Behavioral Health Utilization Management Clinician, Experienced
Rancho Cordova, California
Your Role The Behavioral Health Utilization Management team performs prospective & concurrent utilization reviews and first level determinations for members using BSC evidenced based guidelines, policies, and nationally recognized clinal cr...
17h
| Job Type | Full Time |
Clinical Services Coordinator, Intermediate (BH Specialty TOC )
Rancho Cordova, California
Your Role The Behavioral Health Services (BHS) Specialty team provides support to the clinical Behavioral Health Utilization Management team and processes exception requests. The Behavioral Health (BH) Clinical Services Coordinator (CSC), I...
17h
| Job Type | Full Time |
Sr. Director, Clinical Quality
El Dorado Hills, California
Your Role Reporting to the VP, Quality, the role of the Sr Director is critical to the success of Blue Shield of California and the Clinical Quality department in realizing its goals and objectives. This individual will play a key role as p...
17h
| Job Type | Full Time |
Medical Director, Line of Business
Oakland, California
Your Role The Medical Director, National Accounts position is dedicated to supporting the promotion of growth and increased market share of the National Accounts and the Administrative Services Only (ASO) business. This includes strategic c...
17h
| Job Type | Full Time |
Clinical Services Coordinator, Intermediate (BH Specialty Team)
Long Beach, California
Your Role The Behavioral Health Services (BHS) Specialty team manages continuity of care (CoC) requests, exception requests, and provides support for the clinical Behavioral Health Utilization Management team. The Behavioral Health (BH) Cli...
17h
| Job Type | Full Time |
Clinical Services Coordinator, Intermediate (BH Specialty TOC )
San Francisco, California
Your Role The Behavioral Health Services (BHS) Specialty team provides support to the clinical Behavioral Health Utilization Management team and processes exception requests. The Behavioral Health (BH) Clinical Services Coordinator (CSC), I...
17h
| Job Type | Full Time |
Utilization Management Nurse, Senior (Behavioral Health Post-Service Review)
Woodland Hills, California
Your Role The Commercial Post Service Review team is responsible for clinically reviewing claims that are the result of a claim denial. The Commercial Post Service Review RN will report to the Manager, Post Service. In this role you will pe...
17h
| Job Type | Full Time |
Sr. Director, Clinical Quality
Long Beach, California
Your Role Reporting to the VP, Quality, the role of the Sr Director is critical to the success of Blue Shield of California and the Clinical Quality department in realizing its goals and objectives. This individual will play a key role as p...
17h
| Job Type | Full Time |
Behavioral Health Utilization Management Clinician, Senior
Rancho Cordova, California
Your Role The Behavioral Health Utilization Management team performs prospective & concurrent utilization reviews and first level determinations for members using BSC evidenced based guidelines, policies, and nationally recognized clinal cr...
17h
| Job Type | Full Time |
Sr. Director, Clinical Quality
Sacramento, California
Your Role Reporting to the VP, Quality, the role of the Sr Director is critical to the success of Blue Shield of California and the Clinical Quality department in realizing its goals and objectives. This individual will play a key role as p...
17h
| Job Type | Full Time |