Operations Supervisor

1 week ago


El Dorado Hills, California, United States Blue Shield of California Full time
About the Role

The Commercial Appeals & Grievances department at Blue Shield of California performs comprehensive research related to the facts and circumstances of member complaints, appeals, and grievances.

The Commercial Appeals & Grievances Supervisor will report to the Commercial Appeals & Grievances Senior Manager.

Key Responsibilities
  • Be responsible for routine operations and people management functions
  • Foster a great place to work by communicating clear roles and responsibilities and building successful working relationships across the organization
  • Consult and make recommendations to management on operational issues
  • Use concepts and abilities to manage processes and operations, including procedural changes, inventories, and workload management
  • Apply policies and procedures within health care operations
  • Stay up to date on legislation and regulations to ensure team compliance
  • Interpret audit information requests, prepare narratives, conduct preliminary risk assessments, anticipate adverse findings to prepare for internal corrective action plans
  • Make decisions on people and operational matters consistent with goals and objectives
  • Provide coaching, performance management, skill development, and guidance on team members' Professional Development Plans
  • Perform other related duties as assigned
Requirements
  • Requires a High School Diploma or GED
  • Requires a minimum of 5 years of prior relevant experience
  • Requires a minimum of 2 years of experience operating in a lead role or equivalent leadership training or manager training
  • Requires related experience and/or training, or equivalent combination of education and experience
  • Must have experience in appeals and grievances and preferred experience in claims, customer service, installation & billing, or member services role in the health care industry
  • Appeals and Grievances experience required
  • Understands basic supervision/management approaches such as work scheduling, prioritizing, coaching and process execution
  • Requires broad knowledge of technical or operational practices within assigned discipline
  • Commercial healthcare experience preferred
  • Must be willing to work weekends and holidays as needed
Additional Information

You may be placed in a specialty client, or other unit, such as CalPERs.

The pay range for this role is: $66,600 to $98,900 for California.



  • El Dorado Hills, California, United States Pet Food Express Full time

    About Pet Food Express At Pet Food Express, we pride ourselves on being the premier destination for pet supplies, thanks to our dedicated team members. Our staff is composed of enthusiastic pet lovers who are committed to serving our community. We deliver exceptional customer service and expert guidance for even the most challenging pet-related inquiries. We...


  • El Dorado Hills, California, United States Viscuso's Pizza Full time

    We are seeking a dedicated Assistant Kitchen Supervisor to join our team at Viscuso's Pizza. In this role, you will be responsible for various kitchen operations including food preparation, pizza crafting, and overseeing daily activities. You will supervise staff, manage cash handling, and ensure exceptional service for our customers. The starting hourly...

  • Operations Manager

    5 days ago


    El Dorado Hills, California, United States Blue Shield Of California Full time

    About the RoleThe Manager of Operations will report to the Senior Manager of Operations and be responsible for leading a team in resolving member concerns through a regulated process. This includes accurately, timely, and compliantly addressing each concern. The successful candidate will provide leadership and support to their team, interact with members and...

  • Operations Manager

    1 day ago


    El Dorado Hills, California, United States Blue Shield Of California Full time

    About the RoleThe Manager of Operations will play a crucial role in leading the Appeals and Grievances team at Blue Shield of California. This team is responsible for resolving member concerns through a regulated process, ensuring accurate, timely, and compliant responses to each concern.The successful candidate will report to the Senior Manager of...


  • El Dorado Hills, California, United States Pet Food Express Full time

    À propos de Pet Food Express Pet Food Express est l'endroit idéal pour faire ses courses en fournitures pour animaux de compagnie, et cela est dû aux personnes qui y travaillent. Nos employés sont des passionnés des animaux qui se soucient profondément de notre communauté. Nous offrons un service client exceptionnel et des conseils d'experts pour...

  • Operations Manager

    1 week ago


    El Dorado Hills, California, United States Blue Shield of California Full time

    Job SummaryBlue Shield of California is seeking a highly skilled Business Operations Lead to join our team. As a key member of our Appeals and Grievances team, you will be responsible for resolving member concerns through a regulated process.About the RoleProvide leadership and support to your team, interacting with members and specialty clients.Develop and...


  • El Dorado Hills, California, United States Blue Shield Of California Full time

    Your 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...

  • Operations Manager

    7 days ago


    El Dorado Hills, California, United States Blue Shield Of California Full time

    Job SummaryBlue Shield of California is seeking a highly skilled Manager of Operations to join our Appeals and Grievances team. As a key member of our leadership team, you will be responsible for resolving member concerns through a regulated process, ensuring accurate, timely, and compliant responses.Key ResponsibilitiesProvide leadership and support to your...


  • El Dorado Hills, California, United States Blue Shield Of California Full time

    Job 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...


  • El Dorado Hills, California, United States Blue Shield Of California Full time

    Job 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...


  • El Dorado Hills, California, United States Blue Shield Of California Full time

    Job SummaryBlue Shield of California is seeking a highly skilled Manager of Operations to join our Appeals and Grievances team. As a key member of our leadership team, you will be responsible for resolving member concerns through a regulated process, ensuring accurate, timely, and compliant responses.Key ResponsibilitiesProvide leadership and support to your...


  • El Dorado Hills, California, United States Blue Shield of California Full time

    Job SummaryBlue Shield of California is seeking a highly skilled Manager of Operations to lead our Appeals and Grievances team. As a key member of our organization, you will be responsible for resolving member concerns through a regulated process.About the RoleProvide leadership and support to your team, interacting with members and specialty clients.Develop...


  • El Dorado Hills, California, United States Blue Shield Of California Full time

    Position 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 Cajon, California, United States Security First Full time

    Job OverviewPosition Summary:We are looking for a proactive and skilled Security Operations Supervisor to manage our security services. The Security Operations Supervisor will be tasked with overseeing all facets of security management, including contracts and initiatives, to guarantee the safety and protection of our organization.Key Responsibilities:Design...


  • Beverly Hills, California, United States Sprinkles Cupcakes Full time

    Position OverviewSprinkles at Beverly Hills - Bakery Operations SupervisorBecome a vital part of the Sprinkles team as a Bakery Operations Supervisor, where you will help cultivate the Sprinkles Experience for both our customers and team members. In this role, you will exemplify the Sprinkles ethos, guiding your colleagues towards excellence in bakery...


  • Beverly Hills, California, United States The Hongkong and Shanghai Hotels, Limited Full time

    Join Our Team as a Laundry Operations SupervisorWe are looking for a dedicated Laundry Operations Supervisor to collaborate with the Laundry Manager at The Hongkong and Shanghai Hotels, Limited. This role requires a keen eye for detail and a genuine passion for providing exceptional service.Why Work With Us?Be part of a prestigious luxury hotel...


  • Beverly Hills, California, United States Cedars-Sinai Full time

    Job Description Description for Internal Candidates Align yourself with an organization that has a reputation for excellence Cedars-Sinai was awarded the National Research Corporation's Consumer Choice Award 19 years in a row for providing the highest-quality medical care in Los Angeles. We were also awarded the Advisory Board Company's Workplace of the...

  • Operations Supervisor

    2 weeks ago


    Woodland Hills, California, United States Blue Shield of California Full time

    Your RoleThe Care Management team is dedicated to supporting the mission of the department, which focuses on assisting members in achieving health and wellness in outpatient environments. The supervisor will report directly to the Manager of Care Management Operations. In this capacity, you will oversee the Population Health Management Adult and Family Care...


  • El Cajon, California, United States Live Nation Full time

    Job Overview:Position Summary: We are looking for a dedicated Parking Operations Supervisor to oversee and coordinate the activities of our parking team at events. This role is essential in ensuring a seamless parking experience for our guests.About Us:Live Nation Entertainment stands as the premier global entity in live entertainment, featuring renowned...


  • El Centro, California, United States Spirit Halloween Full time

    Position Overview:As a Retail Operations Supervisor at Spirit Halloween, you will play a crucial role in ensuring exceptional customer experiences. Your responsibilities will include:Guest Services: Establishing and maintaining high standards of customer service to enhance guest satisfaction.Support Leadership: Assisting the Store Manager with various...