Job Posting for Operations Specialist, Experienced at Blue Shield of CA
Your Role
The Delegation Oversight (DO) team, under the purview of the Delegation Oversight Committee (DOC) which is a sub-committee of the Quality Oversight Committee (QOC), is responsible for oversight of contracted delegated entities. This includes auditing, corrective actions follow-up and monitoring activities. The DO team will coordinate with other internal departments on oversight activities. Reporting to the Manager, Delegation Oversight, this role is responsible for documentation of policies and procedures, uploading to the DORMS database, and oversight of LA Care audits and quality review along with submission of data to compliance. The Operations Specialist, Experienced is also responsible for working with colleagues on coordination and submission of state reporting to the Department of Managed Health Care.
Your work
In this role, you will:
Act as a subject matter expert (SME) to review operational workflows of high degree of complexity and/or for multiple departments, identifying problems and developing improvements, modifications, and enhancements
Develop and evaluate tools and materials that enhance operating efficiency, accuracy, and technical skill levels of unit staff
Develop and generate reports ranging from routine to moderately complex for management review
Track and communicate workflow and system changes to appropriate resources
Participate as a SME in the development of written guidelines and documents problems
Assist with documentation needs as needed
Maintain databases required for business operations
Perform other duties as assigned
Your Knowledge and Experience
Requires a bachelor's degree or equivalent experience
Requires 3 years of prior relevant experience. Experience working in or with IPA/Medical Groups is preferred
Strong verbal and written communication skills
Strong knowledge of Microsoft Office products
Strong organizational and attention to detail skills
Pay Range:
The pay range for this role is: $66,770.00 to $93,390.00 for California.
Note:
Please note that this range represents the pay range for this and many other positions at Blue Shield that fall into this pay grade. Blue Shield salaries are based on a variety of factors, including the candidate's experience, location (California, Bay area, or outside California), and current employee salaries for similar roles.
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.
Salary.com Estimation for Operations Specialist, Experienced in Long Beach, CA
$60,608 to $88,891
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