Blue Shield of California Jobs

Your Role The Cost of Healthcare team partners and supports internal business units to drive initiatives that result in cost savings with the goal is to keep the health plan accessible and affordable to all members. The Program Manager, Principal will report to the Senior Manager, Program and Project Management. In this role you will manage a portfolio of initiatives from ideation through implementation that drive cost of healthcare savings. Your Work In this role, you will: Operate at a stra...

Your Role The Federal Employee Program (FEP) Care Management team performs integrated case management (CM) and disease management (DM) activities demonstrating clinical judgment and independent analysis by collaborating with members and those involved with their care including a multidisciplinary team and the member’s treating physicians. The Clinical Program Manager Consultant will report to the FEP Care Management Department Manager. In this role you will be responsible for supporting the o...

Your Role The Group Medicare team oversees all aspects pertaining to the strategy, enrollment growth, day-to-day management, retention, compliance, and financial performance of Blue Shield of California’s Group Medicare membership. The Director, Group Medicare will report to the Senior Director, Medicare Growth. In this role you will be responsible for developing and executing on the strategic growth plan for our Group Medicare product, representing a critical and growing membership base. Acc...

Your Role The Rapid Quality Improvement team is responsible for the development and execution of targeted, quality improvement initiatives in support of the commercial medical groups, hospitals, and affiliated providers to close gaps in care for our members. The Program Manager, Consultant will report to the Senior Manager, Quality Improvement. In this role you will execute data improvement efforts, incentive strategies, and new improvement tactics to raise HEDIS, QRS, and CAHPS outcomes in p...

Your Role The Global Business Services (GBS) department is responsible for delivering strategic and category supplier sourcing, contracting and governance excellence at Blue Shield of California. The Senior Manager, Procurement Contracting role will report to the Director, Contracting. In this role you will be responsible for the management, prioritization and execution of the enterprise contracting initiatives and process including supporting the business in making effective sourcing decisio...

Your Role The Payment Innovation team leads the design, development, and implementation of value-based payment models. The Program Manager, Principal - Payment Innovation will report to the Senior Manager of Payment Innovation. In this role you will be responsible for leading the end-to-end design of new value-based payment models that support Blue Shield’s strategic goals. He/she/they will manage program(s) from initiation through delivery, perform operational responsibilities, and monitor f...

Your Role The Medi-Cal Policy and Procedure Management team implements and oversees the policy and procedure management and governance processes for the organization, ensuring sufficient and complete Medi-Cal policies and procedures that adhere to regulatory standards, contractual obligations, and business objectives. The Program Manager, Senior will report to the Director of Medi-Cal Policy and Procedure Management. In this role you will, conduct reviews of policies and procedures to ensure ...

Your Role The BSC/BSC Promise Health Plan (BSCPHP) Medical Management department is focused on ensuring our members get the right level of care, at the right time, and at the right cost. We do this by developing and deploying medical management capabilities that are aligned with industry best practices. This minimizes the impact of cost of healthcare and improved operational efficiency. Consistent with Blue Shield's values, the Medical Management department will deliver best-in-class health c...

Your Role The Global Business Services (GBS) department is responsible for delivering strategic and category supplier sourcing, contracting and governance excellence at Blue Shield of California. The Principal Sourcing Specialist (Supplier Procurement/Contracting) is responsible for the management and execution of the enterprise sourcing process including supporting the business in making effective sourcing decisions. This person executes and delivers value through strategic, operational, and...

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 Enterprise Cloud Engineer will report to the Vice President of Developer Employee Experience. In this role you will drive the creati...