Top 18 Utilization review administrative specialist Jobs in Roseville, Ca

Operations Specialist, Associate
Blue Shield of California —El Dorado Hills, CA
- $28.33 - $39.66 an hour
- Full-time
- Hybrid work
- Background check
- Writing skills
- Pass drug screening
- Work from home
1d
Utilization Review Administrative Specialist
CorVel Corporation —Folsom, CA
- $16.74 - $26.92 an hour
- Full-time
- Remote
- Computer literacy
- High school diploma or GED
- Organizational skills
- Health savings account
- Disability insurance
Quick Apply
Administrative Operations Specialist
GrowthWise Search Partners —Roseville, CA
- $33 - $36 an hour
- Part-time
- Hybrid work
- Microsoft Outlook
- Mid-level
- Office
- Paid time off
Quick Apply
Health Care Professional – Utilization Review / First-Level Reviewer
Encompass Health Solutions, Inc. —Sacramento, CA
- $42 - $45 an hour
- Overtime
- Remote
- LVN
- RN License
- Mid-level
Quick Apply
17h
Registration Specialist/Administrative Assistant
Christ the King Retreat Center —Citrus Heights, CA
- $21 an hour
- Full-time
- Entry level
- Resort
Office Specialist Level I/II
Sacramento County, CA —Sacramento, CA
- $46,061.28 - $62,953.20 a year
- Online Application
- Writing skills
- Basic math
- No experience needed
- Health savings account
- Disability insurance
14d
Senior Administrative/Document Control Specialists – Northern California
Parsons —Sacramento, CA
- $26.59 - $46.54 an hour
- Microsoft Excel
- Microsoft Outlook
- Office
- Wellness program
- Paid holidays
6d
Administrative Analyst (Professional Standards Unit)
City of Sacramento —Sacramento, CA
- $75,777.96 - $106,627.20 a year
- Email
- Mid-level
- Office
- Analysis skills
- Disability insurance
13d
Rent Administration Specialist
AWI Management Corporation —Roseville, CA
- $26 - $28 an hour
- Full-time
- Mid-level
- Office
- Organizational skills
- Dental insurance
- Paid time off
Quick Apply
14d
Office Support Professional
Cintas —Sacramento, CA
- $19.84 - $25.01 an hour
- Full-time
- Microsoft Excel
- Microsoft Outlook
- English
- Profit sharing
- AD&D insurance
Medical Front Office - Patient Service Specialist
Select Physical Therapy —Sacramento, CA
- $23 - $25 an hour
- Full-time
- Spanish
- Physical & Rehabilitation Medicine
- English
- Health insurance
- Dental insurance
7d
Operations Specialist
International Rescue Committee —Sacramento, CA
- $26 - $27 an hour
- Full-time
- English
- Mid-level
- Office
- 403(b) matching
- Disability insurance
2d
Construction Support Specialist (Administrative support )
Partner Engineering and Science Inc. —Roseville, CA
- $19 - $24 an hour
- Weekends as needed
- Microsoft Word
- English
- Mid-level
Quick Apply

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Operations Specialist, Associate
Blue Shield of California —El Dorado Hills, CA
In this role you will assist with audit preparedness, act as a Behavioral Health subject matter expert (SME) for Utilization Management and Care Coordination/…
$28.33 - $39.66 an hour
1d
Utilization Review Administrative Specialist
CorVel Corporation —Folsom, CA
The Utilization Review (UR) Intake Specialist provides staff support services including typing reports and correspondence, file handling and forms completion in…
$16.74 - $26.92 an hour
Quick Apply

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Operations Specialist, Associate

Blue Shield of California -
El Dorado Hills, CA

Apply Now

Job Details

Full-time
$28.33 - $39.66 an hour
1 day ago

Benefits

Work from home

Qualifications

Risk assessment

Full Job Description

Your Role

The Behavioral Health Utilization Management team provides Utilization Management and Care Coordination for Promise Blue Shield members seeking BHT services. The Operations Specialist, Associate will report to the Sr. Manager of Behavioral Health Utilization Management. In this role you will assist with audit preparedness, act as a Behavioral Health subject matter expert (SME) for Utilization Management and Care Coordination/Management systems development and testing, and contribute to the development of tools, processes, and frameworks that advance best practices and deliver successful utilization management of behavioral health services.

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:

Act as subject matter expert and review operational workflows, identifying problems and acting as a SME to inform improvements, modifications, and enhancements
Track and communicate workflow and system changes to appropriate resources
Review systems and applications and recommend system edits/changes as needed
Notify appropriate department managers about issues and problems in operational workflow requiring immediate attention
Participate as a subject matter expert to inform the development of written guidelines and documents problems as needed
Assist with audit readiness including file preparation and risk assessment
Conduct system testing for Utilization Management and Care Management
Support department oversight and daily operations through report and system review; providing validation and escalating issues to leadership as needed

Your Knowledge and Experience

Requires a bachelor’s degree; or high school (GED) and 4 years relevant experience
0 years of prior relevant experience required if bachelor’s degree
4 years of prior relevant experience if high school or GED
Requires health plan (managed care, government payer, academic) or healthcare experience (working for a provider)
Foundational understanding of managed care utilization management, preferred
Experience with writing workflows and processing documentation, preferred
Ability to work independently
Strong critical thinking skills with attention to detail

Hybrid

This role requires employees to be in-office based on our hybrid workplace model, balancing purposeful in-person collaboration with flexibility. For most teams, this means coming into the office two days each week.

Employees living more than 50 miles from an office location will work with their manager to determine in-office time based on business need.

ABOUT THE TEAM
About Blue Shield of California

As of January 2025, Blue Shield of California became a subsidiary of Ascendiun. Ascendiun is a nonprofit corporate entity that is the parent to a family of organizations including Blue Shield of California and its subsidiary, Blue Shield of California Promise Health Plan; Altais, a clinical services company; and Stellarus, a company designed to scale healthcare solutions. Together, these organizations are referred to as the Ascendiun Family of Companies.

At Blue Shield of California, our mission is to create a healthcare system worthy of our family and friends and sustainably affordable. We are transforming health care in a way that genuinely serves our nonprofit mission by lowering costs, improving quality, and enhancing the member and physician experience.

To achieve our mission, we foster an environment where all employees can thrive and contribute fully to address the needs of the various communities we serve. We are committed to creating and maintaining a supportive workplace that upholds our values and advances our goals.

Blue Shield is a U.S. News Best Company to work for, a Deloitte U.S. Best Managed Company and a Top 100 Inspiring Workplace. We were recognized by Fair360 as a Top Regional Company, and one of the 50 most community-minded companies in the United States by Points of Light. Here at Blue Shield, we strive to make a positive change across our industry and communities – join us!

Our Values:

Honest. We hold ourselves to the highest ethical and integrity standards. We build trust by doing what we say we're going to do and by acknowledging and correcting where we fall short.
Human. We strive to listen and communicate effectively, showing empathy by understanding others' perspectives.
Courageous. We stand up for what we believe in and are committed to the hard work necessary to achieve our ambitious goals.

Our Workplace Model

We believe in fostering a workplace environment that balances purposeful in-person collaboration with flexibility - providing clear expectations while respecting the diverse needs of our workforce. Our workplace model is designed around intentional in-person interaction, collaboration, connection, creativity and flexibility:

For most teams, this means coming into the office two days per week.
Employees living more than 50 miles from an office location, out of state employees, and employees in certain member-facing roles should work with their manager to determine in-office time based on business need.
For employees with medical conditions that may impact their ability to work in-office, we are committed to engaging in an interactive process and providing reasonable accommodations to ensure their work environment is conducive to their success and well-being.

The Company reserves the right to require more presence in the office based on business needs, and requirements are subject to change with periodic reviews.

Physical Requirements:

Office Environment - roles involving part to full time schedule in Office Environment. Based in our physical offices and work from home office/deskwork - Activity level: Sedentary, frequency most of work day.

Equal Employment Opportunity:

External hires must pass a background check/drug screen. Qualified applicants with arrest records and/or conviction records will be considered for employment in a manner consistent with Federal, State and local laws, including but not limited to the San Francisco Fair Chance Ordinance. All qualified applicants will receive consideration for employment without regards to race, color, religion, sex, national origin, sexual orientation, gender identity, protected veteran status or disability status and any other classification protected by Federal, State and local laws.

Apply Now

Refine Your Search

utilization review administrative specialist jobs in roseville, ca

Operations Specialist, Associate

Utilization Review Administrative Specialist

Administrative Operations Specialist

Health Care Professional – Utilization Review / First-Level Reviewer

Registration Specialist/Administrative Assistant

Office Specialist Level I/II

Senior Administrative/Document Control Specialists – Northern California

Administrative Analyst (Professional Standards Unit)

Rent Administration Specialist

Office Support Professional

Medical Front Office - Patient Service Specialist

Operations Specialist

Construction Support Specialist (Administrative support )

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