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Full Time
6/29/2025
Oakland, CA 94616
(43.9 miles)
Your Role The Prior Authorization (PA) team utilizes clinical knowledge to review authorization requests for coverage under the outpatient pharmacy benefit. The Pharmacist, Consultant willwork as part of the pharmacy benefit Prior Authorization (PA) team to support the Blue Shield of California (BSC) Pharmacy and Therapeutics Committee (P&T) by ensuring that evidence based clinical decisions are implemented appropriately to provide a high-quality and cost-effective pharmacy benefit. The Pharmacist, Consultant (Drug Utilization Review Pharmacist) will report to the Drug Utilization Review (DUR) Pharmacist Manager. *This is a short term position expected to last 1 year from hire*Your WorkIn this role, you will:Support the clinical and operational implementation of P&T approved policies for the pharmacy benefit, for both the Commercial and Medicare lines of businessApply clinical expertise to PA reviews and work collaboratively with the PA and Call Center Teams to support access to safe, efficacious, and medically necessary medicationsOperate in compliance with all regulatory and accreditation requirements to ensure all requests are reviewed within regulatory required timeframesServe as a resource to internal and external constituents regarding the Blue Shield drug formulary, medication policies and appropriate drug useEmbrace BSC values by answering clinical and operational questions, participating in group discussions, and supporting other team members while working towards a collective goalUse clear and concise communications and on-brand messaging when communicating with providers or membersFollow all corporate policies and proceduresOperate in compliance with all regulatory and accreditation requirements, and corporate policies and procedures regarding the support access to safe, efficacious, and medically necessary medicationsAssist in preparing materials for audits and reports; complete projects as assignedYour Knowledge and ExperienceRequires a Doctor of Pharmacy (PharmD) degreeRequires a currently active and unrestricted California Registered Pharmacist (RPh) licenseRequires at least 2 years of experience in clinical pharmacyExcellent oral and written communication skillsThorough knowledge of therapeutic use of medications
Full Time
6/26/2025
Vallejo, CA 94589
(27.5 miles)
Speech-Language Pathologist - Inpatient We are looking for a compassionate and skilled Speech-Language Pathologist to join our inpatient care team. In this role, you will assess and treat patients with speech, language, voice, and swallowing disorders, helping them regain critical communication and swallowing functions. Key Responsibilities: Evaluate patients' speech, language, and swallowing abilities to develop individualized treatment plans.Provide therapy to improve communication skills, voice quality, and swallowing function.Select and teach alternative communication systems for patients with severe impairments.Collaborate with interdisciplinary teams to ensure comprehensive patient care.Document patient progress and adjust treatment plans as necessary. Work Environment: Work in hospital inpatient units or rehabilitation facilities.The role may require working with patients recovering from strokes, surgeries, or other medical conditions affecting speech and swallowing. Benefits: Competitive salary with opportunities for growth.Comprehensive health insurance, retirement plans, and paid time off.Access to continuing education programs for professional development. Equal Opportunity Employer: Your expertise is valued here. We are committed to fostering an inclusive environment where all employees can thrive professionally while delivering exceptional patient care. *This information is based on the Bureau of Labor Statistics (BLS). Actual job responsibilities may vary by location.*
Full Time
7/1/2025
Petaluma, CA 94952
(7.1 miles)
We. Are. OneStaff. Medical. An independently-owned, nationally-recognized and amazingly awesome staffing firm ready to work for you! A work ethic forged in the Midwest, we are here to stand by your side and help you find your dream assignment anywhere in this great country. We want the same like-minded, awesome candidates to travel with us. Be bold. Enjoy work again. Let us help. THE POSITION: A physical therapist will examine a patient and focus on creating a recovery plan. They focus on treatments that reduce the need for surgery and prescriptive drugs. A physical therapist uses a combination of exercises, stretches, hands-on techniques and equipment to restore function or relieve pain. *Weekly amount stated in the job postings is scaled based on estimated hourly wages and potential stipends available for the location of the assignment. Hourly wages are based on various factors including but not limited to: experience, demand, availability, location, etc. Please contact one of our amazing OneStaff Recruiting Specialists for more details. **Equal Opportunity Employer** BENEFITS: Insurance We provide group benefits for Health, Dental, Vision, Life, Short Term Disability, Long Term Disability, Accident, Critical Illness, and Identity Theft Protection. 401K You are eligible to enroll 1st of the month following hire date. We match 100% of your first 3% of deferrals and an additional 50% of the next 2% you contribute. Employee Assistance Program Free to all employees who’d like information on personal issues: Education, Dependent Care, Care Giving, Legal, Financial, Lifestyle & Fitness Management, Working Smarter.
Full Time
6/15/2025
Sonoma, CA 95476
(13.0 miles)
Earn a $2,000 Completion Bonus!We are offering up to $2,000 as a Completion Bonus for Special Education Teachers who are brand new to Epic Special Education Staffing who complete their full assignment (must work 30 hours or more per week).ABOUT USTogether, we are the Epic Special Education Staffing family and family is how we view each member of this incredible community. From our family to the nation’s schools, we remain focused on providing a world of opportunities for you to leverage your abilities and make an impact on special education. Apply today!POSITION DESCRIPTIONEpic Special Education Staffing is partnering with an exceptional school district who is looking for a contract Special Education Teacher for the 2025 - 2026 school year.·Duration: 8/6/2025 - 05/29/2026·Location: Sonoma, CA·Location Type: On-Site·Schedule: Full Time·Hours: 40.00·Grade/Age Levels: Elementary School·Weekly Pay Range: $49.50 – $56.93 per hour on a local contractBENEFITSWe offer a variety of benefits for you and your loved ones. As a valued and respected part of the Epic family, you will enjoy:·Competitive compensation packages for both local and travel contracts·Medical, Dental, and Vision benefits·Infertility & Domestic Partner Coverage·Summer Insurance Coverage·PTO & Holiday Pay·401K matching·Wellness and Employee Assistance Program (EAP)·CEU & license reimbursements·Referral bonuses of $1000QUALIFICATIONSThe minimum qualifications for Special Education Teacher:·1 year of verifiable, professional experience as Special Education Teacher within the last 3 years (may include residency or clinical practicum)·Valid Special Education Teacher credential/license or in process in state of practice·Employees must be legally authorized to work in the United States and will be asked for proof upon hire. We are unable to sponsor or take over sponsorship of an employment Visa at this time.·We will consider all qualified applicants for employment, including those with criminal histories, in a manner consistent with the requirements of applicable federal, state, and local laws.·Epic Staffing Group provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, sex, national origin, housing, age, disability or genetics.At Epic Special Education Staffing, you will have the opportunity to apply your unique experience and expertise with school-based special education as your singular focus. We offer stimulating and rewarding careers that provide an opportunity to make a difference in a child's life! Earn more for referring your friends! For a limited time, we are increasing our Referral Bonus for select positions! You could receive up to $2,250 bonus and a $250 charitable contribution! Submit your referrals by October 31, 2025, and ensure your friend begins their contract during the 2025-2026 school year to qualify.By applying for this position, you agree that any calls from Epic Staffing Group and its subsidiaries may be monitored or recorded for training and quality assurance purposes.
Full Time
6/19/2025
Oakland, CA 94616
(43.9 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
6/26/2025
Vallejo, CA 94589
(27.5 miles)
Speech-Language Pathologist - Inpatient We are looking for a compassionate and skilled Speech-Language Pathologist to join our inpatient care team. In this role, you will assess and treat patients with speech, language, voice, and swallowing disorders, helping them regain critical communication and swallowing functions. Key Responsibilities: Evaluate patients' speech, language, and swallowing abilities to develop individualized treatment plans.Provide therapy to improve communication skills, voice quality, and swallowing function.Select and teach alternative communication systems for patients with severe impairments.Collaborate with interdisciplinary teams to ensure comprehensive patient care.Document patient progress and adjust treatment plans as necessary. Work Environment: Work in hospital inpatient units or rehabilitation facilities.The role may require working with patients recovering from strokes, surgeries, or other medical conditions affecting speech and swallowing. Benefits: Competitive salary with opportunities for growth.Comprehensive health insurance, retirement plans, and paid time off.Access to continuing education programs for professional development. Equal Opportunity Employer: Your expertise is valued here. We are committed to fostering an inclusive environment where all employees can thrive professionally while delivering exceptional patient care. *This information is based on the Bureau of Labor Statistics (BLS). Actual job responsibilities may vary by location.*
Full Time
7/1/2025
Petaluma, CA 94952
(7.1 miles)
We. Are. OneStaff. Medical. An independently-owned, nationally-recognized and amazingly awesome staffing firm ready to work for you! A work ethic forged in the Midwest, we are here to stand by your side and help you find your dream assignment anywhere in this great country. We want the same like-minded, awesome candidates to travel with us. Be bold. Enjoy work again. Let us help. THE POSITION: Helps occupational therapy clients by providing rehabilitative services, under the direction of occupational therapists, to persons with mental, physical, emotional, or developmental impairments. *Weekly amount stated in the job postings is scaled based on estimated hourly wages and potential stipends available for the location of the assignment. Hourly wages are based on various factors including but not limited to: experience, demand, availability, location, etc. Please contact one of our amazing OneStaff Recruiting Specialists for more details. **Equal Opportunity Employer** BENEFITS: Insurance We provide group benefits for Health, Dental, Vision, Life, Short Term Disability, Long Term Disability, Accident, Critical Illness, and Identity Theft Protection. 401K You are eligible to enroll 1st of the month following hire date. We match 100% of your first 3% of deferrals and an additional 50% of the next 2% you contribute. Employee Assistance Program Free to all employees who’d like information on personal issues: Education, Dependent Care, Care Giving, Legal, Financial, Lifestyle & Fitness Management, Working Smarter.
Full Time
6/22/2025
Oakland, CA 94616
(43.9 miles)
ABOUT USTogether, we are the Epic Special Education Staffing family and family is how we view each member of this incredible community. From our family to the nation’s schools, we remain focused on providing a world of opportunities for you to leverage your abilities and make an impact on special education. Apply today!POSITION DESCRIPTIONEpic Special Education Staffing is partnering with an exceptional school district who is looking for a contract Deaf and Hard of Hearing Teacher for the 2025 - 2026 school year.·Duration: ASAP - 05/28/2026·Location: Oakland, CA·Location Type: On-Site·Schedule: Full Time·Hours: 37.50·Grade/Age Levels: Elementary School;Kindergarten;Pre-K·Weekly Pay Range: $45.00 – $51.75 per hour on a local contractBENEFITSWe offer a variety of benefits for you and your loved ones. As a valued and respected part of the Epic family, you will enjoy:·Competitive compensation packages for both local and travel contracts·Medical, Dental, and Vision benefits·Infertility & Domestic Partner Coverage·Summer Insurance Coverage·PTO & Holiday Pay·401K matching·Wellness and Employee Assistance Program (EAP)·CEU & license reimbursements·Referral bonuses of $1000QUALIFICATIONSThe minimum qualifications for Deaf and Hard of Hearing Teacher:·1 year of verifiable, professional experience as Deaf and Hard of Hearing Teacher within the last 3 years (may include residency or clinical practicum)·Valid Deaf and Hard of Hearing Teacher credential/license or in process in state of practice·Employees must be legally authorized to work in the United States and will be asked for proof upon hire. We are unable to sponsor or take over sponsorship of an employment Visa at this time.·We will consider all qualified applicants for employment, including those with criminal histories, in a manner consistent with the requirements of applicable federal, state, and local laws.·Epic Staffing Group provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, sex, national origin, housing, age, disability or genetics.At Epic Special Education Staffing, you will have the opportunity to apply your unique experience and expertise with school-based special education as your singular focus. We offer stimulating and rewarding careers that provide an opportunity to make a difference in a child's life! Earn more for referring your friends! For a limited time, we are increasing our Referral Bonus for select positions! You could receive up to $2,250 bonus and a $250 charitable contribution! Submit your referrals by October 31, 2025, and ensure your friend begins their contract during the 2025-2026 school year to qualify.By applying for this position, you agree that any calls from Epic Staffing Group and its subsidiaries may be monitored or recorded for training and quality assurance purposes.
Full Time
6/10/2025
Oakland, CA 94616
(43.9 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
6/20/2025
Vallejo, CA 94589
(27.5 miles)
Physical Therapist Assistant (PTA) We are seeking a dedicated Physical Therapist Assistant (PTA) to support licensed physical therapists in providing therapeutic care. In this role, you will help patients improve mobility, strength, and overall functionality through tailored treatment plans. Key Responsibilities: Assist physical therapists in implementing treatment plans designed to meet individual patient needs.Guide patients through therapeutic exercises and activities aimed at improving mobility and strength.Monitor patient progress during therapy sessions and document findings for review by the supervising therapist.Educate patients and families on exercises or techniques to continue therapy at home.Maintain a clean and organized treatment area and ensure equipment is properly maintained. Work Environment: The role is based in various settings such as hospitals, outpatient clinics, or rehabilitation facilities.This position requires physical stamina as it involves assisting patients with mobility exercises throughout the day. Benefits: A competitive salary with opportunities for career growth within physical therapy settings.A comprehensive benefits package including health insurance, retirement savings plans, and paid time off.Access to continuing education programs to maintain certification and enhance skills as a PTA. Equal Opportunity Employer: Your commitment to improving patient outcomes is valued here. We strive to create an inclusive environment where all employees can thrive professionally while delivering exceptional care to our patients during their recovery journeys. *This information is based on the Bureau of Labor Statistics (BLS). Actual job responsibilities may vary by location.*
Full Time
7/1/2025
Petaluma, CA 94952
(7.1 miles)
We. Are. OneStaff. Medical. An independently-owned, nationally-recognized and amazingly awesome staffing firm ready to work for you! A work ethic forged in the Midwest, we are here to stand by your side and help you find your dream assignment anywhere in this great country. We want the same like-minded, awesome candidates to travel with us. Be bold. Enjoy work again. Let us help. THE POSITION: Helps occupational therapy clients by providing rehabilitative services, under the direction of occupational therapists, to persons with mental, physical, emotional, or developmental impairments. *Weekly amount stated in the job postings is scaled based on estimated hourly wages and potential stipends available for the location of the assignment. Hourly wages are based on various factors including but not limited to: experience, demand, availability, location, etc. Please contact one of our amazing OneStaff Recruiting Specialists for more details. **Equal Opportunity Employer** BENEFITS: Insurance We provide group benefits for Health, Dental, Vision, Life, Short Term Disability, Long Term Disability, Accident, Critical Illness, and Identity Theft Protection. 401K You are eligible to enroll 1st of the month following hire date. We match 100% of your first 3% of deferrals and an additional 50% of the next 2% you contribute. Employee Assistance Program Free to all employees who’d like information on personal issues: Education, Dependent Care, Care Giving, Legal, Financial, Lifestyle & Fitness Management, Working Smarter.
Full Time
6/22/2025
Oakland, CA 94616
(43.9 miles)
ABOUT USTogether, we are the Epic Special Education Staffing family and family is how we view each member of this incredible community. From our family to the nation’s schools, we remain focused on providing a world of opportunities for you to leverage your abilities and make an impact on special education. Apply today!POSITION DESCRIPTIONEpic Special Education Staffing is partnering with an exceptional school district who is looking for a contract Teacher certified in Visual Impairment (TVI) for the 2025 - 2026 school year.·Duration: ASAP - 05/28/2026·Location: Oakland, CA·Location Type: On-Site·Schedule: Full Time·Hours: 37.50·Grade/Age Levels: Elementary School;High School;Kindergarten;Middle School;Pre-K·Weekly Pay Range: $32.50 – $37.38 per hour on a local contractBENEFITSWe offer a variety of benefits for you and your loved ones. As a valued and respected part of the Epic family, you will enjoy:·Competitive compensation packages for both local and travel contracts·Medical, Dental, and Vision benefits·Infertility & Domestic Partner Coverage·Summer Insurance Coverage·PTO & Holiday Pay·401K matching·Wellness and Employee Assistance Program (EAP)·CEU & license reimbursements·Referral bonuses of $1000QUALIFICATIONSThe minimum qualifications for Teacher certified in Visual Impairment (TVI):·1 year of verifiable, professional experience as Teacher certified in Visual Impairment (TVI) within the last 3 years (may include residency or clinical practicum)·Valid Teacher certified in Visual Impairment (TVI) credential/license or in process in state of practice·Employees must be legally authorized to work in the United States and will be asked for proof upon hire. We are unable to sponsor or take over sponsorship of an employment Visa at this time.·We will consider all qualified applicants for employment, including those with criminal histories, in a manner consistent with the requirements of applicable federal, state, and local laws.·Epic Staffing Group provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, sex, national origin, housing, age, disability or genetics.At Epic Special Education Staffing, you will have the opportunity to apply your unique experience and expertise with school-based special education as your singular focus. We offer stimulating and rewarding careers that provide an opportunity to make a difference in a child's life! Earn more for referring your friends! For a limited time, we are increasing our Referral Bonus for select positions! You could receive up to $2,250 bonus and a $250 charitable contribution! Submit your referrals by October 31, 2025, and ensure your friend begins their contract during the 2025-2026 school year to qualify.By applying for this position, you agree that any calls from Epic Staffing Group and its subsidiaries may be monitored or recorded for training and quality assurance purposes.
Full Time
6/10/2025
Oakland, CA 94616
(43.9 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
7/1/2025
Vallejo, CA 94589
(27.5 miles)
We. Are. OneStaff. Medical. An independently-owned, nationally-recognized and amazingly awesome staffing firm ready to work for you! A work ethic forged in the Midwest, we are here to stand by your side and help you find your dream assignment anywhere in this great country. We want the same like-minded, awesome candidates to travel with us. Be bold. Enjoy work again. Let us help. THE POSITION: Speech Therapist work with patients across multiple age groups to facilitate the treatment of speech and language disorders, such as stammers, stutters, Tourettes and mutism. *Weekly amount stated in the job postings is scaled based on estimated hourly wages and potential stipends available for the location of the assignment. Hourly wages are based on various factors including but not limited to: experience, demand, availability, location, etc. Please contact one of our amazing OneStaff Recruiting Specialists for more details. **Equal Opportunity Employer** BENEFITS: Insurance We provide group benefits for Health, Dental, Vision, Life, Short Term Disability, Long Term Disability, Accident, Critical Illness, and Identity Theft Protection. 401K You are eligible to enroll 1st of the month following hire date. We match 100% of your first 3% of deferrals and an additional 50% of the next 2% you contribute. Employee Assistance Program Free to all employees who’d like information on personal issues: Education, Dependent Care, Care Giving, Legal, Financial, Lifestyle & Fitness Management, Working Smarter.
Full Time
6/10/2025
Oakland, CA 94616
(43.9 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
7/1/2025
Vallejo, CA 94589
(27.5 miles)
We. Are. OneStaff. Medical. An independently-owned, nationally-recognized and amazingly awesome staffing firm ready to work for you! A work ethic forged in the Midwest, we are here to stand by your side and help you find your dream assignment anywhere in this great country. We want the same like-minded, awesome candidates to travel with us. Be bold. Enjoy work again. Let us help. THE POSITION: Speech Therapist work with patients across multiple age groups to facilitate the treatment of speech and language disorders, such as stammers, stutters, Tourettes and mutism. *Weekly amount stated in the job postings is scaled based on estimated hourly wages and potential stipends available for the location of the assignment. Hourly wages are based on various factors including but not limited to: experience, demand, availability, location, etc. Please contact one of our amazing OneStaff Recruiting Specialists for more details. **Equal Opportunity Employer** BENEFITS: Insurance We provide group benefits for Health, Dental, Vision, Life, Short Term Disability, Long Term Disability, Accident, Critical Illness, and Identity Theft Protection. 401K You are eligible to enroll 1st of the month following hire date. We match 100% of your first 3% of deferrals and an additional 50% of the next 2% you contribute. Employee Assistance Program Free to all employees who’d like information on personal issues: Education, Dependent Care, Care Giving, Legal, Financial, Lifestyle & Fitness Management, Working Smarter.
Full Time
7/3/2025
Oakland, CA 94616
(43.9 miles)
Your Role The Blue Shield of California Commercial Finance team is responsible for providing financial planning and analysis support for the mid to large segment employer groups.The Financial Analyst, Experienced will report to the Financial Analyst, Principal.In this role, you will be responsible for the monthly close deliverables which include analysis, reporting, and summarizing membership and financial data. You will also work with large sets of data to maintain multiple databases, produce monthly and ad hoc reports, and support membership surveys. You will work closely to collaborate with other stakeholders (actuarial,accounting, underwriting, enterprise finance, growth solutions). This position is based out of California.Your WorkIn this role, you will:Provide expertise related to budgeting, revenue recognition, reimbursement, and system and processes changesCorrelates Revenue/Expense to volumes and prepares reports to assist financial management in assessing financial performanceAnalyze membership and financial results, trends, performance metrics and provide root cause analysis to support contracting and/or business decisionsRecommend budget adjustments, and other cost/revenue improvement measuresPerforms detailed variance analysis against expected budget, forecast, prior periods, modeling or other benchmarks as required to support operationsCollect and evaluate data, develop and maintain financial models, analyze results and conduct scenario analyses to support membership and financial forecasts and strategic initiativesCreate, maintain, and manipulate various databases to create meaningful tools for analysisSupport regulatory and third-party surveys, internal and external inquiries, cost accounting, and internal reportingIdentify business process opportunities, test solutions, and revises desk level procedures to reflect changes. Identify opportunities to automate/digitize processesFollow and conduct audit processes and review internal controls to ensure financial transactions are accurate, timely and comply with accounting standards, principles and company policyProvide policy guidance and interpretation to ensure financial records are consistent and comply with company policies and GAAPSupport and potentially lead projects as a subject matter expertYour Knowledge and ExperienceRequires a bachelor's degree or equivalent experienceRequires at least 3 years of prior relevant experienceRequires advanced Office skills (Access, Excel, Word, PowerPoint)Requires experience in Essbase and SAP Business ObjectsBasic SQL/Tableau/Power BI desiredRequires strong communication skills with the ability to explain complex analytical data simply and connect them to business results for different audiencesRequires ability to learn and adapt quickly
Full Time
6/27/2025
Pleasant Hill, CA 94523
(43.3 miles)
Occupational Therapist Join our team as an Occupational Therapist, where you will help individuals regain independence and improve their quality of life through customized therapeutic programs. This role is ideal for professionals passionate about empowering patients to overcome physical, emotional, or developmental challenges. Key Responsibilities: Evaluate patients' conditions and develop individualized treatment plans to address their needs.Plan and implement rehabilitative programs to improve daily living, vocational, and homemaking skills.Utilize therapeutic techniques, adapt environments, and modify tasks to overcome barriers to independence.Collaborate with patients, families, and other healthcare professionals to optimize care outcomes.Educate patients and caregivers on exercises, therapies, and strategies for continued progress outside the clinical setting.Document patient progress and adjust treatment plans as necessary. Work Environment: Work in diverse settings such as hospitals, outpatient clinics, schools, or patients' homes.Engage in a dynamic environment that may require standing for extended periods or assisting clients with mobility challenges. Benefits: Competitive salary with opportunities for professional growth.Comprehensive health, dental, and vision insurance plans.Retirement savings plan with employer contributions.Access to continuing education programs and certifications. Equal Opportunity Employer: We are committed to fostering a diverse and inclusive workplace where all employees feel valued and supported in their professional journey. *This information is based on the Bureau of Labor Statistics (BLS). Actual job responsibilities may vary by location.*
Full Time
7/2/2025
Oakland, CA 94616
(43.9 miles)
Your Role The Risk Adjustment Analytics & Reporting team is looking for an Experienced Actuarial Analyst. The Experienced Actuarial Analyst will report to the Manager of Risk Adjustment Analytics & Reporting. In this role you will create and own various analytical projects that assist providers in accurately capturing the risk score of their member populations. Additional responsibilities include supporting the member suspecting process as well as supporting Blue Shield’s prospective programs.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 reportsQuantify and project risk scores and revenue for the Medicare line of businessConduct complex actuarial analyses to assess risk scores, including performing root cause analysisCreate data-driven solutions for capturing risk and improving quality of care for our membersPerform vendor return on investment analyses to determine ongoing benefit and decision supportPerform other responsibilities as assignedYour Knowledge and Experience Requires a bachelor’s degree with at least a minor in mathematics, statistics, computer science or equivalent business experienceRequires at least 2 years of professional actuarial experienceRequires one to be an independent, proactive problem solver with patience for working on large scale problemsRequires strong technical skillsProgramming knowledge required (SAS and/or VBA preferred), including sample code (in any language)Requires proficiency with Microsoft ExcelPreferred 4+ exams completed in the Society of Actuaries exam process (but not required)
Full Time
6/23/2025
Oakland, CA 94616
(43.9 miles)
Your Role The Network and Trend Analytics team drives the development of an affordable provider network through data analytics and expertise. The Senior Actuarial Analyst will report to the Senior Manager. In this role you will perform financial analyses and modeling for provider contracting support including term changes, renewals, network changes, and terminations for hospitals, ambulatory surgery centers and other types of providers.Your WorkIn this role, you will:Understand the core principles and functionality of decision, descriptive and predictive 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 to 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 efficienciesDevelop evaluation and financial reporting standards for internal and external reportsConduct independent analysis of high complexity under moderate supervision and guidance, develop novel analyses and reportsDevelop documentation and create and execute workplans for analyses of high complexityCreate financial unit cost trend reporting and rate calculations under moderate supervision using Excel modeling toolsRun and maintain SAS queries to gather data required for complex financial analysisReprice historical data against provider contract terms based on deep understanding on contract structure and configurationAnalyze contract rate proposals from hospitals and ambulatory surgery centers to assess the financial and trend impact • Partner with network management department in maintaining and developing the provider network and contracting strategyYour Knowledge and ExperienceRequires a bachelor’s degree with at least a minor in mathematics, statistics, computer science or equivalent business experienceRequires at least 3 years of professional actuarial experienceRequires 2 years of experience in Health Care (managed care, academic, or government payer)Requires experience analyzing healthcare claims data, trends, and forecastingRequires proficiency in Excel and comfort working with large data setsKnowledge of SAS is preferred
Full Time
7/1/2025
Oakland, CA 94616
(43.9 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
Full Time
7/1/2025
Oakland, CA 94616
(43.9 miles)
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
Full Time
7/2/2025
Oakland, CA 94616
(43.9 miles)
Your Role The Actuarial Provider Strategies team is responsible for partnering with the Blue Shield Health Solutions teams on developing, scaling and executing provider-focused strategies that promote high quality, affordable health care. The Network-Growth Partnership role will report to the Vice President of Actuarial Provider Strategies. In this role you will be responsible for converting pricing and financial goals at the line of business and region level into specific action plans at the provider level that the Network team can execute.Your Work In this role, you will: Be responsible for converting pricing and financial goals at the line of business and region level into specific action plans at the provider level that the Network team can executeCreate value for the Growth team General Managers by ensuring they have a voice when it comes to key network decisions and network strategyCreate value for the Network team by organizing and focusing the various requests from the General Managers and Pricing Team into a prioritized, workable listBe required to have strong influencing skills across multiple functions within Blue Shield with a drive towards consensus, and an ability to handle shifting priorities and ambiguity with agilityLead, coordinate and/or develop strategic, market and competitive analysisConduct 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 strategies Your Knowledge and Experience Requires a bachelor's degree in mathematics, statistics, computer science or equivalent business experienceRequires an ASARequires at least 8 years of professional actuarial experienceRequires at least 1 year of pricing experience, with experience in multiple lines of business desiredRequires at least 2 years of experience in actuarial provider contracting analysis
Full Time
7/4/2025
Oakland, CA 94616
(43.9 miles)
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
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