Blue Shield of California Jobs

Your Work In this role, you will: Be responsible for the design, deployment, and ongoing maintenance of Information Security Risk Management platforms and controls including perimeter, cloud, data, network, automation/orchestration, and endpoint security. Identify areas for automation and implement security tool integration. Design and develop automation capabilities to reduce or eliminate manual tasks related to both application infrastructure delivery and the operations of the resulting sol...

Your Role The Pharmacy team provides pharmacy benefit management services and strategies to support Blue Shield of California’s affordability and membership goals. The Sr. Manager, Program and Project Management will provide pharmacy accounts and sales support and will report to the Director, Pharmacy Services. In this role, you will support pharmacy membership growth and retention strategies and initiatives. Additionally, this role is responsible for the leadership of the pharmacy accounts a...

Your Role The Behavioral Health Utilization Management team performs prospective utilization review for our members and correctly applies the guidelines for nationally recognized levels of care. They collaborate directly with the Member, Member's Family, and Interdisciplinary Care Team to achieve consensus and promote positive Member health outcomes through the assessment, planning, implementation, and evaluation of the Member’s Care Plan. The Promise Health Plan Manager, Program Management C...

Your Role The Data Analytics (D A) team 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. Reporting to the Senior Director of Care Delivery Analytics, the Senior Manager of Value Based Payments Cost Transparency Analytics is responsible for working with the key stakeholders from Finance, Actuary, Health Solutions, Product Management and others to be the Data Anal...

The Information Security Threat Detection and Response team uses advanced technologies like AI-driven threat detection and automated response platforms to monitor and respond to cybersecurity threats in real time. It acts as the hub for defense strategies, security tool integration, and rapid, data-driven decisions to protect the organization’s digital ecosystem. The Senior Manager, Threat Detection and Response will report to the Senior Director, Information Security Operations. In this role...

Your Role The Director, Provider Contracting for Medicare will report to the VP Provider Contracting. In this role, you will be responsible for leading and defining an optimal network strategy by region in collaboration with Medicare Advantage (MA) leadership and leading network design and contracting efforts for MA HMO and PPO plans. Additionally, this role will be responsible in leading and participating in strategic initiatives including, but not limited to, network expansion. We are looki...

Your Role The Strategic Planning and Performance team supports the Middle Market and Small Group Sales organization that manages all group business up to 2,999 members. The Program Manager, Senior will report to the Senior Manager of the Strategic Planning and Performance team. In this role you will work closely with cross-functional teams to support performance management activities, advocate for Middle Market and Small Group across the organization and enable strategic decision-making in pa...

Your Role The Enterprise Architecture Innovation team helps manage and align Blue Shield of California's technology infrastructure with its business goals, ensuring that independently conceived and deployed solutions do not lead to unnecessarily complicated and expensive siloed systems. It defines the enterprise business technology capabilities and their relationships to run, grow, and transform the business. The Enterprise Architect, Principal will report to the Sr. Director Enterprise Archi...