Clinical Quality Analytics, Senior

About the RoleBlue Shield of California and Promise Health Plan are seeking a skilled Clinical Quality Analytics and Informatics professional to join our team. As a Clinical Quality Analyst - Senior, you will play a critical role in delivering high-quality clinical analytics and informatics to support our mission of providing excellent member-centered...

About the RoleAs a Senior Analytical Development Lead at AMPAC Fine Chemicals, you will play a critical role in overseeing analytical services projects and ensuring timely completion in alignment with cGMP quality systems.The ideal candidate will have 7-9 years of directly related technical experience in chemistry and a Bachelor's degree in science. You will...

Job DescriptionJob DescriptionThe role involves overseeing analytical services projects, ensuring timely completion in alignment with cGMP quality systems, and streamlining operations to meet business targets. Key duties include supporting business development through client interactions, proposal writing, and representing AMPAC Analytical at conferences....

Solidigm, a leading global company in the memory industry, is seeking an exceptional Senior HR Technology and People Analytics Leader to drive digital transformation and strategic workforce planning. With a focus on leveraging technology and data-driven insights to streamline People processes and enhance the employee experience, this role plays a pivotal...

Your Role The Quality Improvement and Provider & Plan Quality Incentives (PPQI) team strives to improve the health outcomes of our members. We strategize, plan and execute programs that support provider efforts to get patients into preventive care. We work with a broad spectrum of both internal and external stakeholders to develop programs that are directly...

Job Summary">This role is critical to the success of Blue Shield of California and the Utilization Management department in realizing its goals and objectives. As a Senior Manager, Clinical Operations and Strategy, you will play a key role as part of the Utilization Management team in delivering and collaborating on all aspects of utilization management and...

Job DescriptionJob DescriptionSKpharmteco is a custom manufacturer of active pharmaceutical ingredients (APIs, Drug Substances) and registered intermediates for customers in the pharmaceutical industry. Our integrated facilities specialize in process development, scale-up, and cGMP compliant production from kilograms to multi-ton quantities. We are looking...

Job SummaryIn this challenging and rewarding role as a Senior Utilization Management Nurse at Blue Shield of California, you will be responsible for reviewing inpatient stays to ensure medical necessity in compliance with state and federal regulations. Your expertise in clinical review, discharge planning, and presenting cases to the Medical Director will...

Your Role The Clinical Quality Review (CQR) team is responsible for reviewing potential quality of care issues (PQIs) reported by a member, a member representative, or an internal partner. The Clinical Quality Review (CQR) Nurse Trainer/Auditor will report to the Senior Manager, Clinical Quality Review. In this role you will be responsible for understanding...

Your Role The value-based platform operations team provides the operational support for all the Blue Shield of California pay for value payment models. The Provider Relations Representative, Senior, will report to the Senior Manager of the value-based platform team. In this role, you will work with the providers to roll out and support the pay for value...

Job OverviewThe Clinical Care Specialist, Senior at Blue Shield of California plays a vital role in reviewing inpatient stays for our members, ensuring that care meets nationally recognized levels of necessity. This position reports to the Utilization Management Nurse Manager and involves clinical information review, discharge planning, and transfers as...

Job DescriptionJob DescriptionThe Team Lead, Analytical performs analytical chemistry assignments requiring a wide application of advanced principles, theories, and concepts. With little to no guidance, this position coordinates the short term and long-term activities across a variety of challenging analytical projects to support both business and production...

We are seeking a highly skilled Senior Quality Assurance Specialist to join our team at Link Consulting Services. In this role, you will be responsible for ensuring the quality of our products and services.About the Role:The ideal candidate will have 3-5 years of experience in a related field, such as quality assurance or control. You will work under limited...

Job OverviewThe Utilization Management Nurse, Senior role at Blue Shield of California is a critical position that requires a seasoned professional with expertise in clinical review and prior authorization. This individual will be responsible for conducting thorough assessments of inpatient admissions and length of stay to ensure compliance with regulations...

Utilization Management Nurse, Senior (Prior Authorization - CalPERS) at Blue Shield of California summary: The Senior Utilization Management Nurse conducts clinical reviews to assess the medical necessity of inpatient admissions and length of stay, ensuring compliance with regulations. This role involves collaborating with healthcare teams, preparing...

Your Role The Utilization Management team reviews the inpatient stays for our members under the guidelines for nationally recognized levels of care. The Utilization Management Nurse, Senior will report to the Utilization Management Nurse Manager. In this role you will be assigned a list of inpatient facilities and review clinical information provided by the...

Your RoleAs a Senior Manager of Utilization and Care Coordination at Blue Shield of California, you will play a critical role in realizing the company's goals and objectives. This position is key to the success of the Utilization Management department and requires an individual who can provide direction and leadership in compliance with regulatory...

Overview:Blue Shield of California seeks a highly skilled Healthcare Data Analyst Lead to join the Clinical Quality Analytics and Informatics team.The ideal candidate will possess expertise in data analysis, reporting, and business intelligence to drive quality strategy, performance improvement, and regulatory compliance.About the Role:This senior-level...

About Blue Shield of CaliforniaBlue Shield of California is a leading health plan in the state, dedicated to providing high-quality healthcare services to its members.Job SummaryThe Senior Clinical Care Manager will play a crucial role in our Federal Employee Program (FEP) team, responsible for integrated case management and disease management activities....

Your Role The Utilization Management Prior Authorization team processes accurate and timely prior authorization of designated healthcare services, continuity or care, and access to care clinical review determinations. The Utilization Management Nurse, Senior will report to the Manager, Utilization and Medical Review. In this role you will be performing first...