Your Role The Federal Employee Program (FEP) team performs integrated case management (CM) and disease management (DM) activities demonstrating clinical judgment and independent analysis, collaborating with members and those involved with members' care including clinical nurses and treating physicians . The Behavioral Health Registered Nurse Case Manager will report to th

Your Role The Enterprise Finance Consolidations and Business System team is responsible for the Company's consolidated financial statements, forecasting and reporting activities, business systems and administrative expense allocations. The team manages financial forecast and annual planning activities, provide monthly, quarterly, and annual consolidated financial reportin

Your Role The ACA Chart Program team conducts the following functions (1) identify medical records with unreported diagnosis codes, (2) retrieve those medical charts, (3) perform medical coding to convert them into risk adjustable diagnosis codes, and (4) submit to CMS via the EDGE pathway . The Risk Adjustment, Consultant will report to the Senior Manager . In this role

Your Role The Senior level Developer of the Client Personalization team is responsible for application service level achievement and customer satisfaction of Blue Shield of California's Salesforce Health Cloud capabilities. This developer creates, configures, and manages Salesforce applications and related components and will be accountable for delivering BSC's desired bu

Your Role The Corporate Services Finance team ensures financial stewardship of the Corporate Services administrative budget and serves as the trusted financial advisor to executive leadership. Our team is looking for a Financial Analyst, Consultant to steer financial performance toward Blue Shield goals. The position will support annual planning, monthly forecasting, mont

Your Role The Developer and Employee Experience team is responsible for creation of the standard and automation pipelines that enable our partnering IT teams to build, release, and manage their systems. We are setting the path for how we'll migrate to the Cloud and ensure that we are guiding the movement to a more modern DevOps operating model. The Sr. Principal Enterpris

Your Role As a DevSecOps Engineer in IT Quality Engineering Organization, you will play a crucial role in ensuring the security and quality of software products. As part of a Center of Excellence, your primary responsibility will be to establish best practices and standards for DevSecOps methodologies, ensuring a secure and seamless transition to the cloud environment. Yo

Your Role The Information Security team is responsible for governance over the exchange of protected health information (PHI) and sensitive data with external entities. The Information Security Data Exchange Expert, Principal will report to the Senior Manager, Information Security Data Exchange. In this role you will be responsible for the privacy and security frameworks

Your Role The People & Engagement HR Connect team is a critical part of Human Resources service delivery for all of Blue Shield of California (BSC) The team provides first level support to all BSC employees on a daily basis for both daily operations and employee facing initiatives. The HR Specialist, Advanced will report to the Manager, HR Connect. In this role you will b

Your Role The Medical Care Solutions team manages the clinical operations including utilization management, care management and clinical programs. The Product Manager will initially report to the Vice President of Medical Care Solutions. In this role you will be responsible for setting product vision and strategy via understanding of customer needs and organizational prio

Your Role The IT Development Center Of Excellence team at Blue Shield is tasked with establishing best practices and standards as we rapidly transform ourselves to be a digital first company. The DevSecOps Engineer, Principal will report to the Sr Manager, IT Development Centers Of Excellence. As a DevSecOps Engineer, you will play a critical role in assessing our current

Your Role The Third Party Application Solutions personnel within the Software Development Centers Of Excellence team perform hardware and software system administration as well as set quality expectations. The Senior Application Developer & System Administrator will report to the Centers Of Excellence Senior Manager. In this role you will execute hands on patching and upg

Your Role The Cloud Engineering team is a cross functional group responsible for the advancement and support of the Blue Shield multi cloud presence. The Cloud Engineer Principal will report to the Sr. Director Hybrid Cloud Engineering. In this role you will have a broad and deep impact on how Blue Shield achieves its business and technical goals by leveraging cloud techn

Your Role The Medical Director, Commercial is a key member of the Medical Management and Operations staff within Health Care Services. This is a front line utilization management position that has core responsibilities in the areas of pre and post service utilization review, and collaboration with RN Case and disease managers.This director position will report to the Medi

Your Role The Data & Analytics team is responsible for performing detailed data analysis, source to target designs, data profiling, and metadata management in support of new development/implementation or enhancement of existing data assets. The IT Data Analyst, Consultant will report to the Manager of Data Solutions and Asset Management. In this role, you will participate