Blue Shield Promise Community Health Liaison

About the Role:This is an exciting opportunity to join Blue Shield of California as a Community Resource Center Representative. In this role, you will play a vital part in connecting members and consumers with essential services that foster community connections, address social needs, and promote healthy living.Job Summary:The Community Resource Center (CRC)...

ASO and Specialty Actuary JobWe are seeking an experienced Actuary to join our team as a Senior Manager, Actuary of ASO and Specialty.This role supports rate filing, discount submission, and financial analysis for Blue Shield of California's ASO and Specialty space, reporting to the Senior Director Actuarial Pricing for Select &...

Your RoleThe Senior Community Health Professional will report to the Director of Social Services. In this capacity, you will conduct outreach to Blue Shield of California Promise Health Plan members and perform comprehensive assessments for health-related social needs.Your WorkIn this role, you will:Conduct psychosocial and social drivers of health needs...

Overview:The Blue Shield of California Community Resource Center Representative plays a vital role in connecting members with personalized services, fostering community connections, and addressing social needs. This position is located at our Norwalk Community Resource Center and requires employees to work 5 days per week.Your Role:This Community Resource...

About Blue Shield of CaliforniaBlue Shield of California is a health plan company dedicated to providing high-quality healthcare services to its members. Our team works tirelessly to ensure that our members receive the best possible care.

Job SummaryWe are seeking a highly skilled Behavioral Health Registered Nurse Case Manager to join our team at Blue Shield of California. As a member of our Federal Employee Program (FEP) department, you will play a vital role in determining, developing, and implementing plans of care based on accurate and comprehensive assessments of our members' needs.

About the RoleWe are seeking a skilled Behavioral Health Case Manager to join our team at Blue Shield of California. In this role, you will play a vital part in determining, developing, and implementing plans of care based on comprehensive assessments of members' needs.Your WorkCoordinate care for lower levels of care, including residential treatment,...

About the RoleThis position is for an Advanced Social Support Coordinator to provide telephonic social services support and resource referrals to Blue Shield D-SNP members. The role requires establishing trusting relationships with members, conducting needs assessments, and coordinating support aimed at improving member quality of care.Key ResponsibilitiesBe...

About This RoleThe Social Services Representative, Advanced provides critical support and resource referrals to Blue Shield D-SNP members through telephonic social services. They also offer administrative assistance to the social service team and manager/supervisor.Key ResponsibilitiesEstablish trusting relationships with members while providing...

The Senior Manager, Actuary role at Blue Shield of California offers an exciting opportunity to lead the ASO and Specialty Pricing team. In this position, you will manage the UDS discount submission, oversee the financial performance of our Specialty product lines, and assess financial risk of unique funding arrangements in the self-funded market. To succeed...

OverviewBlue Shield of California's Clinical Access Program is dedicated to ensuring that newly enrolled Medi-Cal members receive quality healthcare services. As a Healthcare Operations Coordinator, you will play a crucial role in achieving this goal by facilitating Initial Health Appointments for these members.ResponsibilitiesConduct daily outreach to...

Company Overview: Blue Shield of California is a leading health plan that provides access to quality healthcare services. Our team is dedicated to delivering exceptional care and support to our members.

About the RoleBlue Shield of California is seeking an experienced Implementation Specialist to join our team. As a Senior Implementation Specialist, you will be responsible for managing complex renewals and ensuring the successful onboarding of groups with Shared Advantage and Fully Insured funding types.Key ResponsibilitiesManage delivery of internal...

Your RoleAs a Clinical Leadership Specialist at Blue Shield of California, you will collaborate with regional medical directors and internal teams to transform healthcare delivery. Your focus will be on ensuring best-in-class care for all members, prioritizing the Quadruple Aim: lower cost care, increased quality, member satisfaction, and physician...

At Blue Shield of California, we are seeking a skilled Clinical Risk Adjustment Strategist to join our team. In this role, you will have the opportunity to make a significant impact on the success of our Risk Adjustment Program.Company OverviewOur company is a leading health insurance provider in California, dedicated to delivering high-quality care to our...

At Blue Shield of California, we're committed to delivering best-in-class care for all members. As a Clinical Leadership Executive, you'll collaborate with our Regional Medical Director and internal teams to transform healthcare delivery.The Clinical Leadership Executive will be responsible for partnering with externally facing partners to drive improvements...

About Clinical Quality Analytics, ConsultantBlue Shield of California's Clinical Quality Analytics and Informatics team delivers high-quality clinical analytics to enable exceptional patient care. Our data-driven insights support quality strategy, performance improvement, and regulatory reporting.Your RoleIn this role, you will provide advanced data analysis...

Join a dynamic team at Blue Shield of California where innovation meets healthcare excellence. We are seeking an experienced Program Manager Clinical, Principal to drive our Behavioral Health Clinical Strategy and Programs forward.We operate in a rapidly changing healthcare landscape, and our team is dedicated to developing, executing, and evaluating...

Clinical Quality Analytics Specialist Role OverviewWe are seeking an experienced Clinical Quality Analytics Specialist to join our team at Blue Shield of California. This role involves delivering advanced clinical quality analytics and reporting to enhance member-centered care.Key Responsibilities:Conduct in-depth analysis of complex data sets to support...

Company Overview">At Blue Shield of California, we strive to provide innovative healthcare solutions that improve the lives of our members. Our team is dedicated to delivering exceptional care and services that meet the unique needs of each individual.">Salary">The estimated annual salary for this role ranges from $87,230 to $130,900, depending on experience...