People Analytics and Reporting, Consultant

Senior Evaluation and Data Strategy Officer - Foundation

San Francisco, USA

Your Role The Foundation is an independent licensee of the Blue Shield Association. Blue Shield of California has contributed more than $500 million to Blue Shield of California Foundation since 2002 to have a positive i

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

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

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

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

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

Special Investigations Investigator, Consultant

Rancho Cordova, USA

Your Role The Special Investigations Unit (SIU) team s responsible for preventing, detecting, investigating, and resolving health care fraud, waste, and abuse. The Special Investigations Investigator, Consultant report t