Academic Director of Forensics and Debate

Job Title: Forensic Debate CoachAre you passionate about debate and forensics? Do you have a knack for teaching and mentoring students? We are seeking a dedicated Forensic Debate Coach to join our team at California State University, Long Beach.

Blue Shield of California seeks an exceptional Pharmaceutical Operations Director to join our team. In this role, you will be responsible for overseeing the management of program area operations and employees. Your leadership skills and experience in managed care settings will be crucial in executing overall vision, goals, objectives, and ensuring...

At Blue Shield of California, we are dedicated to delivering exceptional healthcare services to our members. As a Director of Pharmacy Operations Management, you will play a crucial role in ensuring the efficient and accurate processing of outpatient pharmacy benefit inquiries.The successful candidate will be responsible for supervising a team of licensed...

Your RoleWe are seeking a highly experienced and accomplished Strategic Clinical Director to lead our Behavioral Health Portfolio at Blue Shield of California. As a key member of the Blue Shield Behavioral Health Clinical Strategy and Programs team, you will work closely with internal and external business and clinical partners to drive the development,...

We are seeking a seasoned Healthcare Data Analyst Consultant to join our team at Blue Shield of California. In this role, you will leverage your expertise in data analytics and informatics to enhance member-centered care.Job Description:The Clinical Quality Analytics Consultant utilizes data analytics and informatics to drive performance improvement and...

About FACS & YouAre you passionate about advancing your career in environmental health? At Forensic Analytical Consulting Services (FACS), Inc., we're pioneers in the industry, leveraging cutting-edge solutions to shape safer, healthier communities nationwide. Our mission is to provide expert environmental health services that make a real difference in...

About the RoleThe Pharmacy Services Prior Authorization team conducts medical necessity reviews for drug coverage at Blue Shield of California. As a Pharmacist Manager, you will support the Pharmacy and Therapeutics (P&T) Committee process by ensuring that evidence-based clinical decisions are implemented operationally to support safe, efficacious, and...

Job OverviewThe Medical Claims Review Specialist will be responsible for reviewing facility claims to ensure compliance with medical necessity and billing standards. This role involves conducting retrospective utilization reviews, preparing cases for medical director oversight, and ensuring adherence to regulatory and accreditation requirements.Key...

At Blue Shield of California, we're seeking an experienced Senior Clinical Utilization Review Nurse to join our Facility Compliance Review team. This role is ideal for a highly skilled professional who can ensure medical necessity and billing standards are met.Key Responsibilities:Conduct retrospective utilization reviews and first-level determination...

Senior Healthcare Compliance Specialist Job DescriptionIn this challenging role, you will be responsible for conducting retrospective utilization reviews to ensure compliance with medical necessity and billing standards.The ideal candidate will possess strong analytical skills and effective communication to manage claims and improve quality of care. You will...

About the RoleAre you a detail-oriented healthcare professional with a passion for delivering high-quality care? Blue Shield of California is seeking a skilled Clinical Coding Analyst RN, Senior to join our team. As a member of our Facility Compliance Review team, you will play a critical role in ensuring the accuracy and integrity of medical coding for our...

Job SummaryThe Clinical Review Specialist, Senior at Blue Shield of California will lead retrospective utilization reviews and first-level determination approvals for members using BSC evidenced-based guidelines, policies, and nationally recognized clinical criteria across lines of business or for a specific line of business such as Medicare and FEP.Key...

Role Overview:The Clinical Coding Analyst RN Senior will be responsible for performing in-depth quality audits of hospital claims to support ICD-10-CM and ICD-10 PCS codes, as well as MS-DRG and APR-DRG reviews based on clinical determination. This role requires a strong understanding of medical necessity and reimbursement requirements, as well as the...

Role OverviewThe Senior Clinical Quality Analyst plays a pivotal role in enhancing clinical quality performance through complex data analysis and reporting. This position involves the development of data systems, the execution of high-level analyses for improving healthcare quality metrics, and collaboration with various teams to support regulatory and...

Company Overview:Blue Shield of California is a leading healthcare organization that delivers best-in-class clinical quality analytics and informatics to enable high-quality and affordable member-centered care.About the Role:We are seeking an experienced Data Analyst - Clinical Quality Senior to join our team. This role will provide data, analytic, and...

Pinnacle Health Group invites experienced candidates with strong leadership background to join our team as a Dermatology Residency Program Director.About the OpportunityWe are seeking an exceptional individual to develop and lead our dermatology residency program at an academic medical center. This is an excellent opportunity to build a dermatology practice...

Transformative Clinical Program Management OpportunityAbout the Role:We are seeking a seasoned Clinical Program Manager, Principal to join our team at Blue Shield of California. This strategic business leader will collaborate with Regional Medical Directors and internal teams to drive transformative change in healthcare delivery, ensuring best-in-class care...

Job DescriptionJob Title: Part-Time Dermatology PhysicianLocation: Long Beach, CAJob Type: Part-timeSalary: $350,000 - $400,000 per yearBenefits:Annual Leave (Paid Time Off)Liability ProtectionHealth InsuranceDental and Vision InsuranceFlexible Spending AccountsHealth Savings AccountsLife InsurancePensionThrift Savings PlanSurvivor BenefitsAbout the...

**Overview of Blue Shield of CaliforniaWe are a not-for-profit health plan that provides high-quality healthcare services to millions of Californians. Our mission is to make a meaningful difference in the lives of our members by delivering innovative, patient-centered care.About the RoleWe are seeking an experienced Clinical Review Specialist - Utilization...

Welcome to this exciting opportunity at Blue Shield of California, where you will lead the development, execution, and evaluation of strategies for behavioral health and addiction medicine. As a Program Manager Clinical, Principal, you will collaborate with cross-functional partners to ensure alignment with strategic goals, manage complex projects, and...