Your Role The Blue Shield of California Growth and Servicing analytics organization is part of the centralized Data and Analytics organization and oversees Channel Analytics including Digital, Marketing, Claims, Appeals, Grievances, Disputes, Customer Experience and Line of Business. This role Senior Manager Market Insights & Experience Analytics would report to the Senio

Your Role The Medical Director, Operations Federal Employee Program, is a key member of the Medical Management and Operations staff within Health Care Services. This is a front line utilization management position that has core responsibilities in the areas of inpatient concurrent review, pre and post service utilization review, and collaboration with RN Case and disease

Your Role The Strategic Partnerships and Pilot Programs unit seeks a Market Researcher, Principal to join the Design Studio, a user experience focused team central to piloting innovative member centered solutions to improve health outcomes for Blue Shield of California members and their communities. The researcher in this role will report to the Senior Manager of Market R

Your Role The Business Architecture team, within the Enterprise Architecture organization, is responsible for developing strategies and multi year integrated roadmaps that bridge our business portfolios and technology vision. The Enterprise Business Architect, Principal will report to the Sr. Director, Business Architecture and Innovation Product Strategy. In this role yo

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 Care Management team is looking for a leader with Care Management experience who can help design and lead our Population Health management (PHM) Medi Cal Care Management line of business. The Manager, Care Management will report to the Senior Manager of Care Management PHM. In this role you will act as the practice and operational leader for the care manager

Your Role The Actuarial Pricing Shared Services team is responsible for collaborating with different Finance and Actuarial teams to support enterprise financial tracking and forecasting and drive the pricing target setting and planning to meet Company's operating and growth goals. The Senior Actuarial Analyst will report to the Senior Manager of the Actuarial Pricing Shar

Your Role The Actuarial Provider Strategies team helps design and implement value based care (VBC) payment models, which include Accountable Care Organizations (ACOs) and other innovative alternative payment models (APMs) to improve the affordability and quality of care our members receive. The Associate Actuarial Analyst will report to the Principal of Actuarial Provider

Your Role The Information Security team is responsible for providing cyber security services to Blue Shield of California that enable secure product development and operations. The Director of Information Security will report to the Sr. Director . In this role you will you will lead a team responsible for designing, implementing, and maintaining security capabilities that

Your Role The Trust Assurance Services team drive BSC information security adherence to regulatory standards, as well as policies, standards, and controls with the goal of safeguarding company assets and maintaining confidentiality, integrity, and availability of information. The Technical Business Continuity, Principal will report to the Senior Manager, Technical Busines

Your Role The Communication Governance team supports the development and implementation of strategic communication programs to improve overall member experience, streamline operational processes, and govern member facing communications to align with company policies and regulatory requirements. The Marketing Operations Specialist, Consultant Communication Governance will

Your Role The Network Management team handles provider contracting and provider relations statewide. The Provider Contracting Specialist, Senior will report to the Director, Provider Contracting. In this role you will support Medical Group/IPA and Hospital/Facility contracting in Southern California for all Blue Shield products. You will be responsible for comprehensive m

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 Digital Enterprise Growth team is continuing to reimagine our digital broker products to make it easy for brokers to do business with Blue Shield of California. The Product Manager, Consultant will report to the Director, Digital Growth & B2B Experience. In this role, you will leverage expertise in Product Management and industry knowledge to articulate a co

Your Role The Clinical Quality Analytics and Informatics team delivers best in class clinical quality analytics and informatics to enable high quality and affordable member centered care. Our data, intelligence, and actionable insights help drive quality strategy, performance improvement, and regulatory reporting. The Clinical Quality Analyst Senior will report to the Cli