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Special Investigations Investigator, Consultant
Blue Shield of CA
-
Oakland, CA / Long Beach, CA / El Dorado Hills, CA / 3 more...
Your Role The Special Investigations Unit team is responsible for preventing, detecting, investigating, and resolving health care fraud, waste, and abuse . The Special Investigations Investigator, Consultant will report to the SIU Manager. In this role you will represent a high level of professionalism both internally and externally. Conduct investigations in accordance w
Email Job
Posted 10 days ago
Actuarial Analyst, Experienced
Blue Shield of CA
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Oakland, CA / Long Beach, CA / El Dorado Hills, CA / 3 more...
Your Work In this role, you will Be responsible for analytic work required to convert pricing and financial goals at the line of business and region level into specific action plans at the provider level that the Network team can execute Build and update models that allow the actuarial team to quantify financial gaps and opportunities at a provider level Conduct and devel
Email Job
Posted 10 days ago
Actuarial Analyst, Principal
Blue Shield of CA
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Oakland, CA / Long Beach, CA / El Dorado Hills, CA / 3 more...
Your Work In this role, you will Be responsible for converting pricing and financial goals at the line of business and region level into specific action plans at the provider level that the Network team can execute Create value for the Growth team General Managers by ensuring they have a voice when it comes to key network decisions and network strategy Create value for th
Email Job
Posted 10 days ago
Case Management - Nurse, Senior
Blue Shield of CA
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Rancho Cordova, CA / Oakland, CA / Long Beach, CA / 3 more...
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
Email Job
Posted 10 days ago
Financial Analyst, Senior
Blue Shield of CA
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Oakland, CA / El Dorado Hills, CA
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
Email Job
Posted 11 days ago
Risk Adjustment Consulting, Consultant
Blue Shield of CA
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Oakland, CA / Long Beach, CA / El Dorado Hills, CA / 3 more...
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
Email Job
Posted 11 days ago
Salesforce Application Developer, Senior
Blue Shield of CA
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Oakland, CA / Long Beach, CA / El Dorado Hills, CA
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
Email Job
Posted 12 days ago
Financial Analyst, Consultant
Blue Shield of CA
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El Dorado Hills, CA / Oakland, CA / Long Beach, CA / 3 more...
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
Email Job
Posted 12 days ago
Cloud Engineer, Sr. Principal
Blue Shield of CA
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Oakland, CA / Long Beach, CA / El Dorado Hills, CA
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
Email Job
Posted 12 days ago
Senior DevSecOps Engineer
Blue Shield of CA
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Oakland, CA / Long Beach, CA / El Dorado Hills, CA
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
Email Job
Posted 12 days ago
HR Specialist, Advanced
Blue Shield of CA
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Oakland, CA / Long Beach, CA / El Dorado Hills, CA / 5 more...
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
Email Job
Posted 13 days ago
Information Security Risk and Governance Specialist, Principal
Hispanic Technology Executive Council
-
El Dorado Hills, CA
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
Email Job
Posted 5 days ago
Product Manager, Principal
Blue Shield of CA
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Rancho Cordova, CA / Oakland, CA / Long Beach, CA / 3 more...
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
Email Job
Posted 13 days ago
DevSecOps Engineer, Principal
Blue Shield of CA
-
Oakland, CA / Long Beach, CA / El Dorado Hills, CA / 1 more...
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
Email Job
Posted 16 days ago
Senior Application Developer & System Administrator
Blue Shield of CA
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Oakland, CA / Long Beach, CA / El Dorado Hills, CA / 1 more...
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
Email Job
Posted 16 days ago
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