Sr. Director, Clinical Quality
Los Angeles, 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...
1d
| Job Type | Full Time |
Behavioral Health Utilization Management Clinician, Senior
Lodi, 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...
1d
| Job Type | Full Time |
Behavioral Health Utilization Management Clinician, Senior
San Diego, 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...
1d
| Job Type | Full Time |
Medical Director, Behavioral Health
Denver, Colorado
Your Role The Medical Management team ensures that Blue Shield is on the cutting edge of medical, medication, and payment policy to accelerate the emergence of a value-based health care system in California. The Medical Director, Behavioral...
1d
| Job Type | Full Time |
Medical Director, Behavioral Health
Oakland, California
Your Role The Medical Management team ensures that Blue Shield is on the cutting edge of medical, medication, and payment policy to accelerate the emergence of a value-based health care system in California. The Medical Director, Behavioral...
1d
| Job Type | Full Time |
Clinical Services Coordinator, Intermediate (BH Specialty Team)
El Dorado Hills, 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...
1d
| Job Type | Full Time |
Medical Director, Behavioral Health
Atlanta, Georgia
Your Role The Medical Management team ensures that Blue Shield is on the cutting edge of medical, medication, and payment policy to accelerate the emergence of a value-based health care system in California. The Medical Director, Behavioral...
1d
| Job Type | Full Time |
Clinical Services Coordinator, Intermediate (BH Specialty TOC )
Lodi, 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...
1d
| Job Type | Full Time |
Behavioral Health Utilization Management Clinician, Senior
Oakland, 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...
1d
| Job Type | Full Time |
Utilization Management Nurse, Senior (Behavioral Health Post-Service Review)
Long Beach, 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...
1d
| Job Type | Full Time |