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Full Time
7/4/2025
Corona, CA 92882
(45.0 miles)
Extra attention to detail Exceptional outcomes This is a PRN position BE THE CONNECTION.Your role as a certified occupational therapy assistant (COTA) lets you be the connection between dedication to detail and patient outcomes that exceed expectations. Use your passion for rehabilitation to ensure that patients receive care that sets the standard as you treat patients with compassion and empathy. Enhance the impact of your abilities with national post-acute care leader Encompass Health. What Makes Encompass Health Careers Different-and Better:Working at Encompass Health means being part of something special: A team that is passionate about making an impact on patients' lives each day. Unlike the typical hospital setting, Encompass Health offers you the unique opportunity to walk alongside patients on their road to recovery from stroke, spinal cord injuries, neurological disorders, joint replacements, multiple trauma and cardiac/pulmonary conditions. As you help patients achieve goals and regain independence, you can form significant relationships with them and celebrate the successes they experience along the way.Our culture of compassion and collaboration is founded on more than just the care we provide our patients; it is expressed in the values we live. We encourage and empower each employee to keep learning and growing by providing the resources to deliver a better way to care. At Encompass Health, you'll find something decidedly different and more satisfying: A career that is challenging, inspiring and rewarding. Maximize your talent and join a team that is committed to setting the standard for better healthcare with this engaging opportunity: CERTIFIED OCCUPATIONAL THERAPY ASSISTANT (COTA)Here is your opportunity to channel the full extent of your knowledge, skills, ambition, and experience on a daily basis. Inspire our patients to progress each day as you:• Provide occupational therapy treatment and patient care according to hospital, state and federal regulations and professional guidelines.• Perform occupational therapy treatment tasks as delegated and supervised by occupational therapists.• Maintain open and ongoing communication with hospital departments to ensure that patient, staff and hospital needs are met. Credentials:• Current state licensure or certification or state practice act, whichever is applicable, required.• CPR certification preferred, unless otherwise required by hospital policy.• Successful completion of an associate's degree from an accredited occupational therapy assistant program preferred.• Effective communication skills for working with patients, families and caregivers required.• Demonstrated competency in occupational treatment essential. Enjoy competitive compensation and benefits that start on day one, including: • Benefits that begin when you do.• Affordable medical, dental and vision plans provided to meet the needs of full and part-time employees and their families.• Generous paid time off that increases with tenure.• Tuition reimbursement and continuing education opportunities.• Company-matching 401(k) and employee stock-purchase plans.• Flexible spending and health savings accounts. About Us:Helping patients regain hope and independence, Encompass Health is a national leader in post-acute care. We operate rehabilitation hospitals and offer home health and hospice care in 36 states as well as Puerto Rico. Following the Encompass Way, we are driven by our core values: We proudly set the standard, lead with empathy, do what's right, focus on the positive, and remain stronger together. Realize the powerful difference you can make. Take this opportunity to join our team.To learn more about us, please visit us online at encompasshealth.com Connect with us:Equal Opportunity Employer QualificationsCompensation: $45.00 an hour
Full Time
7/1/2025
Thousand Oaks, CA 91320
(43.9 miles)
Overview: Clinic Director – Licensed Clinical Occupational Therapy Assistant (COTA) - Care Coordination ProgramOccupational Therapy + Care Coordination: The Best of Both Worlds!We’re looking for COTAs 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 licensedClinical Occupational Therapy Assistant (COTA) to serve as Clinic Director at 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 Clinic Director, you will be responsible for:Overseeing how team members at your location(s) deliver care in accordance with federal, state, and local regulations Support care coordination efforts by conducting regular wellness checkpoint visits with patients, communicating with patients’ providers and caregivers, and assisting patients with attending telehealth visitsLeading operational initiatives, including the implementation of company-wide policies, clinical programs, and quality initiativesCollaborating with interdisciplinary care partners on treatment planning and therapeutic interventionsMaintaining professional practices and ethical standards in accordance with company-wide policies and clinical initiativesAs a COTA, you will be responsible for: Providing occupational therapy and wellness services for older adults under the supervision of a OT as part of a multidisciplinary teamContributing to program development, quality improvement, and problem-solvingAssisting 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 Clinical Occupational Therapy Assistant program (New Grads Welcome) Current COTA 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 - $45.00 per hour
Full Time
6/19/2025
Long Beach, CA 90899
(11.9 miles)
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 Health will report to the Senior Medical Director, Behavioral Health. In this role you will have core responsibilities in the areas of behavioral health concurrent review, pre- and post-service utilization review, and collaboration with Clinical Care Managers. 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: Review concurrent, pre- and post-service behavioral health service requests and render decisions based on the member's benefits, medical necessity, Blue Shield of California medical policy, FEP (Federal Employee Program) medical policy, as well as legal and regulatory requirementsMedical decision and support for the behavioral health review for all services currently requiring authorization or review, facilitating appropriate use of all resources, including safe and timely dischargesEngage in telephonic peer-to-peer discussions regarding current members in various levels of care or who may be receiving other specialized services. Therefore, the Medical Director must feel comfortable in clinical conversations with Blue Shield providersTrain BSC utilization and care management staff which may include physicians, psychologists, nurses, social workers, and others as neededPerform clinical reviews to support utilization management and fraud waste and abuse case evaluationsParticipate with the quality management function in the identification and analysis of medical information to develop interventions to improve quality of care and outcomes for our membersParticipate on projects and committees, as necessaryYour Knowledge and ExperienceMinimum 5 years direct patient behavioral health clinical care experience post residency requiredMedical degree (M.D./D.O.)Completed residency in PsychiatryMaintain active, unrestricted California Medical License required; Maintain active, unrestricted Medical License in all additional assigned states requiredMaintain Board Certification in Psychiatry through American Board of Psychology and Neurology (ABPN) or the American Osteopathic Board of Neurology and Psychiatry (AOBNP) requiredPreferred Qualifications:Recent inpatient psychiatric hospital experience (within the past five years)Recent substance use disorders treatment experience (within the past five years)Well-versed with most areas of behavioral health services and conditionsShow ability for rapid, accurate decision-making, and enjoy care review, as well as the investigation and resolution of complex issuesExperience with CPT coding, medical claims review, hospital billing, and reimbursementDeep knowledge of MHPAEA (Mental Health Parity and Addiction Equity Act), SB855 and all regulatory and compliance requirementsManaged care experience supporting utilization management, case review, and/or quality improvement activities in behavioral healthExperience with ASAM, LOCUS, CALOCUS, and WPATH
Full Time
7/2/2025
Simi Valley, CA 93097
(42.8 miles)
Job Details: Build a Career with Meaning and Enhance Your FutureCome join us at Phoenix Ranch as a Support Childcare Teacher!Our educators brighten children’s lives every day while creating a bright future for themselves. We offer a supportive environment for our teachers and empower them with the resources they need to create a positive learning environment for our students.We also help our employees build great careers. With our education incentives and career development programs, we invest in our educators to ensure that they thrive. Our Support Teachers work collaboratively with teachers across various classrooms to create a positive and engaging learning environment that promotes the holistic development of children.How We Work for You:Competitive pay and benefitsChildcare tuition discounts (based on individual school availability)Career development programsOpportunities for advancementSupportive work environmentRelocation options at our 100+ schools nationwideWhat You Get to Do:Help lead innovative learning activities that promote children’s development and growthEnsure the safety and well-being of children at all timesMonitor children’s progress and developmentCreate a harmonious environment where children and fellow teachers enjoy coming to each dayStarting pay: $17.00 to $19.00 hourly, depending on education and Experience.Are You Qualified Whether or not you have experience working in schools, you may be qualified to work with us.The most important quality is that you love working with children.Some of our best educators have come from other fields, including customer service, healthcare, retail, and more!If you have the following, we would love to speak with you:High School Diploma or GEDExperience in Early Childhood Education in a certified child development centerPrior experience with toddler and pre-school studentsAbility to use standard office equipment such as a laptop computer and tablet12 Child Development Units-PreferredStrong collaboration and communication skills are required.Patience, a nurturing attitude, and a sincere interest in the well-being and development of young learners are essential to this position.About Endeavor SchoolsPhoenix Ranch is part of the Endeavor Schools family. With more than 100 schools in 14 states, Endeavor Schools is one of the nation’s fastest-growing education management companies. We believe that there are many ways for children to learn, and that is why we provide schools with different educational styles and methods across the country. Come be part of a team that prioritizes the success and wellbeing of our amazing employees!Endeavor Schools is an Equal Opportunity Employer. Pay Range: USD $17.00 - USD $19.00 /Hr.
Full Time
6/19/2025
Long Beach, CA 90899
(11.9 miles)
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 Health will report to the Senior Medical Director, Behavioral Health. In this role you will have core responsibilities in the areas of behavioral health concurrent review, pre- and post-service utilization review, and collaboration with Clinical Care Managers. 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: Review concurrent, pre- and post-service behavioral health service requests and render decisions based on the member's benefits, medical necessity, Blue Shield of California medical policy, FEP (Federal Employee Program) medical policy, as well as legal and regulatory requirementsMedical decision and support for the behavioral health review for all services currently requiring authorization or review, facilitating appropriate use of all resources, including safe and timely dischargesEngage in telephonic peer-to-peer discussions regarding current members in various levels of care or who may be receiving other specialized services. Therefore, the Medical Director must feel comfortable in clinical conversations with Blue Shield providersTrain BSC utilization and care management staff which may include physicians, psychologists, nurses, social workers, and others as neededPerform clinical reviews to support utilization management and fraud waste and abuse case evaluationsParticipate with the quality management function in the identification and analysis of medical information to develop interventions to improve quality of care and outcomes for our membersParticipate on projects and committees, as necessaryYour Knowledge and ExperienceMinimum 5 years direct patient behavioral health clinical care experience post residency requiredMedical degree (M.D./D.O.)Completed residency in PsychiatryMaintain active, unrestricted California Medical License required; Maintain active, unrestricted Medical License in all additional assigned states requiredMaintain Board Certification in Psychiatry through American Board of Psychology and Neurology (ABPN) or the American Osteopathic Board of Neurology and Psychiatry (AOBNP) requiredPreferred Qualifications:Recent inpatient psychiatric hospital experience (within the past five years)Recent substance use disorders treatment experience (within the past five years)Well-versed with most areas of behavioral health services and conditionsShow ability for rapid, accurate decision-making, and enjoy care review, as well as the investigation and resolution of complex issuesExperience with CPT coding, medical claims review, hospital billing, and reimbursementDeep knowledge of MHPAEA (Mental Health Parity and Addiction Equity Act), SB855 and all regulatory and compliance requirementsManaged care experience supporting utilization management, case review, and/or quality improvement activities in behavioral healthExperience with ASAM, LOCUS, CALOCUS, and WPATH
Full Time
6/10/2025
Long Beach, CA 90899
(11.9 miles)
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
Full Time
6/26/2025
Los Angeles, CA 90033
(22.2 miles)
Respiratory Therapist - NICUWe are seeking a skilled Respiratory Therapist to join our Neonatal Intensive Care Unit (NICU) team. In this role, you will provide specialized respiratory care to premature or critically ill newborns, ensuring their breathing needs are met with precision and compassion.Key Responsibilities:Administer oxygen therapy, ventilator support, and other respiratory treatments to neonates in the NICU.Monitor vital signs and adjust respiratory support based on the infant's condition.Collaborate with neonatologists and NICU staff to develop individualized care plans for each patient.Perform diagnostic tests such as blood gas analysis to evaluate lung function.Educate parents on respiratory equipment and techniques to prepare for discharge when appropriate.Maintain accurate documentation of treatments provided and patient progress.Work Environment:Work in a fast-paced NICU environment that requires critical thinking and attention to detail.Collaborate closely with a multidisciplinary team dedicated to neonatal care.Be prepared for rotating shifts, including nights, weekends, and holidays, as required in critical care settings.Benefits:A competitive salary with comprehensive benefits options available.A focus on professional growth through training opportunities and certifications in neonatal respiratory care.A supportive workplace culture that values teamwork and innovation in patient care delivery systems.*This information is based on the Bureau of Labor Statistics (BLS). Actual job responsibilities may vary by location.*
Full Time
6/10/2025
Long Beach, CA 90899
(11.9 miles)
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
Full Time
6/10/2025
Long Beach, CA 90899
(11.9 miles)
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 Sr. Medical Director, Medical Policy will report to the Chief Medical Officer. In this role you will be accountable for ensuring that all medical, medication, and payment policy initiatives are in aligned with the scientific evidence and professional guidelines. You will lead a team that delivers medical policy that adapts to new clinical innovations and supports medical payment operations, and training for staff in the accurate application of medical, medication, and payment policy, pricing, and coding. In addition to chairing the BSC Pharmacy & Therapeutics, Medical and Payment Policy Committees, you will provide clinical leadership for all evidence-based medicine functions and partner closely with leaders of other business functions to develop strategies to ensure that Blue Shield members are receiving appropriate quality care.Your WorkIn this role, you will:Provide clinical thought leadership for the design and implementation of clinical policy innovation initiatives such as Coverage with Evidence Development, and the development of robust and efficient approaches to developing policies for emerging classes of technology like molecular diagnostics and mobile/digital personal health devicesChair the Medical Policy and Pharmacy and Therapeutics CommitteesProvide clinical leadership and medical consultation for the Blue Shield of California (BSC) medication management process, including working closely with the Pharmacy Services team to promote safe, effective, and cost-efficientProvide medical expertise in daily clinical rounds for drug authorization case reviewChair the Payment Policy Committee and provide clinical leadership for the BSC Payment Policy committee, overseeing and advising about payment policies and tactical approaches to ensure accurate coding of servicesConsult with BSC legal team to support fraud and abuse investigations, provider arbitrations, regulatory inquiries and issues, and litigation related to clinical policy, coding, or pricing issuesAct as BSC’s representative to the Blue Cross Blue Shield Association (BCBSA) Technology Assessment process and the Medical Policy PanelParticipate on the California Technology Assessment Forum and other related activitiesPartner with Network Management and Provider Partnership teams by providing subject matter expertise for contract and benefits coding decisions, including mandated benefits, provider contract language, provider DOFRs (division of financial responsibilities), and providing clinical perspective to resolve issues with BSC providers related to clinical policy, coding, and billing.Provide subject matter expertise for pricing of new, zero-dollar, and other exceptional claimsPresent at IPA/MG and Provider education seminars regarding medical, medication and payment policy Your Knowledge and ExperienceMinimum of 2 years of previous medical leadership experienceMinimum of 5 years of direct patient care experience post residencyMinimum of 8 years of experience developing evidence-based guidelines, medical policies or performing systematic reviews of the medical literatureMedical degree (M.D./D.O.) required. Master’s degree in epidemiology, health services or related degree is preferredCompleted residency preferably in adult based primary care specialty (e.g. Internal Medicine, Family Practice)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 required (preferably Internal Medicine or Family Practice)Has mastery level knowledge and skills within a specific technical or professional discipline with broad understanding of other areas within the job functionOutstanding verbal and written communication skillsAbility to lead through influence in a matrixed organizationExperience performing utilization management reviews is preferredExperience in a health plan or managed care organization is preferred#LI-JS3
Full Time
7/4/2025
Corona, CA 92882
(45.0 miles)
Physical Therapist - OtherWe are seeking a versatile and skilled Physical Therapist to join our team. In this role, you will provide specialized physical therapy services tailored to unique patient populations or settings, helping individuals improve mobility, manage pain, and regain independence.Key Responsibilities:Evaluate patients to determine their physical therapy needs and create individualized treatment plans.Implement therapeutic exercises, manual therapy techniques, and other interventions to address patients' specific conditions.Educate patients and caregivers on exercises, lifestyle changes, and techniques to promote recovery and prevent future injuries.Collaborate with other healthcare professionals to ensure comprehensive patient care.Document patient progress and adjust treatment plans as necessary to achieve optimal outcomes.Adapt therapy approaches based on the unique requirements of the setting or patient population.Work Environment:Provide care in diverse settings such as home health, schools, community programs, or specialized facilities.Work in a dynamic environment requiring adaptability and innovative problem-solving skills.Collaborate with multidisciplinary teams to deliver holistic care tailored to individual needs.Benefits:Competitive salary and comprehensive benefits package.Opportunities for professional growth through specialized 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.*
Full Time
6/10/2025
Long Beach, CA 90899
(11.9 miles)
Your Role The Medical Director, National Accounts position is dedicated to supporting the promotion of growth and increased market share of the National Accounts and the Administrative Services Only (ASO) business. This includes strategic clinical and healthcare cost management guidance for the existing Blue Shield of CA book of business. This position will report directly to the VP, CMO, Commercial Markets. This position provides clinical direction to the sales team and sales processes and interacts directly with employers and consultants. This role will be at the center of driving strategy for how to reduce cost of care, while providing client advisory services, increasing engagement, and improving the quality of care & population health for our employers’ membership.Your Work In this role, you will: Lead client and producer facing activities including finalist presentations and account services meetings, broker and consultant meetings, meetings with Mercer, WTW, Aon, etc. Actively participate in and guide the preparations and the actual client meetings. Other activities include interpreting clinical data for employers at regular or pre-determined intervals, reviewing cost/spending trends, making recommendations on improving member engagement and population health. You will work diligently both internally and externally to develop, refine, and expertly communicate the BSC Clinical Value Proposition.Work collaboratively with other Healthcare Solutions and BSC staff to quickly resolve client service issues, with particular emphasis on clinical issues. Be available to talk with key account members about their issues and the solutions.Act as a strategic thought-partner for key clients (e.g. UC, Stanford, CalPERS) who want best-in-class medical, health and wellness programs.Responsible for the planning, development, and leading the delivery of Healthcare Solutions related materials to clients, producers and business associations that describe and explain the operational details and value of Healthcare Solutions capabilities, services and programs. Includes working with the Health Data Reporting teams to analyze data trends and develop external customer reports.Support other ASO Line of Business activities such as: business planning, business development, and designing and implementing innovations to address market needs.Your Knowledge and Experience Medical Degree (M.D./D.O.)Completed residency preferably in adult based primary care specialty (e.g. internal medicine, family practice)Active, unrestricted California State Medical LicenseMinimum 10 years managed care experience requiredAt least five years clinical experience requiredExperience with California managed care marketplace is requiredPrevious experience in national, complex account management support is requiredExperience supporting Administrative Services Only (ASO) lines of business is preferredPrevious experience in a similar sales role preferredPrior experience as a people manager preferredExcellent verbal and written communication skills, including ability to speak comfortably and extemporaneously to diverse audiencesAbility to explain program, clinical, operational, and quantitative information in a business-like, clear, coherent, and comprehensible wayStrong quantitative and analytic skills working with claims, operational, and clinical data and reportsExcellent interpersonal communication skills, including active listening, self-management and awareness, emotional intelligence, and ability to flex interpersonal style situationalDemonstrated ability to model a collaborative approach with internal and external stakeholdersStrong negotiation and creative problem-solving skillsStrong skills with Microsoft Office Suite, including PowerPoint, Excel, Word and Outlook
Full Time
6/10/2025
Long Beach, CA 90899
(11.9 miles)
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
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