Your Role This role resides within the IT Applications' Transformation, Operations & Customer Experience team. The candidate will report to the IT Director, Solution & Delivery Lead in the Portfolio. In this role you will be responsible for leading, facilitating, and driving continuous improvement of Agile practices for the team or teams that you'll be supporting. The Por

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

Your Role The Data and Analytics (D&A) organization focuses enterprise wide to partner with business stakeholders to apply the power of data & analytics to deliver new insights and data driven solutions to accelerate business outcomes. The Data Services & Solutions team is part of the centralized D&A organization and leads the design and implementation of data solutions a

Your Role The Population Health Management team responsible for implementing whole person integrated healthcare by engaging members, reducing disparities and gaps in care, improving quality for our members. The Product Owner (PO) will report to the Sr. Director, Population Health Management, and represents the "voice of the customer" or proxy for the business into the Agi

Your Role The Social Services Representative, Advanced will report to the Supervisor, Social Services. In this role you will provide telephonic social services support and resource referrals for high acuity Blue Shield Promise members, in addition to administrative support to the Social Services Management Team. The Social Services Representative regularly reaches out to

Your Role The Appeals and Grievances team receives, documents, investigates, refers, and coordinates grievances, appeals and complaints . The Appeals and Grievances Coordinator will report to the Appeals and Grievances Supervisor. In this role you will be responsible for taking incoming telephone calls, reviewing, researching, and responding to incoming appeals and grieva

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 Delegation Oversight Utilization Management team is responsible for the organization, tracking and data entry of IPA Utilization Management audits, issues, complaints and monitoring. Identifies root cause of the problem and maintains monthly reporting that track and compare patters of delegated entities. The Delegation Operations Nurse Auditor LVN Experience

Your Role The Care Management team will serve to support the mission of the department, which is to provide support to patients in maintaining health and wellness in the outpatient setting . The Senior Care Manager will report to the Manager of Care Management. In this role you will ensure that services are provided based on standardized procedures including coordination

Office Service Representative I Job Locations US CA EL DORADO HILLS Requisition ID 2024 17828 # of Openings 1 Category (Portal Searching) Customer Service/Support Position Type (Portal Searching) Regular Full Time Overview Under general supervision, is responsible for all mail, packages and interoffice correspondence handling and dispatching for all classes of mail/packag

Your Role The Information Security team is responsible for providing cyber security services to Blue Shield of California that enable secure product development and operations. The Director of Information Security will report to the Sr. Director . In this role you will you will lead a team responsible for designing, implementing, and maintaining security capabilities that

Your Role The Information Security team is responsible for providing cyber security services to Blue Shield of California that enable secure product development and operations. The Director of Information Security will report to the Sr. Director . In this role you will you will lead a team responsible for designing, implementing, and maintaining security capabilities that

Your Role The Centers of Excellence (COE) Systems Analyst team defines and deliver solutions that meet business objectives and will serve as a facilitator between the business and IT in understanding the business needs; leads eliciting, analyzing, validating, and managing requirements, processes, and high level solution designs; is a proactive member of an Agile product t

Your Role The Innovation Analyst, Consultant is responsible for supporting the improvement and maintenance of our integrated enterprise strategy to execution process and supporting initiatives designed to provide strategic thought leadership to business leaders across the enterprise to address ambiguous problems and opportunities. This role will serve as a change agent, l

Your Role The Workforce Management team partners with operations to ensure the contact centers are staffed appropriately to meet KPI's while looking for opportunities to gain efficiency. The Workforce Optimization Analyst will report to the Sr. Manager of WFM. In this role you will analyze contact center trends, including call volumes, offline inventory, and call patterns