Actuarial Analyst, Experienced

Data Consulting Analyst - Health, Principal

Woodland Hills, USA

Your Role The Network Performance Analysis and Contracts team focuses on provider network performance analysis, reporting, and consulting. The Data Analyst-Health, Principal role will report to the Senior Director, Provi

Data Scientist, Consultant

Oakland, USA

Your Role The AI & Machine Learning team works in partnership across the enterprise to accelerate business outcomes by applying machine learning, statistical analysis, generative AI, and applied AI to build intelligent p

AI Auditor, Consultant

Oakland, USA

Your Role 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

Risk Adjustment Consulting, Associate

Oakland, USA

Your Work In this role, you will: Actively learning the core principles of decision analytics with knowledge of the analytic tools and techniques that are used to acquire and analyze data for reporting and decision makin

Appeals and Grievances Representative

Long Beach, USA

Your Role The Appeals and Grievances teams receive, document, investigate, refer, and coordinates grievances, appeals and complaints. The Appeals and Grievances Coordinator will report to the Appeals and Grievances Super

Director, Operations (Government Markets)

Lodi, USA

Your Role The Government Markets Customer Experience team supports member interactions from our Government Markets members. The Director, Government Markets Customer Service will report to the Sr. Director, Government Ma

RN- Clinical Quality Reviewer - Nurse, Senior

El Dorado Hills, USA

Your Role The Clinical Quality Review (CQR) team is responsible for reviewing potential quality of care issues (PQIs) reported by a member, a member representative, or an internal or external partner. The Clinical Qualit

Pharmacy Technician, Intermediate (Short Term Employment)

Rancho Cordova, USA

Your Role The Pharmacy Prior Authorization team provides efficient and accurate responses to external customers (physicians, office staff, pharmacy providers, members, and brokers) and internal team members for all outpa