Clinical Case Manager

At Blue Shield of California, we are seeking a skilled Appeals and Grievances Case Manager, Senior to join our team. In this role, you will play a critical part in managing and resolving member appeals and grievances in a timely manner.About the RoleThis position involves answering inquiries, investigating issues, and providing explanations of health plan...

Job SummaryThe Care Management team at Blue Shield of California supports the mission of providing support to patients in maintaining health and wellness in the outpatient setting. As a Senior Care Manager, you will report to the Manager of Care Management and ensure that services are provided based on standardized procedures, including coordination of care...

Job SummaryWe are seeking an experienced Healthcare Operations Manager to join our team at Blue Shield of California.About the RoleThe ideal candidate will have a strong background in healthcare management, with experience in care coordination, utilization management, and quality improvement. The successful applicant will be responsible for ensuring that...

Specialty Healthcare: Case Management RoleWe are seeking a highly skilled and experienced Case Manager to join our team at Specialty Professional Services in Mission Hills, CA. This role requires a valid RN license and at least one year of recent experience in case management.Key Responsibilities:Evaluate patient needs and develop comprehensive care...

Hospice Case Manager Opportunity at Incredible HealthWe are actively hiring a skilled Registered Nurse to join our team as a Hospice Case Manager in Beverly, MA. As a key member of our healthcare team, you will play a critical role in providing high-quality patient care and support.Job Overview:This is a full-time position with shift flexibility, including...

Senior Case Manager Position at Razi Law GroupRazi Law Group A Professional Law is seeking a highly skilled Senior Case Manager to join our team. This is a full-time, in-person position located in Beverly Hills.Key Responsibilities:Manage Personal Injury Cases: Handle cases from medical treatment to preparing demands, working closely with attorneys to build...

At Blue Shield of California, we are committed to providing exceptional healthcare services to our members. As a Nurse Case Manager, you will play a vital role in ensuring that our members receive high-quality care and support throughout their healthcare journey.About the RoleThis is a challenging and rewarding opportunity for an experienced nurse to join...

Hiring for Registered Nurses to join our team in Beverly, MA. We're actively recruiting skilled professionals to fill Home Health Case Manager positions.Overview:Incredible Health is a leading healthcare organization with a strong presence in the Beverly area. As a Home Health Case Manager Registered Nurse, you'll play a vital role in delivering high-quality...

About Blue Shield of CaliforniaBlue Shield of California is committed to accelerating the emergence of a value-based healthcare system in California. Our team ensures that we stay on the cutting edge of medical, medication, and payment policy.Job Description: Medical Director, Utilization ManagementWe are seeking a highly skilled Medical Director,...

Mass General Brigham is seeking a highly skilled Registered Nurse (RN) to join their team as a Case Management professional in Beverly, Massachusetts. With a strong focus on delivering exceptional patient care and outcomes, this role will play a vital part in ensuring seamless transitions for patients across the healthcare continuum.About the Role:Initial...

We are OneStaff Medical, a forward-thinking staffing firm dedicated to empowering your career. Our commitment to excellence and employee-centric approach makes us an ideal partner for professionals seeking new challenges.The estimated weekly amount for this role is based on hourly wages and potential stipends available for the location of the assignment....

About Blue Shield of CaliforniaBlue Shield of California is a leading health plan that is dedicated to transforming healthcare through innovation and collaboration. Our mission is to ensure that Californians have access to high-quality, affordable healthcare services.The RoleWe are seeking a highly skilled Clinical Director, Health Policy and Management to...

The Operational Governance team at Blue Shield of California plays a vital role in supporting project implementation, analyzing operational performance, and optimizing complex processes for the Installation & Billing department.As a Strategic Business Operations Specialist, you will report directly to the Program Manager and be responsible for reviewing...

OverviewThe Appeals and Grievances team at Blue Shield of California plays a crucial role in managing and resolving member appeals and grievances. As an Appeals and Grievances Representative, Advanced Coordinator, you will be responsible for taking incoming telephone calls, reviewing, researching, and responding to appeals and grievances within established...

About This RoleAs a Healthcare Advocate Coordinator at Blue Shield of California, you will play a critical role in managing and resolving member appeals and grievances in a timely manner.Your key responsibilities will include answering inquiries, investigating issues, and providing explanations of health plan benefits to members and providers. To succeed in...

Job Title: Case Manager RN Medical ProfessionalMass General Brigham is seeking a highly skilled Registered Nurse (RN) to fill the role of Case Manager. This nursing position is based in Beverly, Massachusetts.About the Role:This is an ongoing opportunity with 32 hours per week, working 8-hour days. As a Case Manager RN, you will be part of a dynamic team...

Job Summary:We are seeking a Chief Clinical Officer, Utilization Management to join our team at Blue Shield of California.About Us:At Blue Shield of California, we strive to be on the cutting edge of medical, medication, and payment policy to accelerate the emergence of a value-based health care system in California.The successful candidate will report to...

**Job Title:** Cloud Security ExpertCompany Overview:Blue Shield of California is a leading health plan that provides high-quality, affordable healthcare services to its members. We are committed to delivering exceptional care and improving the health and well-being of our communities.About the Role:We are seeking a highly skilled Cloud Security Expert to...

Your Role at Blue Shield of CaliforniaThe Behavioral Health Strategy team at Blue Shield of California ensures members have access to affordable, high-quality care that differentiates the company as a market leader in behavioral health.As a Business Analyst, Consultant, you will report to the Director, Clinical Strategy & Performance. In this role, you will...

Your RoleAs a Cloud Security Engineer in the IT Quality Engineering Organization at Blue Shield of California, you will play a crucial role in ensuring the security and quality of software products. Your primary responsibility will be to establish best practices and standards for cloud-based security methodologies, ensuring a secure and seamless transition...