Your Role With pharmacy benefits being an essential component of the medical benefits, Pharmacy Care Reimagined is a critical Blue Shield of California initiative along with other Health Care Reimagined initiatives. The Pharmacy Care Reimagined goal is to enable every person with safe, equitable access to sustainably affordable prescription drugs. To enable our vision, we

Your Role The Clinical Services Coordinator (CSC) will report directly to the Supervisor of Promise Medi Cal Care Management. This individual will interact telephonically and electronically with members and providers as per established protocol or direction to ensure that members are effectively and efficiently managed through the outreach, engagement, and care management

Your Role The Federal Employee Program (FEP) team performs integrated case management (CM) and disease management (DM) activities in collaboration with members and those involved with members' care including registered nurse case managers, social workers, dietitians, health coaches, pharmacists, and physicians. The FEP Health Coach will report to the FEP Department Manage

Your Role The Social Services Representative, Advanced will report to the Supervisor, Social Services. In this role you will provide telephonic social services support and resource referrals for high acuity Blue Shield Promise members, in addition to administrative support to the Social Services Management Team. The Social Services Representative regularly reaches out to

Your Role The Data Engineering development team Is responsible for design, development, test and deployment of large enterprise data warehouse/BI data solutions using both on prem and cloud technologies. The Data Engineer, Consultant will report to the Manager, Data Engineering Development. In this role you will be responsible for design, development, and implementation o

Your Role The Innovation Analyst, Principal is responsible for providing thought leadership to business leaders across the enterprise to address ambiguous problems and opportunities through internal strategy and/or innovation consulting engagements. This role will serve as a change agent, leveraging a consistent and disciplined approach to strategy and innovation to desig

Your Role The Physical Platform Engineer, Consultant will report to the Productivity Engineering Manager. In this role you will manage development, automation, and engineering delivery of the Windows platform end to end, from OS engineering, configuration down to application management and drive to an endpoint modern management vision. Your Work In this role, you will Ope

Your Role The Operations Portfolio team within Blue Shield of California provides robust solutions for our business partners, providers and members which improve the overall health care experience from claims processing to benefit enrollment. IT Product Manager, Consultant will report to the Senior Manager, Applications Services Lead in the Operations Portfolio. In this r

Your Role This position is located in our Panorama City Community Resource Center Location & require employee to work 5 days per week in the Panorama City Community Resource Center The Community Programs team provides high touch engagement with members and community based organizations to remove barriers to healthcare access, enhance population health initiatives and adva

Your Role The Global Business Services (GBS) department is responsible for delivering strategic and category supplier sourcing, contracting and governance excellence at Blue Shield of California. The Senior Manager, Procurement Contracting role will report to the Director, Contracting. In this role you will be responsible for the management, prioritization and execution o

Your Role The Information Security team is responsible for governance over the exchange of protected health information (PHI) and sensitive data with external entities. The Information Security Data Exchange Expert, Principal will report to the Senior Manager, Information Security Data Exchange. In this role you will be responsible for the privacy and security frameworks

Our Customer Experience Teams receive incoming telephone calls from our members. Our Call Centers are open 7 days a week. If hired, you will be required to attend and complete a paid, mandatory training. Training will be held in a remote environment. Remote training requires secure, reliable internet connectivity. Any hybrid work or training requires both remote and on pr

Your Role The Medi Cal Program Support (MPS) team ensures sufficient and complete Medi Cal operational documentation by reviewing and supporting development of business process documentation; development of regulatory data and files process documentation; and development of employee trainings. The Business Analyst will report to the Senior Manager of the Business Process

Your Role The Special Investigations Unit team is responsible for preventing, detecting, investigating, and resolving health care fraud, waste, and abuse . The Special Investigations Investigator, Consultant will report to the SIU Manager. In this role you will represent a high level of professionalism both internally and externally. Conduct investigations in accordance w

Your Work In this role, you will Be responsible for analytic work required to convert pricing and financial goals at the line of business and region level into specific action plans at the provider level that the Network team can execute Build and update models that allow the actuarial team to quantify financial gaps and opportunities at a provider level Conduct and devel