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 LVN, Care Manager will report to the ...
Your Role The Risk Adjustment Analytics and Reporting team is looking for a Senior Actuarial Analyst. The Senior Actuarial Analyst will report to the Senior Manager of Risk Adjustment Analytics and Reporting. In this role you will help pr...
or equivalent experience Requires a current California RN License Requires at least 7 years of prior relevant experience Requires...
Your Role The Network and Trend Analytics team drives the development of an affordable provider network through data analytics and expertise. The Experienced Actuarial Analyst will report to the Actuarial Manager. In this role you will ma...
Your Role The Actuarial Pricing Shared Services team is responsible for collaborating with different Finance and Actuarial teams to support enterprise financial tracking and forecasting and drive the pricing target setting and planning to...
Your Role The MCS Clinical Service Intake team responsible for timely and accurate processing of Treatment Authorization Requests. The Clinical Services Coordinator (CSC), Intermediate will report to the Supervisor of Clinical Services In...
Your Role The Pharmacy Claims Quality team provides oversight to ensure Pharmacy claims process accurately. The Operations Specialist, Experienced will report to the Pharmacy Claims Quality Manager. In this role you will ensure claims pro...
and internal stakeholders to inform the optimization of member experiences specific to BlueShield members, all while driving...
patients, individuals with complex health needs, or underserved communities) Requires current, active California RN, NP, PA...
for managing the BlueShield Promise Health Plan Information Resource Center (IRC) and jointly operating CRCs throughout... Los Angeles County with L.A. Care. The IRC and CRCs connect members from both BlueShield Promise and L.A. Care health plans...