preparation of complex US GAAP income tax provisions (OneSource) and financial statement footnote disclosures Calculate estimated tax payments (OneSource Provision) Assist with the preparation of complex stand-alone,...

2 months ago seen See more...

(Medi-Cal) Correspondence Phone Support, Intermediate

Blue Shield Of California

Long Beach, CA

$18.61 - $26.05 an hour

Taking the lead our CSRs take ownership of members' issues, relieving members' stress while guiding them to a quick and easy resolution. Identifying future problems not only do our CSRs solve the current member concern but the...

2 months ago seen See more...

Delegation Operations Auditor, Senior

Blue Shield Of California

Long Beach, CA

$77,990 - $116,930 a year

Be responsible for overseeing policy and procedure review and completing full/complex pre-delegation, annual or follow-up onsite audits/assessments of delegated entities (including vendors) in support of the regulatory requirement...

2 months ago seen See more...

Appeals and Grievances Representative, Intermediate

Blue Shield Of California

El Dorado Hills, CA

$20.48 - $28.67 an hour

Assist with telephone inquiries regarding member appeals. Respond to member appeals, grievances, and complaints. Clarify and educate members on Appeals and grievance policies. Interpret and explain health plan benefits, policies,...

2 months ago seen See more...

Community Resource Center Representative, Intermediate (Bilingual Cantonese) - Lincoln Heights

Blue Shield Of California

Long Beach, CA

$20.47 - $28.66 an hour

Resolve issues and inquiries concerning members eligibility, benefits, provider information, clinical, pharmacy and other health or social service needs Compose routine and non-routine correspondence to answer benefits/provider in...

2 months ago seen See more...

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