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153174 jobs as of 1/12/2020
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Utilization Management Nurse, Senior
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Utilization and Medical Review – - Ensures accurate and timely prior authorization of designated healthcare services, concurrent review activity, and retrospective review activity. - Utilization Management Nurse - Performs prospective, concurrent...
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From Blue Shield Of California
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Date
2020-01-10
Company
Blue Shield Of California
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Location
Rancho Cordova, CA
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About the job:
Utilization and Medical Review – - Ensures accurate and timely prior authorization of designated healthcare services, concurrent review activity, and retrospective review activity. - Utilization Management Nurse - Performs prospective, concurrent and retrospective utilization reviews and first level determination approvals for members using BSC evidenced based guidelines, policies and nationally recognized clinal criteria across lines of business or for a specific line of business such as Medicare and FEP. - Reviews for medical necessity, coding accuracy, medical policy compliance and...
Location:
Rancho Cordova, CA
Job Type:
Full-Time
Permanent
Occupation:
Medical and Health Services Managers
Salary:
High Income Jobs ($80K-$99K)
Career Level/Education:
Bachelor's degree
Certifications/Licenses:
ICD-10 / ICD-9
Preferred WorkKeys®
Applied Math
4
Graphic Literacy
4
Workplace Documents
5

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Manager, Clinic Services Management
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Position Summary: This position performs duties as a Manager of general Clinic Operations and works closely with the Sr. Manager, Clinical Operations and Medical Director of the Blue Shield of California Promise Health Plan Clinics in Antelope...
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From Blue Shield Of California
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Date
2020-01-04
Company
Blue Shield Of California
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Location
Palmdale, CA
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About the job:
Position Summary: This position performs duties as a Manager of general Clinic Operations and works closely with the Sr. Manager, Clinical Operations and Medical Director of the Blue Shield of California Promise Health Plan Clinics in Antelope Valley (Palmdale and Lancaster). Understands basic management approaches such as work scheduling, prioritizing, coaching and process execution, work organization, risk management and delegation. Understands Blue Shields of CA’s mission and business plan. Has functional expertise within the area of responsibility. Specific Responsibilities Include: -...
Location:
Palmdale, CA
Job Type:
Full-Time
Permanent
Occupation:
Medical and Health Services Managers
Salary:
High Income Jobs ($80K-$99K)
Career Level/Education:
Bachelor's degree
Certifications/Licenses:
Driver's License
National Committee for Quality Assurance
Preferred WorkKeys®
Applied Math
4
Graphic Literacy
4
Workplace Documents
5

Display

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Sr. Manager, Clinical Services
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Position Summary: The Senior Manager, Clinic Operations works closely with the Medical Director of the Blue Shield of California Promise Health Plan Clinics in Antelope Valley (Palmdale and Lancaster), leading effective operations and supporting...
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From Blue Shield Of California
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Date
2020-01-03
Company
Blue Shield Of California
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Location
Lancaster, CA
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About the job:
Position Summary: The Senior Manager, Clinic Operations works closely with the Medical Director of the Blue Shield of California Promise Health Plan Clinics in Antelope Valley (Palmdale and Lancaster), leading effective operations and supporting the transformation of healthcare for the patients they serve. The Senior Manager, under direction of the Senior Medical Director, will be accountable for operations, process improvement, and transformation with goal of helping the clinics provide comprehensive, longitudinal care addressing the social determinants of the patients served. Goals include...
Location:
Lancaster, CA
Job Type:
Full-Time
Permanent
Occupation:
Medical and Health Services Managers
Salary:
High Income Jobs ($80K-$99K)
Career Level/Education:
Bachelor's degree
Certifications/Licenses:
Driver's License
National Committee for Quality Assurance
Preferred WorkKeys®
Applied Math
4
Graphic Literacy
4
Workplace Documents
5

Display

Recommended

WorkKeys®

Sr. Manager, Clinical Services
Quick view
Position Summary: The Senior Manager, Clinic Operations works closely with the Medical Director of the Blue Shield of California Promise Health Plan Clinics in Antelope Valley (Palmdale and Lancaster), leading effective operations and supporting...
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From Blue Shield Of California
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Date
2020-01-03
Company
Blue Shield Of California
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Location
Palmdale, CA
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About the job:
Position Summary: The Senior Manager, Clinic Operations works closely with the Medical Director of the Blue Shield of California Promise Health Plan Clinics in Antelope Valley (Palmdale and Lancaster), leading effective operations and supporting the transformation of healthcare for the patients they serve. The Senior Manager, under direction of the Senior Medical Director, will be accountable for operations, process improvement, and transformation with goal of helping the clinics provide comprehensive, longitudinal care addressing the social determinants of the patients served. Goals include...
Location:
Palmdale, CA
Job Type:
Full-Time
Permanent
Occupation:
Medical and Health Services Managers
Salary:
High Income Jobs ($80K-$99K)
Career Level/Education:
Bachelor's degree
Certifications/Licenses:
Driver's License
National Committee for Quality Assurance
Preferred WorkKeys®
Applied Math
4
Graphic Literacy
4
Workplace Documents
5

Display

Recommended

WorkKeys®

Manager, Clinic Services Management
Quick view
Position Summary: This position performs duties as a Manager of general Clinic Operations and works closely with the Sr. Manager, Clinical Operations and Medical Director of the Blue Shield of California Promise Health Plan Clinics in Antelope...
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From Blue Shield Of California
Report this job
Date
2020-01-03
Company
Blue Shield Of California
View company profile

Location
Lancaster, CA
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About the job:
Position Summary: This position performs duties as a Manager of general Clinic Operations and works closely with the Sr. Manager, Clinical Operations and Medical Director of the Blue Shield of California Promise Health Plan Clinics in Antelope Valley (Palmdale and Lancaster). Understands basic management approaches such as work scheduling, prioritizing, coaching and process execution, work organization, risk management and delegation. Understands Blue Shields of CA’s mission and business plan. Has functional expertise within the area of responsibility. Specific Responsibilities Include: -...
Location:
Lancaster, CA
Job Type:
Full-Time
Permanent
Occupation:
Medical and Health Services Managers
Salary:
High Income Jobs ($80K-$99K)
Career Level/Education:
Bachelor's degree
Certifications/Licenses:
Driver's License
National Committee for Quality Assurance
Preferred WorkKeys®
Applied Math
4
Graphic Literacy
4
Workplace Documents
5

Display

Recommended

WorkKeys®

Maternal Care Community Health Program Manager, Healthcare Transformation
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Position Summary : Focusing on the member population covered by Blue Shield of California Promise Health Plan, the program manager, community health transformation in maternal health will support a number of strategic initiatives that seeks to...
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From Blue Shield Of California
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Date
2019-12-19
Company
Blue Shield Of California
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Location
Monterey Park, CA
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About the job:
Position Summary : Focusing on the member population covered by Blue Shield of California Promise Health Plan, the program manager, community health transformation in maternal health will support a number of strategic initiatives that seeks to evolve the definition of healthcare by centering members, involving their supports and community, empowering and supporting providers, and incorporating a variety of social services into healthcare. The program manager, reporting to the director of social services and programs, will assist in organizing, developing, and implementing a variety of...
Location:
Monterey Park, CA
Job Type:
Full-Time
Permanent
Occupation:
Medical and Health Services Managers
Salary:
High Income Jobs ($80K-$99K)
Career Level/Education:
Bachelor's degree
Certifications/Licenses:
N/A
Preferred WorkKeys®
Applied Math
4
Graphic Literacy
4
Workplace Documents
5

Display

Recommended

WorkKeys®

Maternal Care Community Health Program Manager, Healthcare Transformation
Quick view
Position Summary : Focusing on the member population covered by Blue Shield of California Promise Health Plan, the program manager, community health transformation in maternal health will support a number of strategic initiatives that seeks to...
Add to Your Backpack | See all jobs from this company
From Blue Shield Of California
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Date
2019-12-14
Company
Blue Shield Of California
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Location
San Diego, CA
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About the job:
Position Summary : Focusing on the member population covered by Blue Shield of California Promise Health Plan, the program manager, community health transformation in maternal health will support a number of strategic initiatives that seeks to evolve the definition of healthcare by centering members, involving their supports and community, empowering and supporting providers, and incorporating a variety of social services into healthcare. The program manager, reporting to the director of social services and programs, will assist in organizing, developing, and implementing a variety of...
Location:
San Diego, CA
Job Type:
Full-Time
Permanent
Occupation:
Medical and Health Services Managers
Salary:
High Income Jobs ($80K-$99K)
Career Level/Education:
Bachelor's degree
Certifications/Licenses:
N/A
Preferred WorkKeys®
Applied Math
4
Graphic Literacy
4
Workplace Documents
5

Display

Recommended

WorkKeys®

Medicare Community Health Program Manager, Healthcare Transformation
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Position Summary : Focusing on the member population cover by Blue Shield of California Promise Health Plan, the program manager, community health transformation will support a number of strategic initiatives that seeks to evolve the definition of...
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From Blue Shield Of California
Report this job
Date
2019-12-12
Company
Blue Shield Of California
View company profile

Location
Monterey Park, CA
View Map
About the job:
Position Summary : Focusing on the member population cover by Blue Shield of California Promise Health Plan, the program manager, community health transformation will support a number of strategic initiatives that seeks to evolve the definition of healthcare by centering members, involving their supports and community, empowering and supporting providers, and incorporating a variety of social services into healthcare. The program manager, reporting to the director of social services and programs, will assist in organizing, developing, and implementing a variety of initiatives and programs...
Location:
Monterey Park, CA
Job Type:
Full-Time
Permanent
Occupation:
Medical and Health Services Managers
Salary:
High Income Jobs ($80K-$99K)
Career Level/Education:
Bachelor's degree
Certifications/Licenses:
N/A
Preferred WorkKeys®
Applied Math
4
Graphic Literacy
4
Workplace Documents
5

Display

Recommended

WorkKeys®

Medicare Community Health Program Manager, Healthcare Transformation
Quick view
Position Summary : Focusing on the member population cover by Blue Shield of California Promise Health Plan, the program manager, community health transformation will support a number of strategic initiatives that seeks to evolve the definition of...
Add to Your Backpack | See all jobs from this company
From Blue Shield Of California
Report this job
Date
2019-12-12
Company
Blue Shield Of California
View company profile

Location
San Diego, CA
View Map
About the job:
Position Summary : Focusing on the member population cover by Blue Shield of California Promise Health Plan, the program manager, community health transformation will support a number of strategic initiatives that seeks to evolve the definition of healthcare by centering members, involving their supports and community, empowering and supporting providers, and incorporating a variety of social services into healthcare. The program manager, reporting to the director of social services and programs, will assist in organizing, developing, and implementing a variety of initiatives and programs...
Location:
San Diego, CA
Job Type:
Full-Time
Permanent
Occupation:
Medical and Health Services Managers
Salary:
High Income Jobs ($80K-$99K)
Career Level/Education:
Bachelor's degree
Certifications/Licenses:
N/A
Preferred WorkKeys®
Applied Math
4
Graphic Literacy
4
Workplace Documents
5

Display

Recommended

WorkKeys®

Sr. Manager, Provider Contracting
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- Negotiate and finalize IPA/Medical Group and Hospital provider contracts as directed by the Director of Contracting. - Work with internal departments and staff to negotiate Letter of Agreements with non­ contracted providers. Conduct analyses to...
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From Blue Shield Of California
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Date
2019-11-13
Company
Blue Shield Of California
View company profile

Location
Monterey Park, CA
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About the job:
- Negotiate and finalize IPA/Medical Group and Hospital provider contracts as directed by the Director of Contracting. - Work with internal departments and staff to negotiate Letter of Agreements with non­ contracted providers. Conduct analyses to identify network deficiencies and develop action plans to ensure deficiencies are met. - Assist in the writing, amending, and revision of contracts for IPA/Medical Group and Hospital providers. - Plans and establishes goals and objectives for assigned contracts or in partnership with the department lead. - Responsible for adjusting or recommended...
Location:
Monterey Park, CA
Job Type:
Full-Time
Permanent
Occupation:
Medical and Health Services Managers
Salary:
High Income Jobs ($80K-$99K)
Career Level/Education:
Bachelor's degree
Certifications/Licenses:
N/A
Preferred WorkKeys®
Applied Math
4
Graphic Literacy
4
Workplace Documents
5

Display

Recommended

WorkKeys®

Results

153174 jobs as of 1/12/2020
Sort by Relevance | Date
Jobs 1 To 10 of 10 Page 1 of 1 Page [1]

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