Blue Shield of California

Oversee and plan initiatives requiring development and delivery, supporting product managers with budgeting, scheduling, and managing dependencies and escalations. | Bachelor's degree or equivalent and at least 7 years relevant experience, able to work in a hybrid office environment. | Your Role The Nexus Platform team is looking for a Project Manager to provide oversight and planning for various size initiatives that require development and delivery from the Platform . The Project Manager, Consultant will report to the Senior Manager . In this role you will provide project management for the work that impacts the Nexus Platform. This may be enterprise strategic initiatives driven by the Platform team or it may be complex operational implementations with multiple cross functional dependencies. This role will be supporting the Product Managers on the delivery of the initiatives by supporting planning, budgeting, scheduling, and assisting with dependencies and escalations.   Our leadership model is about developing great leaders at all levels and creating opportunities for our people to grow – personally, professionally, and financially. We are looking for leaders that are energized by creative and critical thinking, building and sustaining high-performing teams, getting results the right way, and fostering continuous learning.   About Blue Shield of California As of January 2025, Blue Shield of California became a subsidiary of Ascendiun. Ascendiun is a nonprofit corporate entity that is the parent to a family of organizations including Blue Shield of California and its subsidiary, Blue Shield of California Promise Health Plan; Altais, a clinical services company; and Stellarus, a company designed to scale healthcare solutions. Together, these organizations are referred to as the Ascendiun Family of Companies.  At Blue Shield of California, our mission is to create a healthcare system worthy of our family and friends and sustainably affordable. We are transforming health care in a way that genuinely serves our nonprofit mission by lowering costs, improving quality, and enhancing the member and physician experience.  To achieve our mission, we foster an environment where all employees can thrive and contribute fully to address the needs of the various communities we serve. We are committed to creating and maintaining a supportive workplace that upholds our values and advances our goals. Blue Shield is a U.S. News Best Company to work for, a Deloitte U.S. Best Managed Company and a Top 100 Inspiring Workplace. We were recognized by Fair360 as a Top Regional Company, and one of the 50 most community-minded companies in the United States by Points of Light. Here at Blue Shield, we strive to make a positive change across our industry and communities – join us!   Our Values:  * Honest. We hold ourselves to the highest ethical and integrity standards. We build trust by doing what we say we're going to do and by acknowledging and correcting where we fall short.  * Human. We strive to listen and communicate effectively, showing empathy by understanding others' perspectives. * Courageous. We stand up for what we believe in and are committed to the hard work necessary to achieve our ambitious goals.  Our Workplace Model  We believe in fostering a workplace environment that balances purposeful in-person collaboration with flexibility - providing clear expectations while respecting the diverse needs of our workforce. Our workplace model is designed around intentional in-person interaction, collaboration, connection, creativity and flexibility: * For most teams, this means coming into the office two days per week. * Employees living more than 50 miles from an office location, out of state employees, and employees in certain member-facing roles should work with their manager to determine in-office time based on business need. * For employees with medical conditions that may impact their ability to work in-office, we are committed to engaging in an interactive process and providing reasonable accommodations to ensure their work environment is conducive to their success and well-being. The Company reserves the right to require more presence in the office based on business needs, and requirements are subject to change with periodic reviews.   Physical Requirements: Office Environment - roles involving part to full time schedule in Office Environment. Based in our physical offices and work from home office/deskwork - Activity level: Sedentary, frequency most of work day. Please click here for further physical requirement detail. [https://www.blueshieldca.com/physical-job-requirements]  Equal Employment Opportunity: External hires must pass a background check/drug screen. Qualified applicants with arrest records and/or conviction records will be considered for employment in a manner consistent with Federal, State and local laws, including but not limited to the San Francisco Fair Chance Ordinance. All qualified applicants will receive consideration for employment without regards to race, color, religion, sex, national origin, sexual orientation, gender identity, protected veteran status or disability status and any other classification protected by Federal, State and local laws.

Serve as liaison between Blue Shield and homelessness response systems to improve program effectiveness. | Bachelor's degree and 5+ years experience with homelessness or social service program management. | Your Role The Medi-Cal Operational Readiness team leads cross-functional implementation and operational readiness for Medi-Cal programs, including CalAIM initiatives that support members experiencing homelessness. The Program Manager, Senior - Coordinated Entry System will report to the Senior Manager, Program and Project Management. In this role, you will serve as Blue Shield’s primary connection to local homelessness response systems, community-based organizations, and Continuums of Care. You will help ensure Blue Shield’s investments in street medicine, Enhanced Care Management, Community Supports, Transitional Rent, and related homelessness programs are aligned toward housing stability for members while strengthening program effectiveness, accountability, and real-world outcomes. Our leadership model is about developing great leaders at all levels and creating opportunities for our people to grow – personally, professionally, and financially. We are looking for leaders that are energized by creative and critical thinking, building and sustaining high-performing teams, getting results the right way, and fostering continuous learning.   About Blue Shield of California As of January 2025, Blue Shield of California became a subsidiary of Ascendiun. Ascendiun is a nonprofit corporate entity that is the parent to a family of organizations including Blue Shield of California and its subsidiary, Blue Shield of California Promise Health Plan; Altais, a clinical services company; and Stellarus, a company designed to scale healthcare solutions. Together, these organizations are referred to as the Ascendiun Family of Companies.  At Blue Shield of California, our mission is to create a healthcare system worthy of our family and friends and sustainably affordable. We are transforming health care in a way that genuinely serves our nonprofit mission by lowering costs, improving quality, and enhancing the member and physician experience.  To achieve our mission, we foster an environment where all employees can thrive and contribute fully to address the needs of the various communities we serve. We are committed to creating and maintaining a supportive workplace that upholds our values and advances our goals. Blue Shield is a U.S. News Best Company to work for, a Deloitte U.S. Best Managed Company and a Top 100 Inspiring Workplace. We were recognized by Fair360 as a Top Regional Company, and one of the 50 most community-minded companies in the United States by Points of Light. Here at Blue Shield, we strive to make a positive change across our industry and communities – join us!   Our Values:  * Honest. We hold ourselves to the highest ethical and integrity standards. We build trust by doing what we say we're going to do and by acknowledging and correcting where we fall short.  * Human. We strive to listen and communicate effectively, showing empathy by understanding others' perspectives. * Courageous. We stand up for what we believe in and are committed to the hard work necessary to achieve our ambitious goals.  Our Workplace Model  We believe in fostering a workplace environment that balances purposeful in-person collaboration with flexibility - providing clear expectations while respecting the diverse needs of our workforce. Our workplace model is designed around intentional in-person interaction, collaboration, connection, creativity and flexibility: * For most teams, this means coming into the office two days per week. * Employees living more than 50 miles from an office location, out of state employees, and employees in certain member-facing roles should work with their manager to determine in-office time based on business need. * For employees with medical conditions that may impact their ability to work in-office, we are committed to engaging in an interactive process and providing reasonable accommodations to ensure their work environment is conducive to their success and well-being. The Company reserves the right to require more presence in the office based on business needs, and requirements are subject to change with periodic reviews.   Physical Requirements: Office Environment - roles involving part to full time schedule in Office Environment. Based in our physical offices and work from home office/deskwork - Activity level: Sedentary, frequency most of work day. Please click here for further physical requirement detail. [https://www.blueshieldca.com/physical-job-requirements]  Equal Employment Opportunity: External hires must pass a background check/drug screen. Qualified applicants with arrest records and/or conviction records will be considered for employment in a manner consistent with Federal, State and local laws, including but not limited to the San Francisco Fair Chance Ordinance. All qualified applicants will receive consideration for employment without regards to race, color, religion, sex, national origin, sexual orientation, gender identity, protected veteran status or disability status and any other classification protected by Federal, State and local laws.

Conduct telephonic outreach to members, assess needs, maintain records, coordinate care services, and provide administrative support in a managed care environment. | High school diploma with 3+ years relevant experience, preferably in managed care or health insurance, strong communication skills, and ability to work flexible hours including occasional Saturdays. | Your Role The Care Management Department is seeking a dedicated and compassionate Clinical Service Coordinator (CSC) to join our team. The Clinical Service Coordinator will report to the Supervisor of Care Operations . The CSC will play a vital role in outreach and engagement efforts with our members, introducing them to care management services, and conducting assessments to identify their needs. The successful candidate will interact telephonically with members to assist with simple care coordination needs and facilitate connections between members and appropriate services, including internal nurse care managers, vendors, and behavioral health providers. Your Work In this role, you will: • Conduct telephonic outreach efforts to engage members and introduce them to care management services. • Complete thorough assessments to identify member needs and care gaps • Maintain accurate and up-to-date member records and documentation of all interactions and services provided • Conduct follow-up calls to ensure members’ needs are being met • Provide members with information and resources about available care management services and how to access them • Provides administrative/clerical support to medical and disease management programs. • Acts as a liaison, gathers information, and track all patients referred to the care management programs. • Assists in coordinating care for specific high risk/high-cost patient population, including referrals to community resources, facilitation of medical services, referral to ancillary providers, etc. • Assists in verifying health plan benefits and coordinating ambulatory services. • Demonstrates cultural competence to work effectively, respectfully, and sensitively within the client’s cultural context. • Assists with precepting responsibilities for new hires and auditing efforts. Your Knowledge and Experience • A minimum of a high school diploma or equivalent required • A minimum of 3 years of relevant experience is required • A minimum of 1 year experience in a managed care environment preferred • Health insurance/ managed care experience (Commercial, Medicare, and Medi-Cal) preferred • Community resources and advocacy experience preferred • Ability to identify issues and develop effective solutions to meet members' needs • Flexibility to adjust to changing circumstances and member needs • Strong verbal and written communication skills to effectively convey information to members and colleagues • Ability to work an 8 hour shift between the hours of 8 am to 7 pm PST. Ability to work Saturdays once per quarter. ABOUT THE TEAM About Blue Shield of California As of January 2025, Blue Shield of California became a subsidiary of Ascendiun. Ascendiun is a nonprofit corporate entity that is the parent to a family of organizations including Blue Shield of California and its subsidiary, Blue Shield of California Promise Health Plan; Altais, a clinical services company; and Stellarus, a company designed to scale healthcare solutions. Together, these organizations are referred to as the Ascendiun Family of Companies. At Blue Shield of California, our mission is to create a healthcare system worthy of our family and friends and sustainably affordable. We are transforming health care in a way that genuinely serves our nonprofit mission by lowering costs, improving quality, and enhancing the member and physician experience. To achieve our mission, we foster an environment where all employees can thrive and contribute fully to address the needs of the various communities we serve. We are committed to creating and maintaining a supportive workplace that upholds our values and advances our goals. Blue Shield is a U.S. News Best Company to work for, a Deloitte U.S. Best Managed Company and a Top 100 Inspiring Workplace. We were recognized by Fair360 as a Top Regional Company, and one of the 50 most community-minded companies in the United States by Points of Light. Here at Blue Shield, we strive to make a positive change across our industry and communities – join us! Our Values: • Honest. We hold ourselves to the highest ethical and integrity standards. We build trust by doing what we say we're going to do and by acknowledging and correcting where we fall short. • Human. We strive to listen and communicate effectively, showing empathy by understanding others' perspectives. • Courageous. We stand up for what we believe in and are committed to the hard work necessary to achieve our ambitious goals. Our Workplace Model: At Blue Shield of California and the Ascendiun Family of Companies, we believe in fostering a workplace environment that balances purposeful in-person collaboration with flexibility. As we continue to evolve our workplace model, our focus remains on creating spaces where our people can connect with purpose – whether working in the office or through a hybrid approach – by providing clear expectations while respecting the diverse needs of our workforce. Two Ways of Working: • Hybrid (Default): Work from a business unit-approved office at least two (2) times per month (for roles below Director-level) or once per week (for Director-level roles and above). Exceptions: o Member-facing and approved out-of-state roles remain remote. o Employees living more than 50 miles from their assigned offices are expected to work with their managers on a plan for periodic office visits. o For employees with medical conditions that may impact their ability to work in-office, we are committed to engaging in an interactive process and providing reasonable accommodations to ensure their work environment is conducive to their success and well-being. • On-Site: Work from a business unit-approved office an average of four (4) or more days a week. Physical Requirements: Office Environment - roles involving part to full time schedule in Office Environment. Based in our physical offices and work from home office/deskwork - Activity level: Sedentary, frequency most of work day. Equal Employment Opportunity: External hires must pass a background check/drug screen. Qualified applicants with arrest records and/or conviction records will be considered for employment in a manner consistent with Federal, State and local laws, including but not limited to the San Francisco Fair Chance Ordinance. All qualified applicants will receive consideration for employment without regards to race, color, religion, sex, national origin, sexual orientation, gender identity, protected veteran status or disability status and any other classification protected by Federal, State and local laws.