Your Role Reporting to the Sr. Director, Utilization Management, the role of the Director, Medicare & Medi-Cal Utilization Management is critical to the success of Blue Shield of California and the Utilization Management department in realizing its goals and objectives.This individual will play a key role as part of the Utilization Management team in delivering and collaborating on all aspects of utilization management and care coordination for our Medicare and Medi-Cal membership. The Director, Medicare & Medi-Cal Utilization Management role will also provide direction and leadership in compliance to regulatory requirements and key operational metrics.Your Work In this role, you will: Manages and monitors prior authorization and concurrent review to ensure that the patient is getting the right care in a timely and cost-effective way.Leading development of UM strategy by leveraging the use of data/analytics to inform and technology solutions to streamline operational efficiencies while also building a cost-benefit methodology to rationalize decisions on UM reviews to be performed based upon staffing costs, productivity, and projected medical cost savings.Provides analysis and reports of significant utilization trends, patterns, and resource allocation.Partners with physicians and others to develop improved utilization of effective and appropriate services.Establishing and measuring productivity metrics to support workforce planning methodology and rationalization of services required to perform UM reviews.Reviewing and reporting out on Utilization Review (UR) trending for Medicare and Medi-Cal membership.Ensuring alignment of the authorization strategy with clinical policy, payment integrity, and network development strategies to optimize quality and cost of care.Responsible for managing strategic projects and supporting operations initiatives.Leading operational implementation of transformation changes (organizational management, process implementation, technology adoption).Responsible for operational teams' performance, resource management, continuous improvement, and training.Responsible for operational audit readiness, ensuring adequate processes and internal audit measures in place and maintained quarterly.Ensuring all operational processes are meeting regulatory and accreditation requirements.Fosters a culture of process excellence, BSC leadership principles, and a great place to work environment.Occasional business travel required.Your Knowledge and Experience Requires current CA RN LicenseBachelor’s of Science in Nursing or advanced degree preferredMaster’s degree or equivalent experience preferredMinimum of 10 years of Utilization Management or relevant experience, including 6 years of management experienceMinimum of 5 years of progressive leadership in Utilization Management operationsHealth plan or similar health care organization structure experience requiredSuccessful track record in driving organizational change managementExcellent relationship and consensus-building skills required

Futures start here. Where first steps, new friendships, and confident learners are born. At KinderCare Learning Companies, the first and only early childhood education provider recognized with theGallup Exceptional Workplace Award, we offer a variety of early education and child care options for families. Whether it’s KinderCare Learning Centers, Champions, or Crme de la Crme, we build confidence for kids, families, and the future we share. And we want you to join us in shaping itin neighborhoods, at work, and in schools nationwide.When you join Champions, you’ll be supporting hardworking families and elementary-aged kids during out-of-school time, on school grounds. Whether you’re partnering with administrators to bring our programs to their district, or buddying up with students to aim higher, think bigger, and never give up, you’ll be leading the way toward inspired learning.If you’re passionate about inspiring children and teachers alike to learn and grow, the Site Director role could be for you! Site Directors are passionate about educational excellence and empowering confident teachers. As a Site Director, you will use our nationally recognized curriculum as a framework to create unique and engaging classroom experiences. Site Directors are committed to making their site successful and know that important relationships with children, families, and their team are critical to success. Successful Site Directors are fully engaged, enthusiastic about their work, and eager to share their knowledge.When you join our team as a Site Director, you will:Lead and supervise a group of teachers to create unique and engaging classroom experiences, leverage and develop “best in class” educators to be passionate and committed professionalsEnsure your site is operating effectively; maintain licensing, safety, and educational standardsPartner with parents with a shared desire to provide the best care and education for their childrenCultivate positive relationships with families, teachers, school and district leaders, state licensing authorities, community contacts, and corporate partnersLead recruitment and enrollment efforts of new families and children in our sitesRequired Skills and Experience:At least one year of teaching experience with the ability to develop, engage, and inspire a teamA love for children and a strong desire to make a difference every dayAbility to build relationships with families and staff and create a dynamic environment where play and discovery go hand-in-handOutstanding customer service skills, strong organizational skills, multi-task and manage multiple situations effectivelyMeet state specific guidelines for the roleBe physically able to use a computer with basic proficiency, lift a minimum of 40 pounds, and work indoors or outdoors. Be able to assume postures in low levels to allow physical and visual contact with children, see and hear well enough to keep children safe, and engage in physical activityRead, write, understand, and speak English to communicate with children and their parents in EnglishRange of pay $16.35 - $33.15 HourlyOur benefits meet you where you are. We’re here to help our employees navigate the integration of work and life:- Know your whole family is supported with discounted child care benefits.- Breathe easy with medical, dental, and vision benefits for your family (and pets, too!).- Feel supported in your mental health and personal growth with employee assistance programs.- Feel great and thrive with access to health and wellness programs, paid time off and discounts for work necessities, such as cell phones.- and much more.We operate research-backed, accredited, and customizable programs in more than 2,000 sites and centers across 40 states and the District of Columbia. As we expand, we’re matching the needs of more and more families, dynamic work environments, and diverse communities from coast to coast. Because we believe every family deserves access to high-quality child care, no matter who they are or where they live. Every day, you’ll help bring this mission to life by building community and delivering exceptional experiences. And if you’re anything like us, you’ll come for the work, and stay for the people.KinderCare Learning Companies is an Equal Opportunity employer. All qualified applicants will receive consideration for employment without regard to race, national origin, age, sex, religion, disability, sexual orientation, marital status, military or veteran status, gender identity or expression, or any other basis protected by local, state, or federal law.Job Posting End Date : 2025-08-25

Overview: Physical Therapist Assistant (PTA)Your Schedule, Your Way!What sets EmpowerMe Wellness apart from other therapy providers It’s simple: we offer truly flexible scheduling. Need to be home for family or other obligations No problem! You can easily adjust your day to fit your needs all while making a huge difference in the lives of seniors!Incentive OpportunitiesFor some leadership positions at EmpowerMe Wellness, we offer financial incentive opportunities tied to performance. Be sure to ask your recruiter to learn more! Responsibilities: The OpportunityWe are hiring a Physical Therapist Assistant (PTA) to join our team and work with the residents of a senior living community that offers one or more of the following care settings: independent living, assisted living, and memory care. Therapy services for the residents at this community are covered by private insurance and/or Medicare Part B. As a PTA, you will be responsible for: Providing physical therapy and wellness services for older adults under the supervision of a PTMaintaining professional practices and ethical standards in accordance with company-wide policies and clinical initiativesContributing to program development, quality improvement, and problem-solvingAssist with optimizing each patient’s functional well-being and satisfactionYour ScheduleWhile our clinics typically operate 8 a.m. to 5 p.m. Monday through Friday, our flexible scheduling lets you craft a schedule that’s suited to your unique lifestyle!Our Amazing BenefitsAll Employees Get: Fun at Work, a Team You’ll Love, and a Culture You Can Stand Behind! 401(k) Eligibility with Opportunity for Matching FundsAmazing Career Advancement and Cross Training OpportunitiesRecognition ProgramsEmployee Assistance ProgramPart-Time Employees Also Get:Voluntary Benefits (Accident, Critical Illness, Hospital Indemnity, Identity Theft, Pet Protection)Full-Time Employees Also Get:Full Benefits, including HSA, FSA, and Life & Disability InsuranceVoluntary Benefits (Accident, Critical Illness, Hospital Indemnity, Identity Theft, Pet Protection)Flexible Paid Time OffYou’re Our Perfect Fit If...You’re energetic, dedicated, and hard-wired to help others – especially seniors. You want to make a difference in the world and help others lead fuller, healthier lives. You want more than just a jobyou seek a calling – a mission you can feel great about. And you want a support system to ensure your career ascends to the highest of heights.Plus, you have the following: Completion of an accredited Physical Therapy Assistant program (New Grads Welcome) Current PTA state licensure Excellent verbal and written communication skills A results-oriented mindset with a dash of critical thinking Tech-savvy skills – quick learners are our favorite kind! Professional curiosity and a knack for finding solutionsCome be a part of our mission to make a positive impact on the lives of seniors. Apply today! Qualifications: About EmpowerMe WellnessEmpowerMe Wellness is on a mission to improve the lives of seniors and the communities they call home! We provide fully integrated healthcare to senior living communities nationwide, offering on-site care coordination, therapy, and pharmacy services. Our experienced team of more than 3,500 clinicians and professionals provide personalized health and wellness solutions that lead to healthier, happier tomorrows!To learn more about us, visit empowerme.com today.This employer is an Equal Opportunity Employer. In compliance with the Americans with Disabilities Act, the employer will provide reasonable accommodations to qualified individuals with disabilities and encourages prospective employees and incumbents to discuss potential accommodations with the employer. Compensation: $33.00 - $46.00 per hour

Speech-Language Pathologist - OtherWe are seeking a versatile Speech-Language Pathologist to join our team. In this role, you will assess and treat individuals with diverse communication and swallowing disorders in various settings, helping them improve their quality of life.Key Responsibilities:Evaluate patients to identify speech, language, or swallowing difficulties.Develop and implement individualized treatment plans tailored to specific needs.Provide therapy focused on articulation, fluency, voice quality, and cognitive-communication skills.Educate patients and families on strategies to support communication and swallowing improvements.Collaborate with other healthcare professionals to ensure comprehensive care.Document patient progress and adjust therapy plans as needed for optimal outcomes.Work Environment:Work in varied environments such as private practices, hospitals, or community health programs.Engage in a dynamic setting requiring adaptability and innovative problem-solving skills.Benefits:Competitive salary and comprehensive benefits package.Opportunities for professional growth through training and certifications.A supportive work environment focused on collaboration and innovation in patient care.*This information is based on the Bureau of Labor Statistics (BLS). Actual job responsibilities may vary by location.*

Your Role The Behavioral Health (BH) Utilization Management (UM) team performs prospective, concurrent, retrospective utilization reviews and first level determinations for members using BSC evidenced based guidelines, policies, and nationally recognized clinical criteria across multiple lines of business. The Behavioral Health Utilization Management, Consultant (Lead), will report to the Manager of Behavioral Health Utilization Management (BH UM). In this role you will support the clinicians with daily operations, provide coaching, and serve as the subject matter expert for the BH UM team as they conduct clinical reviews of mental health and substance use authorization requests at various levels of care for medical necessity.Your WorkIn this role, you will:Facilitate communication between leadership, Medical Directors, and non-clinical leads to address line staff questions and issues; escalate matters to management with recommendations or consultation as neededLead onboarding/training of incoming staff, provide proactive and guided support through the onboarding processMaintain and gain knowledge of behavioral health utilization management through team and departmental expansion as neededAct as subject matter expert to review and evaluate the effectiveness of operational workflows to identify problems and develop improvements, modifications, and enhancementsDevelop and evaluate tools and materials that enhance operating efficiency, accuracy, and technical skill levels of unit staffAssist with audit readiness in collaboration with internal BSC partnersPerform advanced or complicated prior authorization and concurrent utilization reviews and first level determinations for members using non-profit association guidelines ensure discharge (DC) planning at levels of care appropriate for the members needs and acuity; prepare and present cases to Medical Director (MD) for oversight and necessity determinationIdentify process and control improvement opportunities and provide recommendations that help improve the effectiveness, efficiency and/or economic value of a control or processProvide guidance, coaching and training on internal behavioral health utilization management processes to other employees across the company as appropriateLead, manage, and execute other special projects and team initiatives as assignedLead team huddles/meetings to support processes and collaboration of team membersSupport team through consistent and successful caseload management and workload to achieve team goals, regulatory timelines, and accreditation standardsYour Knowledge and ExperienceCurrent unrestricted CA license (LCSW, LMFT, LPCC, PhD/PsyD or RN with Behavioral Health experience) requiredAdvanced degree commensurate with field is preferredRequires at least seven (7) years of prior experience in healthcare related fieldExperience operating in a lead role or equivalent leadership training is preferredFive (5) years conducting Behavioral Health Utilization Management for a health insurance plan or managed care environment preferredDeep knowledge of Behavioral Health Utilization Management including ability to apply and interpret admission and continued stay clinical against nonprofit association guidelinesFamiliarity with medical terminology, diagnostic terms, and treatment modalities including ability to comprehend psychiatric evaluations, clinical notes, and lab resultsProficient with Microsoft Excel, Outlook, Word, Power Point, and the ability to learn and utilize multiple systems/databasesExcellent analytical, communication skills, written skills, time management, and organizational skillsPossess outstanding interpersonal, organizational, and communication skills, positive attitude, and high level of initiativeAbility to identify problems and works towards problem resolution independently, seeking guidance as needed

Futures start here. Where first steps, new friendships, and confident learners are born. At KinderCare Learning Companies, the first and only early childhood education provider recognized with theGallup Exceptional Workplace Award, we offer a variety of early education and child care options for families. Whether it’s KinderCare Learning Centers, Champions, or Crme de la Crme, we build confidence for kids, families, and the future we share. And we want you to join us in shaping itin neighborhoods, at work, and in schools nationwide.When you join Champions, you’ll be supporting hardworking families and elementary-aged kids during out-of-school time, on school grounds. Whether you’re partnering with administrators to bring our programs to their district, or buddying up with students to aim higher, think bigger, and never give up, you’ll be leading the way toward inspired learning.When you join our team as a Teacher you will:Lead, coach and mentor less experienced teachers in your classroom; model behaviors and provide feedbackImplement KinderCare's curriculum in a way that is consistent with the unique needs of each childCreate a safe, nurturing environment where children can play and learnPartner and connect with parents, with a shared desire to provide the best care and education for their childrenSupport your center’s success; partner with center staff and leadership to achieve goals around enrollment, accreditation, and engagementCultivate positive relationships with families, teachers, state licensing authorities, community contacts and corporate partnersRequired Skills and Experience:Outstanding customer service skills, strong organizational skills, and the ability to multi-task and handle multiple situations effectivelyPossess active Child Development Associate (CDA) Credential or meet NAEYC candidacy requirementsApproved state trainer (preferred)2-3 years Early Childhood Education Experience (preferred)Bachelor’s degree in Early Childhood Education (preferred)Meet state specific qualifications for the role or willingness to obtainCPR and First Aid Certification or willingness to obtainPhysically able to lift a minimum of 40 pounds, and work indoors or outdoorsAble to assume postures in low levels to allow physical and visual contact with children, see and hear well enough to keep children safe, and engage in physical activity with childrenRead, write, understand, and speak English to communicate with children and their parents in EnglishRange of pay $12.50 - $32.00 HourlyOur benefits meet you where you are. We’re here to help our employees navigate the integration of work and life:- Know your whole family is supported with discounted child care benefits.- Breathe easy with medical, dental, and vision benefits for your family (and pets, too!).- Feel supported in your mental health and personal growth with employee assistance programs.- Feel great and thrive with access to health and wellness programs, paid time off and discounts for work necessities, such as cell phones.- and much more.We operate research-backed, accredited, and customizable programs in more than 2,000 sites and centers across 40 states and the District of Columbia. As we expand, we’re matching the needs of more and more families, dynamic work environments, and diverse communities from coast to coast. Because we believe every family deserves access to high-quality child care, no matter who they are or where they live. Every day, you’ll help bring this mission to life by building community and delivering exceptional experiences. And if you’re anything like us, you’ll come for the work, and stay for the people.KinderCare Learning Companies is an Equal Opportunity employer. All qualified applicants will receive consideration for employment without regard to race, national origin, age, sex, religion, disability, sexual orientation, marital status, military or veteran status, gender identity or expression, or any other basis protected by local, state, or federal law.Job Posting End Date : 2025-09-02

Overview: Licensed Physical Therapist Assistant (PTA) - Care Coordination ProgramPhysical Therapy + Care Coordination: The Best of Both Worlds!We’re looking for Physical Therapy Assistants to support our innovative new care coordination program! This opportunity empowers you to practice at the top of your license, while giving you the chance to branch out into care coordination duties designed to standardize your hours and grow your career. All this plus truly flexible scheduling, amazing benefits, and the ability to make a huge difference in the lives of seniors!Incentive OpportunitiesFor some leadership positions at EmpowerMe Wellness, we offer financial incentive opportunities tied to performance. Be sure to ask your recruiter to learn more! Responsibilities: The OpportunityWe are hiring a licensed Physical Therapist Assistant (PTA) to join our team and work with the residents of a senior living community that offers one or more of the following care settings: independent living, assisted living, and memory care. Therapy services for the residents at this community are covered by private insurance and/or Medicare Part B. As a PTA, you will be responsible for: Providing physical therapy and wellness services for older adults under the supervision of a PT as part of a multidisciplinary teamSupport care coordination efforts by conducting regular wellness checkpoint visits with patients, communicating with patients’ providers and caregivers, and assisting patients with attending telehealth visitsMaintaining professional practices and ethical standards in accordance with company-wide policies and clinical initiativesContributing to program development, quality improvement, and problem-solvingAssist with optimizing each patient’s functional well-being and satisfactionYour ScheduleWhile our clinics typically operate 8 a.m. to 5 p.m. Monday through Friday, our flexible scheduling lets you craft a schedule that’s suited to your unique lifestyle!Our Amazing BenefitsAll Employees Get: Fun at Work, a Team You’ll Love, and a Culture You Can Stand Behind! 401(k) Eligibility with Opportunity for Matching FundsAmazing Career Advancement and Cross Training OpportunitiesRecognition ProgramsEmployee Assistance ProgramPart-Time Employees Also Get:Voluntary Benefits (Accident, Critical Illness, Hospital Indemnity, Identity Theft, Pet Protection)Full-Time Employees Also Get:Full Benefits, including HSA, FSA, and Life & Disability InsuranceVoluntary Benefits (Accident, Critical Illness, Hospital Indemnity, Identity Theft, Pet Protection)Flexible Paid Time Off Qualifications: You’re Our Perfect Fit If...You’re energetic, dedicated, and hard-wired to help others – especially seniors. You want to make a difference in the world and help others lead fuller, healthier lives. You want more than just a jobyou seek a calling – a mission you can feel great about. And you want a support system to ensure your career ascends to the highest of heights.Plus, you have the following: Completion of an accredited Physical Therapy Assistant program (New Grads Welcome) Current PTA state licensure Excellent verbal and written communication skills A results-oriented mindset with a dash of critical thinking Tech-savvy skills – quick learners are our favorite kind! Professional curiosity and a knack for finding solutionsCome be a part of our mission to make a positive impact on the lives of seniors. Apply today!About EmpowerMe WellnessEmpowerMe Wellness is on a mission to improve the lives of seniors and the communities they call home! We provide fully integrated healthcare to senior living communities nationwide, offering on-site care coordination, therapy, and pharmacy services. Our experienced team of more than 3,500 clinicians and professionals provide personalized health and wellness solutions that lead to healthier, happier tomorrows!To learn more about us, visit empowerme.com today.This employer is an Equal Opportunity Employer. In compliance with the Americans with Disabilities Act, the employer will provide reasonable accommodations to qualified individuals with disabilities and encourages prospective employees and incumbents to discuss potential accommodations with the employer. Compensation: $33.00 - $46.00 per hour

Speech-Language Pathologist - OtherWe are seeking a versatile Speech-Language Pathologist to join our team. In this role, you will assess and treat individuals with diverse communication and swallowing disorders in various settings, helping them improve their quality of life.Key Responsibilities:Evaluate patients to identify speech, language, or swallowing difficulties.Develop and implement individualized treatment plans tailored to specific needs.Provide therapy focused on articulation, fluency, voice quality, and cognitive-communication skills.Educate patients and families on strategies to support communication and swallowing improvements.Collaborate with other healthcare professionals to ensure comprehensive care.Document patient progress and adjust therapy plans as needed for optimal outcomes.Work Environment:Work in varied environments such as private practices, hospitals, or community health programs.Engage in a dynamic setting requiring adaptability and innovative problem-solving skills.Benefits:Competitive salary and comprehensive benefits package.Opportunities for professional growth through training and certifications.A supportive work environment focused on collaboration and innovation in patient care.*This information is based on the Bureau of Labor Statistics (BLS). Actual job responsibilities may vary by location.*

Your Role Reporting to the Chief Medical Officer, the Senior Medical Director, Clinical Strategy will define the vision and priorities for Blue Shield of California’s strategy to deliver best in class clinical outcomes for our members while working to ensure that health care is affordable. In this role you will be accountable for working in partnership with other leaders to deliver best in class clinical programs and align our value-based care models to meet our clinical strategy objectives. Your WorkIn this role, you will:Develop a clinical strategy framework and guiding principles, grounded in data on population health outcomes and cost, to deliver Best in Class clinical outcomes for Blue Shield of California membersDefine the organization’s overall clinical strategy, as relates to priorities, partnerships, and key measures of success to improve member experience, population health and affordability, inclusive of primary care and specialty careCo-chair the Clinical Program Review and Governance Committee with the Chief Medical Officer to ensure that all clinical programs are delivering expected clinical and cost of care outcomes for our membersWork with teams performing vendor management to ensure that contracts include appropriate metrics to ensure programs are meeting operational targets to achieve clinical objectivesCollaborate with the Health Economics team to develop the methodology to evaluate the effectiveness and lead a process to ensure robust evaluation of all clinical programsCollaborate with business leaders to ensure that the clinical strategy and clinical programs are meeting business, client, and member needsCreate an environment of accountability and continuous quality improvement to ensure that all clinical programs continue to meet and exceed objectives necessary to deliver best in class clinical outcomes for Blue Shield of California membersCommunicate internally and externally the vision and strategy to transform healthcare to deliver Best in Class clinical outcomes for Blue Shield of California membersYour Knowledge and ExperienceMinimum of 2 years of previous medical leadership experienceMinimum of 5 years of direct patient care experience post residencyMinimum 4 years experience in observational study design and execution and/or clinical program evaluationMedical degree (M.D./D.O.)Maintain active, unrestricted California State Medical License required; Maintain active, unrestricted Medical License in all additional assigned states requiredMaintain Board Certification in one of ABMS, ABOS, or AOA recognized specialty requiredOutstanding verbal and written communication skillsAbility to lead through influence in a matrixed organizationMasters or PhD in Health Services Research, Epidemiology, Biostatistics or similar field preferredExperience in a health plan or managed care organization is preferred

Overview: Physical Therapist Assistant (PTA) - SNFYour Schedule, Your Way!What sets EmpowerMe Wellness apart from other therapy providers It’s simple: we offer truly flexible scheduling. Need to be home for family or other obligations No problem! You can easily adjust your day to fit your needs all while making a huge difference in the lives of seniors!Incentive OpportunitiesFor some leadership positions at EmpowerMe Wellness, we offer financial incentive opportunities tied to performance. Be sure to ask your recruiter to learn more! Responsibilities: The OpportunityWe are hiring a Physical Therapist Assistant (PTA) to join our team and work with the residents of a skilled nursing care facility (SNF) that may offer rehab-to-home or long-term care settings. Therapy services for the residents at this community are covered by private insurance and/or Medicare Part A.As a PTA, you will be responsible for: Providing physical therapy and wellness services for older adults under the supervision of a PTMaintaining professional practices and ethical standards in accordance with company-wide policies and clinical initiativesContributing to program development, quality improvement, and problem-solvingAssist with optimizing each patient’s functional well-being and satisfactionYour ScheduleWhile our clinics typically operate 8 a.m. to 5 p.m. Monday through Friday, our flexible scheduling lets you craft a schedule that’s suited to your unique lifestyle!Our Amazing BenefitsAll Employees Get: Fun at Work, a Team You’ll Love, and a Culture You Can Stand Behind! 401(k) Eligibility with Opportunity for Matching FundsAmazing Career Advancement and Cross Training OpportunitiesRecognition ProgramsEmployee Assistance ProgramPart-Time Employees Also Get:Voluntary Benefits (Accident, Critical Illness, Hospital Indemnity, Identity Theft, Pet Protection)Full-Time Employees Also Get:Full Benefits, including HSA, FSA, and Life & Disability InsuranceVoluntary Benefits (Accident, Critical Illness, Hospital Indemnity, Identity Theft, Pet Protection)Flexible Paid Time OffYou’re Our Perfect Fit If...You’re energetic, dedicated, and hard-wired to help others – especially seniors. You want to make a difference in the world and help others lead fuller, healthier lives. You want more than just a jobyou seek a calling – a mission you can feel great about. And you want a support system to ensure your career ascends to the highest of heights.Plus, you have the following: Completion of an accredited Physical Therapy Assistant program (New Grads Welcome) Current PTA state licensure Excellent verbal and written communication skills A results-oriented mindset with a dash of critical thinking Tech-savvy skills – quick learners are our favorite kind! Professional curiosity and a knack for finding solutionsCome be a part of our mission to make a positive impact on the lives of seniors. Apply today! Qualifications: About EmpowerMe WellnessEmpowerMe Wellness is on a mission to improve the lives of seniors and the communities they call home! We provide fully integrated healthcare to senior living communities nationwide, offering on-site care coordination, therapy, and pharmacy services. Our experienced team of more than 3,500 clinicians and professionals provide personalized health and wellness solutions that lead to healthier, happier tomorrows!To learn more about us, visit empowerme.com today.This employer is an Equal Opportunity Employer. In compliance with the Americans with Disabilities Act, the employer will provide reasonable accommodations to qualified individuals with disabilities and encourages prospective employees and incumbents to discuss potential accommodations with the employer. Compensation: $36.00 - $45.00 per hour

Physical Therapist - Acute CareWe are seeking a dedicated Physical Therapist to join our acute care team. In this role, you will provide specialized therapy to patients recovering from surgeries, injuries, or illnesses in a hospital setting, helping them regain mobility and independence.Key Responsibilities:Assess patients' physical conditions and develop individualized treatment plans tailored to their needs.Implement therapeutic exercises, manual therapy techniques, and mobility training to aid recovery.Collaborate with physicians, nurses, and other healthcare professionals to ensure comprehensive patient care.Educate patients and families on techniques for improving mobility and preventing future complications.Document patient progress and adjust treatment plans as necessary to achieve optimal outcomes.Work Environment:Work in hospital settings, often in fast-paced environments requiring quick decision-making skills.Collaborate with multidisciplinary teams to address the complex needs of acute care patients.Benefits:Competitive salary and comprehensive benefits package.Opportunities for professional growth through specialized training and certifications.A supportive work environment focused on teamwork and innovation in patient care delivery.*This information is based on the Bureau of Labor Statistics (BLS). Actual job responsibilities may vary by location.*

Your Role The Network Contracting and Trend Analytics (NTA) team supports the Network Management team with analytical and financial modeling for provider contracting and network development activities for Blue Shield of California. The Senior Principal, Medical Informatics of NTA will report to the Senior Director of NTA. In this role you will be responsible for behavioral health finance analytics including measurement of internal cost of healthcare and reporting, analytics supporting coordination of care opportunities, and oversight of provider contracting analytics. 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.Your Work In this role, you will: Develop the financial management and modeling best practices, specifically for Behavior Health as we move to an in-sourced environmentImplement on-going behavior health costs analysis and trendsBe responsible for CoHC - Behavior HealthBe the lead on modeling the financial aspects. Example, evaluating the financial aspects of care activities such as hospital ER vs behavioral health servicesLead all financial aspects in developing Value-Based Contracting, specifically in Behavior Health marketplace.Be accountable for development of the financial contractual arrangements and the implementation of these providers, which we are bringing in house Your Knowledge and Experience Requires a college degree or equivalent experienceMPH, MBA, MS, MA, RN, or RHIA preferredRequires 10 years of relative experienceRequires a minimum of 5 years’ experience in Health Care (managed care, academic, or gov't payer)Requires contracting in healthcare with a behavioral health specialtyRequires experience developing programs that will translate into CoHC savings specifically in extensive vendor knowledge of financial healthcare within behavioral healthRequires experience with behavioral health financial reporting and modelingRequires one to be comfortable with an ever changing business model that is continually seeking the optimal solution in the behavioral health spaceRequires a SAS Certified Base Programmer Credential or equivalent or a SAS Certified Advanced Programmer Credential or equivalent

Physical Therapist - Acute CareWe are seeking a dedicated Physical Therapist to join our acute care team. In this role, you will provide specialized therapy to patients recovering from surgeries, injuries, or illnesses in a hospital setting, helping them regain mobility and independence.Key Responsibilities:Assess patients' physical conditions and develop individualized treatment plans tailored to their needs.Implement therapeutic exercises, manual therapy techniques, and mobility training to aid recovery.Collaborate with physicians, nurses, and other healthcare professionals to ensure comprehensive patient care.Educate patients and families on techniques for improving mobility and preventing future complications.Document patient progress and adjust treatment plans as necessary to achieve optimal outcomes.Work Environment:Work in hospital settings, often in fast-paced environments requiring quick decision-making skills.Collaborate with multidisciplinary teams to address the complex needs of acute care patients.Benefits:Competitive salary and comprehensive benefits package.Opportunities for professional growth through specialized training and certifications.A supportive work environment focused on teamwork and innovation in patient care delivery.*This information is based on the Bureau of Labor Statistics (BLS). Actual job responsibilities may vary by location.*

Your Role The Middle Market underwriting team is responsible for balancing operating income and membership goals while protecting the company’s bottom line from loss. The Underwriter - Large Group, Experiencedwill report to the group underwriting manager. In this role you will directly contribute to the company achieving its financial and strategic goals for employer accounts with 101 or more eligible subscribers. Your Work In this role, you will: Collect, review and analyze customer specific information including financial condition, employee demographics, carrier history and previous claim experience to determine risk, potential benefit features and premium rates for fully insured groups requiring minimal customizationUnderwrite new and renewal business by calculating monetary risk along with amendments to existing contractsAssist as necessary in the negotiation of benefit plan designs and financial assumptions with sales teams on new and renewed businessReview and approve all sales requests within company established standards and policy guidelinesReview and interpret ad hoc reports as requested and produce ongoing reportsMay assist the sales team in implementing new and existing contracts by reviewing final enrollment numbersProvides underwriting knowledge sharing and education to peers and/or members of the sales teamYour Knowledge and Experience Requires a bachelor's degree in a related field such as finance, mathematics or accounting and/or equivalent combination of education and experienceRequires at least 3 years of prior relevant experienceRequires working knowledge of underwriting principles and proceduresRequires demonstrated math/statistical, analytical and problem-solving skillsRequires an attention to detail and accuracy and understanding of the company’s revenue, operating income and membership goalsRequires ability to solve complex problems with sometimes ambiguous informationRequires good time management and customer service skills

Occupational Therapist - OutpatientWe are looking for a dedicated Occupational Therapist to join our outpatient team. In this role, you will help patients improve their ability to perform daily activities and regain independence through personalized therapy programs.Key Responsibilities:Assess patients' needs and develop individualized treatment plans to address physical, emotional, or developmental challenges.Design and implement therapeutic interventions to improve daily living, vocational, and social skills.Modify environments or tasks to remove barriers and enhance patients' ability to function independently.Collaborate with patients, families, and other healthcare professionals to ensure comprehensive care.Document patient progress and adjust treatment plans as necessary to achieve optimal outcomes.Work Environment:Provide care in outpatient clinics focused on short-term rehabilitation and long-term wellness.Work in a collaborative setting alongside other healthcare professionals dedicated to patient success.Benefits:Competitive salary and comprehensive benefits package.Opportunities for professional growth through training and certifications.A supportive work environment that values innovation and teamwork.*This information is based on the Bureau of Labor Statistics (BLS). Actual job responsibilities may vary by location.*

Your Role The Network and Trend Analytics team drives the development of an affordable provider network through data analytics and expertise. The Experienced Actuarial Analyst will report to the Senior Principal and will perform actuarial analysis primarily supporting the Behavioral Health provider network.Your Work In this role, you will: Understand the core principles and functionality of decision, descriptive, predictive and prescriptive analytic methods including forecasting, statistical and machine learning techniquesConduct and develop analysis, assess risk and population risk scores and assignment, develop pricing and trends, assess changes in benefit designs, develop reserves, perform forecasting, analyze provider reimbursement terms and/or evaluates actuarial risk related analysisCoordinate, prepare, perform and audit actuarial analyses to assist in the development of complex actuarial formulations leading to the recommendation of pricing, trending, reserving, provider reimbursement and/or risk assessment strategiesPerform data exploration using a combination of statistical programming languages (including, but not limited R, Python, SQL, SAS) and deploy predictive analytics and machine learning techniques to improve risk prediction, improve reserve, trend and financial forecasting in a manner that is actuarially sound, and enable real-time results and operational efficienciesDirect, coordinate, and/or develop evaluation and financial reporting standards for internal and external reportsUnderstand and accurately track the unit cost trend, support database upgradeGenerate reports and analysis from unit cost tracking database, respond to requests from inside and outside of the teamYour Knowledge and Experience Requires a bachelors degree with at least a minor in mathematics, statistics, computer science or equivalent business experienceRequires at least 2 years of professional actuarial experienceRequires proficiency in Excel and AccessPrefers proficiency in VBA and SAS

Occupational Therapist - OutpatientWe are looking for a dedicated Occupational Therapist to join our outpatient team. In this role, you will help patients improve their ability to perform daily activities and regain independence through personalized therapy programs.Key Responsibilities:Assess patients' needs and develop individualized treatment plans to address physical, emotional, or developmental challenges.Design and implement therapeutic interventions to improve daily living, vocational, and social skills.Modify environments or tasks to remove barriers and enhance patients' ability to function independently.Collaborate with patients, families, and other healthcare professionals to ensure comprehensive care.Document patient progress and adjust treatment plans as necessary to achieve optimal outcomes.Work Environment:Provide care in outpatient clinics focused on short-term rehabilitation and long-term wellness.Work in a collaborative setting alongside other healthcare professionals dedicated to patient success.Benefits:Competitive salary and comprehensive benefits package.Opportunities for professional growth through training and certifications.A supportive work environment that values innovation and teamwork.*This information is based on the Bureau of Labor Statistics (BLS). Actual job responsibilities may vary by location.*

Your Role The End-to-End Member Experience team is responsible for developing a comprehensive Member Experience (MX) strategy that integrates digital, call center, marketing, and operations efforts to achieve excellence within the healthcare industry. The End-to-End Member Experience Strategic Insights, Consultant will report to the Senior Manager, Strategic Insights for End-to-End Member Experience. In this role, you will design, manage, and conduct MX research in collaboration with external vendors and internal stakeholders to inform the optimization of member experiences specific to Blue Shield members, all while driving our Net Promoter Score (NPS) and Forrester program performance.Your WorkIn this role, you will:Drive MX strategy by generating insights to prioritize and refine the MX roadmap, focusing on initiatives to enhance the experience for all membersSynthesize complex data and concepts into easily understood stories and recommendations for senior leadership and cross-functional teams, by scaling our NPS and Forrester programsSupport the Voice of the Customer (VoC) programs and collaborate across the organization to translate member reported issues into effective actionable resultsDerive insights and trends from data and analytics to create high-level strategies to drive optimization of customer experience and enhancement of loyaltyIdentify critical short and long-term business opportunities that enable transformational change across the enterpriseSynthesize complex data and concepts into easily understood stories and recommendations for senior leadership, by scaling our NPS & Forrester programsProduce impactful insights by leveraging expertise in survey design, statistical analysis, and data-driven storytellingCollaborate with internal teams to leverage insights in the development of journey maps and action plansNavigate ambiguity through strategic thinking, identify and implement improvements to various processes, programs, and tools used in support of the VoC best practicesOwn monthly, quarterly, and annual reporting, sharing insights in presentations to internal teamsYour Knowledge and ExperienceRequires a bachelor’s degree or equivalent experience and/or equivalent combination of education and experienceRequires at least 7 years of prior relevant experience, including in Member or Customer Experience, Voice-of-Customer programs (e.g., CAHPS, Digital MSAT, NPS, Forrester, etc.) or Market ResearchRequires ability to analyze ambiguous feedback from members/customers, employees, and other sources to turn into actionable insights for practical useRequires experience with tools to analyze and interpret member feedback data (e.g., Tableau, Vendor managed software, etc.)Requires experience with applying a variety of data analysis techniques and combining survey and operational dataExperience in customer experience program reporting, design, and roadmap development, in roles such as analyst, program manager, or adjacent strongly preferredExperience managing customer experience improvement projects from insights to building business cases to managing implementation (working with cross-functional teams), strongly preferredStrong communicator, self-starter, strategic thinker with a blend of business understanding and quantitative skills#LI-AD3