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 Sr. Manager, Information Security Technical Business Continuity will report to the Director,

Your Role The Back Office Analytics team supports operations stakeholders with dashboarding, analytic studies, and statistical modeling to drive a better member/provider experience while reducing both administrative and healthcare costs. The Medical Informatics Analyst, Consultant will report to the Sr. Manager of Back Office Analytics. In this role you will provide analy

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 Managed Care Finance team administers the financial terms and conditions of our capitated contracts with IPA/Medical Groups, Hospitals, and Vendors. The Financial Analyst, Experienced will report to the Manager of Managed Care Finance. In this role you will be performing provider contract analysis, financial research, preparing financial forecasts, analyzing

Your Role The clinical services coordinator (CSC) will report directly to the supervisor of care management support operations and will serves as initial point of contact for providers and members in the medical management process by telephone or correspondence. The CSC will interact telephonically with members as per established protocol or direction to ensure that membe

Your Role The Clinical Service Coordinator, Specialist responsible for the daily operations within the Promise Health Plan Case Management Department for non clinical functions. The Lead will be responsible for the coordination of Health Risk Assessment / Individualize Care Plan Outreach Process, Case Management services, Transitions of care services provided by the PHP C

Your Role The Actuarial Reserving team develops Incurred but Not Reported (IBNR) reserve models and reporting while considering the impacts of emerging operational and trend dynamics on reserve levels . The Actuarial Analyst, Experienced will report to the Senior Manager of Reserving. In this role you will collaborate with partners in Accounting, Operations, IT, and other

Your Role The Back Office Analytics team supports back office operations stakeholders with dashboarding, analytic studies, and statistical modeling to drive a better member/provider experience while reducing both administrative and healthcare costs. The Business Data Analyst, Senior will report to the Sr. Manager of Back Office Analytics. In this role you will provide ana

Your Role The Children's Health Program (CHP) team provides identification, referrals, and care management for all Medi Cal members under 21 years old and collaborates within Promise Clinical Team. The Case Management, Senior will report to the CHP Manager. In this role you will be Perform clinical review, assessment, evaluation of medical services for the organization us

Your Role The Network Trend Analytics team is responsible for performing financial modeling and analytics for provider contract negotiations for hospitals and ambulatory surgery centers. The Associate Actuarial Analyst will report to the Senior Manager. In this role you will be applying your analytical toolset to project future unit cost trends and drive the development o

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 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 Clinical Quality team oversees and is responsible of HEDIS medical record review, pursuit, and overall HEDIS submission. The Clinical Quality Coordinator will report to the Supervisor of the HEDIS Outreach Team. In this role you will be responsible for conducting provider outreach during the HEDIS season for medical record pursuit and retrieval. Also, partic

Your Role The Corporate Citizenship Sustainability team sets environmental strategy, standards and targets, collects and analyzes environmental data, conducts environmental reporting (including greenhouse gas inventory and climate related risk/resilience), and oversees mitigation, adaptation and climate leadership work along Blue Shield's value chain. The Corporate Citize

Your Role The Network Management team handles provider contracting and provider relations statewide. The Provider Contracting Specialist, Experienced will report to the Sr Manager of Provider Contracting. In this role you will support Medical Group/IPA and Hospital/Facility contracting in Northern California for all Blue Shield products. You will be responsible for compre