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Results based on filters ( 4 jobs found )

Sr. Manager, Provider Contracting

Blue Shield Of California
Rancho Cordova, CA
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External Description Str : Your Role The Provider Partnerships & Network ...
Details
Summary
About the job:
Management team is responsible for managing California’s largest PPO Physician Network to support our members in achieving access to high quality care at an affordable price. The Sr. Manager, Provider Contracting will report to the Director, PPO Professional, Specialty & Ancillary Networks. In this role you will lead a high performing team to maintain network adequacy by contract negotiation, recruitment and building/maintaining professional relationships. Our leadership model is about developing great leaders at all...
Location:
Rancho Cordova, CA
Job Type:
Full-Time
Permanent
Occupation:
Medical and Health Services Managers
Career Level / Education:
Bachelor's degree
Salary:
Six Figure Jobs (more than $100K)
Certifications / Licenses:
N/A
Workkeys
Applied Math
5
Graphic Literacy
4
Workplace Documents
4
apply
Detailed Job Information

Utilization Management Nurse, Consultant

Blue Shield Of California
Rancho Cordova, CA
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External Description Str : Your Role The Utilization Management team ...
Details
Summary
About the job:
facilitates the review of requests for medical necessity to assure that care is provided to our members timely, at the correct level of care with quality and cost effectiveness standards. The Utilization Management Nurse Consultant will report to the Utilization Management Manager. In this role you will be an individual with advanced level knowledge. Considered the subject matter expert (SME) and could engage in project or program management activities. Your Work In this role, you will: - Perform prospective, concurrent and...
Location:
Rancho Cordova, CA
Job Type:
Full-Time
Permanent
Occupation:
Medical and Health Services Managers
Career Level / Education:
Bachelor's degree
Salary:
Six Figure Jobs (more than $100K)
Certifications / Licenses:
Certified Registered Nurse
Workkeys
Applied Math
4
Graphic Literacy
4
Workplace Documents
5
apply
Detailed Job Information

Program Manager Clinical, Principal

Blue Shield Of California
Rancho Cordova, CA
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External Description Str : Your Role The Care Management Department, which ...
Details
Summary
About the job:
oversees all outpatient care management for the Commercial and Medicare lines of business, is seeking a Clinical Program Manager, Principal to join our team. In this role, the candidate will provide comprehensive support and collaborate effectively with stakeholders across various departments. The ideal candidate must possess extensive care management experience and be a subject matter expert in compliance and regulatory requirements, particularly with a strong understanding of NCQA (National Committee for Quality...
Location:
Rancho Cordova, CA
Job Type:
Full-Time
Permanent
Occupation:
Medical and Health Services Managers
Career Level / Education:
Bachelor's degree
Salary:
Six Figure Jobs (more than $100K)
Certifications / Licenses:
Certified Registered Nurse
National Committee for Quality Assurance
Workkeys
Applied Math
4
Graphic Literacy
4
Workplace Documents
5
apply
Detailed Job Information

Medical Director, Operations

Blue Shield Of California
Rancho Cordova, CA
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External Description Str : Your Role The Medical Director, Commercial is a ...
Details
Summary
About the job:
key member of the Medical Management and Operations staff within Health Care Services. This is a front-line utilization management position that has core responsibilities in the areas of pre and post service utilization review, and collaboration with RN Case and disease managers. This director position will report to the Medical Director of Medical Operations. Your Work In this role, you will: - Be the medical decision-maker and support for the prior authorization registered nurse (RN) team, facilitating appropriate...
Location:
Rancho Cordova, CA
Job Type:
Full-Time
Permanent
Occupation:
Medical and Health Services Managers
Career Level / Education:
Bachelor's degree
Salary:
Six Figure Jobs (more than $100K)
Certifications / Licenses:
Certified Registered Nurse
Board Certified
Workkeys
Applied Math
4
Graphic Literacy
4
Workplace Documents
5
apply
Detailed Job Information
1

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Location: Rancho Cordova
(Radius: Exact location only)
Occupation: Medical and Health Services Managers
Company Name: Blue Shield Of California
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