Behavioral Health Utilization Management Clinician, Experienced
El Dorado Hills, 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 |
VP, Chief Medical Officer, Medicare
El Dorado Hills, California
Your Role The VP, CMO, Medicare is accountable for providing medical oversight, expertise and leadership to ensure the delivery of affordable, quality healthcare services across all Medicare product lines (Individual, Group, PPO). The role ...
1d
| Job Type | Full Time |
Dental Director, Clinical Advisor
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 Dental Director will report ...
1d
| Job Type | Full Time |
Manager, Utilization Management Nurse Management
El Dorado Hills, California
Your Role The Utilization Management team reviews inpatient stays for our members and correctly applies the guidelines for nationally recognized levels of care for our Shared Services department including concurrent review, transplant and N...
1d
| Job Type | Full Time |
Medical Director, Behavioral Health
Baltimore, Maryland
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)
Woodland 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 |
Behavioral Health Utilization Management Clinician, Experienced
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 |
Dental Director, Clinical Advisor
Rancho Cordova, 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 Dental Director will report ...
1d
| Job Type | Full Time |
Behavioral Health Utilization Management Clinician, Senior
Woodland Hills, 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)
San Diego, 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 |