The Behavioral Health Utilization Management team performs prospective utilization review for our members and correctly applies the guidelines...
The Behavioral Health Utilization Management team performs prospective & concurrent utilization reviews and first level determinations for...
The Behavioral Health Utilization Management team performs prospective, concurrent, retrospective utilization reviews and first level determination...
The Medical Management team ensures that Blue Shield is on the cutting edge of medical, medication, and payment policy to accelerate the emergence...
The Medical Care Solutions Post Service Clinical Review team is hiring one RN Manager who will be responsible for leading the clinical team that...
The Facility Compliance Review (FCR) team reviews post service prepayment facility claims for contract compliance, industry billing standards...
Reporting to the Sr. Director, Utilization Management, the role of the Director, Medicare & Medi-Cal Utilization Management is critical to the...
The Care management team is looking for a leader with Medi-Cal experience who can help design and lead our Medi-Cal line of business. The Senior...
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