![Blue Shield Of California](https://media.trabajo.org/img/noimg.jpg)
Operations Specialist, Experienced
3 weeks ago
Your Role
The Commercial Appeals and Grievances team performs comprehensive research related to the facts and circumstances of member complaints, appeals and grievances. The Commercial Appeals and Grievances Operations Specialist - Experienced will report to a Commercial Appeals and Grievances Supervisor. In this role you will partner with the Commercial Appeals & Grievances leadership team by supporting the business with ensuring all Desk Level Procedures (DLPs) are up to date and accurate. You will be responsible for supporting the Commercial Appeals and Grievances leadership team with compliance, quality, production, workflow, process improvements, employee engagement and developing relationships with a diverse group of cross-functional business partners.
Your Work
In this role, you will:
- Act as subject matter expert and review operational workflows, identify problems, perform root cause analysis and develop improvements, modifications, and enhancements.
- Maintain databases required for business operations.
- Develop and evaluate tools and materials that enhance operating efficiency, accuracy, and technical skill levels of unit staff.
- Develop and generate reports for management review; notify appropriate department managers about issues and problems in operational workflow requiring immediate attention.
- Participate as a subject matter expert in the development of written guidelines and document problems as needed.
- Support leadership team through current and future system changes and enhancements.
- Create and support employee engagement activities.
- Other tasks as needed.
Your Knowledge and Experience
- Requires a bachelor's degree or equivalent experience
- Requires at least 3 years of prior relevant experience
- Requires at least 1 year of Appeals & Grievances experience
- Requires knowledge of job area typically obtained through experience
- Excellent attention to detail, analytical, communication and problem-solving skills
- Able to work independently and meet deadlines consistently
- Note: You may be placed in a specialty client, or other unit, such as CalPERs.
Pay Range:
The pay range for this role is: $ 66,800 to $ 93,400 for California.
Note:
Please note that this range represents the pay range for this and many other positions at Blue Shield that fall into this pay grade. Blue Shield salaries are based on a variety of factors, including the candidate's experience, location (California, Bay area, or outside California), and current employee salaries for similar roles.
#LI-CP3
-
Operations Specialist, Experienced
2 weeks ago
El Dorado Hills, United States Blue Shield of California Full timeYour Role The Commercial Appeals and Grievances team performs comprehensive research related to the facts and circumstances of member complaints, appeals and grievances. The Commercial Appeals and Grievances Operations Specialist - Experienced will report to a Commercial Appeals and Grievances Supervisor. In this role you will partner with the Commercial...
-
Operations Specialist, Experienced
2 weeks ago
El Dorado Hills, United States Blue Shield Of California Full timeYour Role The Commercial Appeals and Grievances team performs comprehensive research related to the facts and circumstances of member complaints, appeals and grievances. The Commercial Appeals and Grievances Operations Specialist - Experienced will report to a Commercial Appeals and Grievances Supervisor. In this role you will partner with the Commercial...
-
Experienced Operations Coordinator
1 week ago
El Dorado Hills, California, United States Blue Shield Of California Full timeYour RoleThe Commercial Appeals and Grievances team conducts thorough investigations concerning the details and situations surrounding member complaints, appeals, and grievances. The Operations Specialist - Experienced will report to a Supervisor within the Commercial Appeals and Grievances department. In this capacity, you will collaborate with the...
-
Experienced Operations Coordinator
1 week ago
El Dorado Hills, California, United States Blue Shield Of California Full timeJob OverviewYour RoleThe Commercial Appeals and Grievances team is dedicated to conducting thorough investigations concerning member complaints, appeals, and grievances. The Experienced Operations Specialist will report directly to a Supervisor within the Commercial Appeals and Grievances department. In this capacity, you will collaborate with the leadership...
-
Experienced Operations Coordinator
1 week ago
El Dorado Hills, California, United States Blue Shield Of California Full timeJob OverviewYour RoleThe Commercial Appeals and Grievances team is dedicated to conducting thorough investigations concerning member complaints, appeals, and grievances. The Experienced Operations Specialist in this area will report directly to a Supervisor within the Commercial Appeals and Grievances team. In this capacity, you will collaborate with the...
-
Experienced Operations Coordinator
1 week ago
El Dorado Hills, California, United States Blue Shield Of California Full timePosition OverviewThe Commercial Appeals and Grievances team is dedicated to conducting thorough investigations regarding member complaints, appeals, and grievances.The Operations Specialist in this area will report directly to a Supervisor within the Commercial Appeals and Grievances team.Key ResponsibilitiesIn this position, you will collaborate with the...
-
El Dorado Hills, United States Blue Shield of California Full timeYour Role The Operations Audit Oversight team (within the Claims Organization) partners with external audit firms, regulators and internal partners to support required audits. The Experienced Compliance Audit Services Specialist will report to the Senior Manager of the Claims Partnerships and Communications team. In this role you will have the opportunity to...
-
El Dorado Hills, United States Blue Shield of California Full timeYour Role The Operations Audit Oversight team (within the Claims Organization) partners with external audit firms, regulators and internal partners to support required audits. The Experienced Compliance Audit Services Specialist will report to the Senior Manager of the Claims Partnerships and Communications team. In this role you will have the opportunity to...
-
el dorado hills, United States Blue Shield of California Full timeYour Role The Operations Audit Oversight team (within the Claims Organization) partners with external audit firms, regulators and internal partners to support required audits. The Experienced Compliance Audit Services Specialist will report to the Senior Manager of the Claims Partnerships and Communications team. In this role you will have the opportunity to...
-
El Dorado Hills, United States Blue Shield of California Full timeYour Role The Operations Audit Oversight team (within the Claims Organization) partners with external audit firms, regulators and internal partners to support required audits. The Experienced Compliance Audit Services Specialist will report to the Senior Manager of the Claims Partnerships and Communications team. In this role you will have the opportunity to...
-
El Dorado Hills, United States Blue Shield of California Full timeYour RoleThe Operations Audit Oversight team (within the Claims Organization) partners with external audit firms, regulators and internal partners to support required audits. The Experienced Compliance Audit Services Specialist will report to the Senior Manager of the Claims Partnerships and Communications team. In this role you will have the opportunity to...
-
El Dorado Hills, United States Blue Shield of California Full timeYour Role The Operations Audit Oversight team (within the Claims Organization) partners with external audit firms, regulators and internal partners to support required audits. The Experienced Compliance Audit Services Specialist will report to the Senior Manager of the Claims Partnerships and Communications team. In this role you will have the opportunity to...
-
El Dorado Hills, United States Blue Shield of California Full timeYour Role The Operations Audit Oversight team (within the Claims Organization) partners with external audit firms, regulators and internal partners to support required audits. The Experienced Compliance Audit Services Specialist will report to the Senior Manager of the Claims Partnerships and Communications team. In this role you will have the opportunity to...
-
el dorado hills, United States Blue Shield of California Full timeYour Role The Operations Audit Oversight team (within the Claims Organization) partners with external audit firms, regulators and internal partners to support required audits. The Experienced Compliance Audit Services Specialist will report to the Senior Manager of the Claims Partnerships and Communications team. In this role you will have the opportunity to...
-
El Dorado Hills, United States Blue Shield of California Full timeYour Role The Operations Audit Oversight team (within the Claims Organization) partners with external audit firms, regulators and internal partners to support required audits. The Experienced Compliance Audit Services Specialist will report to the Senior Manager of the Claims Partnerships and Communications team. In this role you will have the opportunity to...
-
El Dorado, Kansas, United States Daimler Trucks North America Full timeAbout the RoleWe are seeking a highly skilled and experienced Operative Power Train Procurement Specialist to join our team at Daimler Trucks North America. As a key member of our procurement organization, you will be responsible for establishing sustainable supply chains with suppliers worldwide and driving commercial contributions to the company.Key...
-
El Dorado Hills, CA, United States Blue Shield of California Full timeYour Role The Operations Audit Oversight team (within the Claims Organization) partners with external audit firms, regulators and internal partners to support required audits. The Experienced Compliance Audit Services Specialist will report to the Senior Manager of the Claims Partnerships and Communications team. In this role you will have the opportunity...
-
El Dorado Hills, CA, United States Blue Shield of California Full timeYour Role The Operations Audit Oversight team (within the Claims Organization) partners with external audit firms, regulators and internal partners to support required audits. The Experienced Compliance Audit Services Specialist will report to the Senior Manager of the Claims Partnerships and Communications team. In this role you will have the opportunity...
-
El Dorado Hills, CA, United States Blue Shield of California Full timeYour Role The Operations Audit Oversight team (within the Claims Organization) partners with external audit firms, regulators and internal partners to support required audits. The Experienced Compliance Audit Services Specialist will report to the Senior Manager of the Claims Partnerships and Communications team. In this role you will have the opportunity to...
-
Business Analyst, Experienced
2 weeks ago
El Dorado Hills, United States Blue Shield of California Full timeYour Role The Operational Governance team provides project support, operational analysis, and complex process management support for operational teams within Blue Shield of California’s Installation & Billing department. The Business Analyst, Experienced will report to the Program Manager. In this role you will review process performance and manage...