Top 13 Shield of Jobs in Placerville, Ca

Regulatory Complaint Coordinator, Intermediate
Blue Shield of California —El Dorado Hills, CA
- $21.73 - $30.43 an hour
- Full-time
- Hybrid work
- Background check
- Pass drug screening
- Research
- Work from home
6d
Manager, Behavioral Health Utilization Management
Blue Shield of California —El Dorado Hills, CA
- $111,540 - $167,420 a year
- Full-time
- Hybrid work
- Background check
- LMFT
- Nursing
- Work from home
Utilization Management Nurse, Senior
Blue Shield of California —El Dorado Hills, CA
- $90,860 - $136,290 a year
- Weekends as needed
- Hybrid work
- Background check
- Nursing
- RN License
- Work from home
Care Management - Nurse, Senior
Blue Shield of California —El Dorado Hills, CA
- $90,860 - $136,290 a year
- Weekends as needed
- Hybrid work
- Background check
- Nursing
- 5 years
- Work from home
Platform Administrator, Consultant
Blue Shield of California —El Dorado Hills, CA
- $111,500 - $167,400 a year
- Full-time
- Hybrid work
- Background check
- Pass drug screening
- Office
- Work from home
Product Manager, Consultant
Blue Shield of California —El Dorado Hills, CA
- $123,100 - $184,800 a year
- Full-time
- Hybrid work
- Background check
- 6 years
- Bachelor of Science
- Work from home
Accountant, Consultant - Automation & Process Improvement
Blue Shield of California —El Dorado Hills, CA
- $111,540 - $167,420 a year
- Full-time
- Hybrid work
- Background check
- 7 years
- Microsoft Excel
- Work from home
Product Strategist, Consultant - Small Business
Blue Shield of California —El Dorado Hills, CA
- $123,090 - $184,800 a year
- Full-time
- Hybrid work
- Background check
- 7 years
- Pass drug screening
- Work from home
Product Manager, Consultant - Automation & AI Business Delivery
Blue Shield of California —El Dorado Hills, CA
- $123,100 - $184,800 a year
- Full-time
- Hybrid work
- Background check
- 6 years
- Bachelor of Science
- Work from home
Medical Informatics Analyst, Principal
Blue Shield of California —El Dorado Hills, CA
- $148,940 - $223,300 a year
- Full-time
- Hybrid work
- Background check
- 5 years
- Pass drug screening
- Work from home
7d
Product Manager, Senior
Blue Shield of California —El Dorado Hills, CA
- $102,700 - $154,200 a year
- Full-time
- Hybrid work
- Background check
- Bachelor of Science
- Pass drug screening
- Work from home
Digital Personalization Product Manager
Blue Shield of California —El Dorado Hills, CA
- $123,100 - $184,800 a year
- Full-time
- Hybrid work
- Background check
- 6 years
- Computer Science
- Work from home

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shield of jobs near placerville, ca

Regulatory Complaint Coordinator, Intermediate

Blue Shield of California -
El Dorado Hills, CA

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Job Details

Full-time
$21.73 - $30.43 an hour
6 days ago

Benefits

Work from home

Qualifications

Research
High school diploma or GED

Full Job Description

Your Role

The Appeals and Grievance Department Regulatory team is responsible for responding to inquiries received directly from our state regulatory agencies. The Regulatory Complaint Coordinator, Intermediate, will report to the Regulatory Complaint Supervisor. In this role you will be responsible for effectively managing your time daily to ensure you are meeting and/or exceeding compliance, quality, and production metrics.

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:

Prepare detailed file summary responses for submission to multiple regulatory, legislative, and accreditation agencies.
Be involved in evaluating and researching end-to-end timelines of member health provider services, claim processing, and other data to determine decision and/or alternative ways to resolve grievance/appeal.
Respond to the most complex and highest financial and/or goodwill impact regulatory complaint inquiries.
Research the data files and develop a timeline of events and gather missing information from third parties such as medical providers, to determine the response to the inquiry.
Respond to correspondence addressed to highest level executives regarding issues and/or concerns that an individual (member or non-member) may have.

Your Knowledge and Experience

Requires a high school diploma or GED
Requires at least 3 years of experience

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

shield of jobs in placerville, ca

Regulatory Complaint Coordinator, Intermediate

Manager, Behavioral Health Utilization Management

Utilization Management Nurse, Senior

Care Management - Nurse, Senior

Platform Administrator, Consultant

Product Manager, Consultant

Accountant, Consultant - Automation & Process Improvement

Product Strategist, Consultant - Small Business

Product Manager, Consultant - Automation & AI Business Delivery

Medical Informatics Analyst, Principal

Product Manager, Senior

Digital Personalization Product Manager

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