Top 5027 Operational quality services specialist, associate Jobs in Irwindale, Ca

Operational Quality Services Specialist, Associate
Blue Shield of California —Long Beach, CA
- $28.34 - $39.67 an hour
- Full-time
- Hybrid work
- Background check
- Pass drug screening
- Mid-level
- Work from home
Associate Attorney - Workers Compensation Defense
Louie & Stettler —Burbank, CA
- From $100,000 a year
- Full-time
- Writing skills
- Analysis skills
- US work authorization
- Health insurance
- Dental insurance
Quick Apply
6d
Associate Veterinarian
Covina Pet Care —Covina, CA
- $120,000 - $180,000 a year
- Full-time
- Surgery
- Entry level
- Continuing education credits
- Paid holidays
Quick Apply
Litigation Associate Attorney - Employment (Open to All Levels)
Jaurigue Law Group —Glendale, CA
- $150,000 - $180,000 a year
- Full-time
- Microsoft Word
- Microsoft Excel
- Writing skills
- Free parking
- Paid holidays
Quick Apply
5d
Associate Attorney (Entry Level)
HBK Lawyers —Glendale, CA
- $100,000 - $150,000 a year
- Full-time
- Hybrid work
- In-person
- Communication skills
- Entry level
- Health insurance
- Dental insurance
Quick Apply
Associate Attorney
Agajanian, McFall, Weiss & Tetreault LLP —Los Angeles, CA
- $120,000 - $150,000 a year
- Full-time
- Hybrid work
- Mid-level
- Office
- Profit sharing
- Disability insurance
Quick Apply
HR/Admin Associate (Bilingual English/Korean)
PK Retail Holdings —Brea, CA
- $26 - $33 an hour
- Full-time
- Background check
- Microsoft Outlook
- English
- Health insurance
- Dental insurance
Quick Apply
Associate Attorney - Labor & Employment
O'Hagan Meyer —Los Angeles, CA
- $170,000 - $215,000 a year
- Full-time
- Hybrid work
- Writing skills
- Mid-level
- 3 years
- Paid parental leave
- Health insurance
Quick Apply
Litigation Associate Attorney
The Dominguez Firm, Inc. —Los Angeles, CA
- From $140,000 a year
- Full-time
- Hybrid work
- Spanish
- US work authorization
- Senior level
- Paid holidays
- Health insurance
Quick Apply
Supervisor, Transportation Network Management
Inland Empire Health Plan —Rancho Cucamonga, CA
- $80,059.20 - $106,059.20 a year
- Full-time
- Hybrid work
- Microsoft Word
- Mid-level
- Office
- Disability insurance
- Health insurance
Associate Attorney
Wood, Smith, Henning & Berman —Glendale, CA
- $110,000 - $160,000 a year
- Full-time
- Hybrid work
- Writing skills
- Mid-level
- Disability insurance
- Health insurance
Quick Apply
5d
Associate Attorney - Consumer Class Action (RCRM only)
Wilshire Law Firm —Los Angeles, CA
- $185,000 - $250,000 a year
- Full-time
- 18 years or older
- Mid-level
- Office
- AD&D insurance
- Paid holidays
Senior Associate Attorney - Family Law
Confidential —California
- $220,000 - $320,000 a year
- Full-time
- Remote
- US work authorization
- Organizational skills
- Senior level
- Profit sharing
- Paid holidays
Quick Apply
Workers' Compensation Defense Associate Attorney Hybrid Remote
DJG Law Group —Anaheim, CA
- $90,000 - $195,000 a year
- Full-time
- Hybrid work
- Mid-level
- Communication skills
- Under 1 year
- Disability insurance
- Health insurance
Quick Apply
Associate Attorney - Workers' Compensation
PEARLMAN, BROWN & WAX —Orange, CA
- $100,000 - $175,000 a year
- Urgently hiring
- Hybrid work
- Research
- Mid-level
- 3 years
- Health insurance
- Dental insurance
Quick Apply
6d
Associate Attorney - Consumer Class Action
Confidential —Los Angeles, CA
- $150,000 - $200,000 a year
- Full-time
- Hybrid work
- Mid-level
- 3 years
- Typing
Quick Apply
Associate Dentist
WEST COAST DENTAL ADMINISTRATIVE SERVICES LLC —South Gate, CA
- $200,000 - $400,000 a year
- Full-time
- Dental office
- Doctoral degree
- Children
- Health insurance
- Dental insurance
Quick Apply
13d
Associate Attorney
Wood, Smith, Henning & Berman —Ontario, CA
- $110,000 - $160,000 a year
- Full-time
- Hybrid work
- Writing skills
- Mid-level
- 1 year
- Disability insurance
- Health insurance
Quick Apply
Civil Engineer Mid Level
LEE + RO —City of Industry, CA
- $79,040 - $151,840 a year
- Full-time
- Microsoft Word
- Background check
- Microsoft Excel
- Relocation assistance
- Health insurance
Quick Apply
Associate Attorney | Medical Malpractice Defense | Hybrid
LaFollette Johnson DeHaas Fesler & Ames —Glendale, CA
- $120,000 - $165,000 a year
- Full-time
- Hybrid work
- Mid-level
- US work authorization
- Organizational skills
- Health savings account
- Health insurance
Quick Apply

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operational quality services specialist, associate jobs near irwindale, ca

Operational Quality Services Specialist, Associate

Blue Shield of California -
Long Beach, CA

Apply Now

Job Details

Full-time
$28.34 - $39.67 an hour

Benefits

Work from home

Qualifications

Health insurance knowledge

Full Job Description

Your Role

The Medi-Cal Operations team is responsible for ensuring claims are processed accurately and in a timely manner. The Operational Quality Services Specialist, Associate will report to the Medi-Cal Operations Senior Manager of direct manager. In this role you will be responsible for performing audits that are routine in nature for the Medi-Cal line of business for all claim types.

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:

Be responsible for performing basic production and quality control audits for internal claims and Medi-Cal providers that are routine in nature where limited judgement is required
Assure quality to in-house and/or external specifications and standards
Conduct comprehensive quality reviews of claims, enrollment, or customer service using a standard audit model
Be responsible for identifying revision of policies and procedures to comply with regulatory changes and for training internal staff or delegated providers
Initiate corrective measures and track timely completion
Identify and resolve routine problems independently; escalate issues with Supervisor as appropriate
Identify root cause of errors and perform impact analysis as well as the ability to effectively communicate mitigation steps to appropriate parties
Maintain current and comprehensive knowledge of all applicable claims regulatory requirements, including AB 1455 and DHCS regulations
Ability to independently review and interpret standards, procedural documentation, contracts and legal verbiage
Responsible for providing guidance, coaching and training to other employees within job area
Other related duties as assigned

Your Knowledge and Experience

Requires a college degree or equivalent experience
Requires relevant experience
Prior auditing experience preferred
Minimum 1 or more years previous claims processing experience of all claim types

Hybrid Virtual Work

This role allows employees to work virtually full-time, however employees will be expected to come to the office 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

operational quality services specialist, associate jobs in irwindale, ca

Operational Quality Services Specialist, Associate

Associate Attorney - Workers Compensation Defense

Associate Veterinarian

Litigation Associate Attorney - Employment (Open to All Levels)

Associate Attorney (Entry Level)

Associate Attorney

HR/Admin Associate (Bilingual English/Korean)

Associate Attorney - Labor & Employment

Litigation Associate Attorney

Supervisor, Transportation Network Management

Associate Attorney

Associate Attorney - Consumer Class Action (RCRM only)

Senior Associate Attorney - Family Law

Workers' Compensation Defense Associate Attorney Hybrid Remote

Associate Attorney - Workers' Compensation

Associate Attorney - Consumer Class Action

Associate Dentist

Associate Attorney

Civil Engineer Mid Level

Associate Attorney | Medical Malpractice Defense | Hybrid

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