Learn about Blue Shield of California culture, salaries, benefits, work-life balance, management, job security, and more. Blue Shield of California Effective January 1, 2022, the Department of Health Care Services (DHCS) will transition all administrative services related to Medi-Cal Managed Care (Medi-Cal) pharmacy benefits billed on pharmacy claims from the existing fee-for-service fiscal intermediary (FI) under Medi-Cal or the member’s managed care plan to DHCS’ new pharmacy vendor/FI for Medi-Cal, Magellan … Blue Shield Of California Learn how Anthem is providing help for members impacted by the California wildfires. If you are a member of UC High Option Supplement to Medicare or UC Medicare PPO with Prescription Drugs, you should also receive an ID card from OptumRx for pharmacy benefits. Blue Shield of California is a tax paying, nonprofit, independent member of the Blue Shield Association with over 4.5 million members, over 7,500 employees and more than $21 billion in annual revenue. Pharmacy network | Blue Shield Medicare Blue Shield also pays for insurance coverage for accidental death or injury while traveling on Blue Shield business. The lower costs advertised in our plan materials for these pharmacies may not be available at the pharmacy you use. Call Blue Shield’s member services at 855.829.3566 or go to Blue Shield’s web site at www.blueshieldca.com for more information. Next-gen pharmacy benefit manager Capital Rx signs Health Equity Pledge to leverage data in addressing disparities ... Blue Cross and … Blue Shield of California Pharmacy Benefit Management - Blue Shield of California The typical Blue Shield Of California Pharmacy Technician salary is $23 per hour. Lowest cost. Claims reports. Generic drugs are as effective, safe and high quality as their brand … Blue Shield of California hiring Program Manager ... Simply present your Blue Shield ID card to the network pharmacy of your choice. Talk to a licensed agent: 833-959-1535 | TTY 711. PPO members: Assistance with transition from Blue Blue Shield of California is a non-profit mutual benefit corporation and health plan founded in 1939 by the California Medical Association. Urgent care. Blue Shield Of California Pharmacy Benefits Management … 800-995-2800. Unfortunately this position has been closed but you can search our 325 open jobs by clicking here . Blue Shield Of California Work From Home. Posted 10:22:55 AM. Anthem Blue Blue Shield of California and Blue Shield of California Life & Health Insurance Company are qualified to provide quality and affordable pharmacy benefits to our members. Coronavirus Update FEP will waive early medication refill limits on 30-day prescription maintenance medications. Vinay Panchal, PharmD, MBA, BCPS Sr. Pharmacist Manager, Pharmacy Benefit Prior Authorization at Blue Shield of California San Francisco Bay Area 500+ connections Each level has a different copay or coinsurance. Los Angeles, CA 90051-6127. The average Blue Shield of California salary ranges from approximately $50,000 per year for Auditor to $274,000 per year for Director of Internal Audit. 122 employees reported this benefit. Overview Overview 1.5k Reviews 282 Jobs 1.8k Salaries 203 Inter­views 556 Benefits 24 Photos. Blue Cross Blue Shield Association. El Dorado Hills, CA 95726. The call is free. Blue Shield of California and St. Joseph Health System announced an accountable care initiative, set to launch Jan. 1, 2012, which is designed to serve approximately 30,000 Blue Shield HMO members in Orange County, Calif., who are patients of SJHS.. SJHS's regional delivery system in the county, includes St. Joseph Hospital in Orange, St. Jude Medical Center in … The Blue Cross and Blue Shield Service Benefit Plan has a variety of pharmacy programs to meet your prescription needs. Blue Shield of California, Kaiser Permanente, and UnitedHealthcare Group Medicare Advantage PPO health plans were not affected. Care Management. Your Knowledge and Experience. Thanks for your interest in the Program Manager, Principal position. Here at Blue Shield of California, we are striving to make a positive change across our industry and the communities we live in – join us! Kaiser (HMO) Kaiser Permanente (800) 305-1220. Box 629005. 24/7 online access to account transactions and other useful resources, help to ensure that your account information is available to you any time of the day or night. SUBJECT: BLUE SHIELD OF CALIFORNIA’S PHARMACY BENEFIT MANAGER TRANSITION . One of the ways Blue Shield supports employees’ well-being is through Wellvolution®, a suite of programs that are social and fun and can help with health goals such as weight management, nutrition, and smoking cessation. Blue Shield of California's recognition program is called L.O.V.E. (Living Our Values Every day). We are a not-for-profit, independent member of the Blue Cross Blue Shield Association with 7,500 employees, more than $21 billion in annual revenue and 4.5 million members. It focuses on condition management and whole-person care, according to the announcement. Pharmacy. Fair hiring practices Blue Shield of California is an Equal Opportunity Employer.All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, gender identity, sexual orientation, or protected veteran status, and abides by both Employee Rights and Pay Transparency practices. Include in medical claim. Salary information comes from 4 data points collected directly from employees, users, and past and present job advertisements on Indeed in the past 36 months. ** Prescription Network The SCPT Health Funds partnership with Blue Shield of California to take advantage of Blue Shiels's pharmacy provider to provide discounts on prescription medication. Accidental injury benefit. COVID update: Blue Shield of California has updated their hours and services. Blue Shield Pharmacy Benefits Direct Pay Payee Blue Shield of California. Select Blue Cross Blue Shield Global™ or GeoBlue if you have international coverage and need to find care outside the United States. Unfortunately this position has been closed but you can search our 325 open jobs by clicking here . Express Scripts is the prescription drug administrator for the MCSIG HDHP plan. Online bill pay. Salary information comes from 1 data point collected directly from employees, users, and past and present job advertisements on Indeed in the past 24 months. With a four-level drug benefit, prescription medications fall into one of four categories or “levels.”. Druing your web experience you may be transferred to the Prime Therapeutics website. The purpose of Blue Shield of California's Managed Care Pharmacy Residency Program is to prepare residents for a career in managed care pharmacy. Attn: Cash Receiving. 30% per Tier 4 prescription, up to $300 max (excluding specialty drugs) Dental care. Average Blue Shield of California Senior Manager yearly pay in the United States is approximately $142,528, which is 21% above the national average. Blue Shield of California is your claims administrator for the County of Orange Wellwise Choice PPO, Sharewell Choice PPO, Wellwise Retiree PPO, Sharewell Retiree PPO and the County of Orange Management and Attorney dental plans. Kaiser (HMO) Kaiser Permanente (800) 305-1220. Call Member Services at 1-844-396-2329 (TTY 711). The program provides opportunities to develop proficient clinical, project management, analytical, and leadership skills, and is customized based on the resident’s professional goals. Project Manager | Pharmacy Benefit Management Advanced Medical Reviews Sep 2012 - 2015 3 ... Public Health Research Consultant at Blue Shield of California | Pharmacy Analytics. Blue Cross Blue Shield members can search for doctors, hospitals and dentists: In the United States, Puerto Rico and U.S. Virgin Islands. Blue Shield of California. The Patient Safety and Quality Monitoring (PSQM) program features a set of closely aligned programs that are designed … 4.6. The purpose of this circular letter is to provide information to all employers about Blue Shield’s Pharmacy Benefit Manager (PBM) transition to CVS No: OptumRx is the Pharmacy Benefit Manager (PBM) providing prescription benefits for this health plan. Blue Shield of California, a tax-paying nonprofit with 4.4 million members and $20 billion in revenue, aims to expand those local programs that succeed quickly. Glassdoor is your resource for information about the 401K Plan benefits at Blue Shield Of California. Register or download the Sydney Health app to access all our digital tools, including claims, benefits, pharmacy, and ID cards. With a four-level drug benefit, prescription medications fall into one of four categories or “levels.”. The Pharmacy Markets, Analytics, Products and Strategies team is responsible for leading and collaborating cross-functionally with key stakeholders across Pharmacy and Blue Shield. No: OptumRx is the Pharmacy Benefit Manager (PBM) providing prescription benefits for this health plan. Blue Shield of California’s pharmacy network includes very limited lower-cost, preferred pharmacies in certain counties within California. Pharmacy Benefit Management (PDF, 300KB): … Your Role. Pharmacy Benefit Management. Drug benefit levels. phone: (800) 237-2767. fax: (800) 323-2445. As defined in Health and Safety Code Section 1385.001, a “pharmacy benefit manager” is a person, business, or other entity that, pursuant to a contract with a health care service plan, manages the prescription drug coverage provided by the health care service plan. View Jobs. Member Services: 1-844-396-2329 (TTY 711) Get translation and interpretation services free of charge. For information about coverage under our Affordable Care Act (ACA) ... BlueCross BlueShield of South Carolina is an independent licensee of the Blue Cross Blue Shield … Requires a Master's Degree in Public Health, MBA, MD, PhD, PharmD, or other degree with relevant experience. If you're a Regence member, sign in. Mailing Address. Benefits Manager is a secure site, is easy to use and offers you convenient access to your group’s billing and coverage information online when you need it. This estimate is based upon 12 Blue Shield Of California Pharmacy Technician salary report (s) provided by employees or estimated based upon statistical methods. Your Role. Salary information comes from 4 data points collected directly from employees, users, and past and present job advertisements on Indeed in the past 36 months. Learn about Blue Shield Of California Vacation & Paid Time Off, including a description from the employer, and comments and ratings provided anonymously by current and former Blue Shield Of California employees. The … You'll get information specific to your plan, such as: If you're not a registered member, select your insurance coverage below. Blue Shield 65 Plus (HMO) summary of benefits Group Medicare Advantage-Prescription Drug Plan for Santa Ana Unified School District retirees July 1, 2016 to June 30, 2017 Blue Shield of California is a HMO plan with a Medicare contract. Project Manager | Pharmacy Benefit Management Advanced Medical Reviews Sep 2012 - 2015 3 ... Public Health Research Consultant at Blue Shield of California | Pharmacy Analytics. TO: ALL HEALTH BENEFIT OFFICERS AND ASSISTANT HEALTH BENEFIT OFFICERS. Your Knowledge and Experience. Outside the United States. Salary information comes from 12 data points collected directly from employees, users, and past and present job advertisements on Indeed in the past 36 months. Add Benefits. Online account management has never been easier. This range is not provided by Blue Shield of California — it is based on 3 Linkedin member-reported salaries for Program Manager at Blue Shield … Health Net of California (HMO) Salud y Más HMO; SmartCare HMO; Health Net of California (888) 926-4921. Include in medical claim if covered under medical benefits Submit claim to TransactRx if covered under Rx benefits. Blue Shield of California’s mission is to ensure all Californians have access to high-quality…See this and similar jobs on LinkedIn. Blue Cross and Blue Shield of Illinois contracts with Prime Therapeutics to provide pharmacy benefit management and other related services. Pharmacy benefit management (PDF, 300KB) … San Francisco. You can also login directly to the our pharmacy benefit manager website. Reviews from Blue Shield of California employees about working as a Processor at Blue Shield of California. SAUSD H0504_16_143C 05042016 Pharmacy submits claim through PBM. This change does not impact benefits, formulary, or the pharmacy network. Prior experience in pharmacy benefit management operations and demonstrated ability to interpret pharmacy benefit utilization and financial data is required. Covered vaccines are usually eligible under medical benefits and can be included in the medical claim (for commercial and Medicare) except those that CMS has designated as Medicare Part D for Medicare patients. Blue Shield of California’s mission is to ensure all Californians have access to high-quality health care at a sustainably affordable price. Director, Pharmacy Benefit & Claims Operations. CCPOA pharmacy benefits are administered by Blue Shield. Possesses strong business acumen with proven experience in thinking strategically required. If you are a UC PPO member, you should receive a new ID card from Anthem Blue Cross. We are transforming health care in a way that truly serves our nonprofit mission by lowering costs, improving quality, … Pharmacy benefits. As a manager of pharmacy benefits, we combine all aspects of pharmacy benefit and medical plan management, helping to ensure comprehensive coordination of services. 800-633-4581. Members can take advantage of OptumRx benefits that include: Home delivery and Preferred90 retail pharmacy program; receive up to a three-month supply on maintenance medication for two copayments. Prime Therapeutics is responsible for: Processing and paying Rx claims. If you are enrolled in any other Blue Shield of California Medicare Advantage or Prescription drug plans, your pharmacy network includes pharmacies that offer standard cost-sharing and pharmacies that offer preferred cost-sharing. You may go to either, but your cost may be lower at pharmacies with preferred cost-sharing. Blue Shield is headquartered in Oakland, California with 21 additional locations including Sacramento, Los Angeles, and San Diego. I need to find another insurance company for my family. Anthem Blue Cross and Anthem Blue Cross Life and Health Insur ance Company are independent licensees of the ... Express Scripts, Inc. is a separate company that provides pharmacy services and pharmacy benefit management services on behalf of health plan members. Refer to the Benefit Plan Documents for detailed plan information. Online claims submission. The Blue Cross and Blue Shield Service Benefit Plan has a special program to promote patient safety and monitor healthcare quality. If you are deaf, hard of hearing, or have a speech disability, dial 711 for TTY relay services. Thanks for your interest in the Program Manager, Principal position. Your enrolled employees and their dependents who have coverage from Blue Shield of California and Blue Shield of California Life & Health Insurance Company can use the following resources and online tools to help understand and manage the choices and costs of their prescription drugs. With the Blue Shield HMO plan, you: Only pay a fixed copayment for most services like doctor visits, urgent care, and emergency care; Have access to one of the largest provider networks in California, with more than 10,000 primary care physicians (PCPs), 270 … This includes, but is not limited to, the processing and payment of claims for … Requires a Master's Degree in Public Health, MBA, MD, PhD, PharmD, or other degree with relevant experience. Company Overview Organization Structure FAQ. The Pharmacy Markets, Analytics Products and Strategies team is responsible in leading and collaborating cross functionally with key stakeholders across Blue Shield to evaluate pharmacy cost of health care opportunities and identify drug management strategies for all lines of business. Shield Concierge Tandem PPO members Phone: (855) 599-2657 7:00 a.m. to 7:00 p.m., Pacific Time Monday through Friday Member Services Access+ HMO members Phone: (855) 256-9404 7:00 a.m. to 7:00 p.m., Pacific Time Each level has a different copay or coinsurance. Drug benefit levels. Vaccines. Optional non-FEHB dental plan (Blue Shield Dental HMO or PPO plans) You pay total premiums plus various copayments. BCBSA employees work in our offices in Chicago and Washington, D.C. Some plans may have a pharmacy benefit deductible, which is the set dollar amount which must be paid by you for each calendar year for covered prescriptions before your co-payments, and/or co-insurances apply. Health Net of California (HMO) Salud y Más HMO; SmartCare HMO; Health Net of California (888) 926-4921. Average Blue Shield of California Senior Manager yearly pay in the United States is approximately $142,528, which is 21% above the national average. See all Blue Shield Of California Benefits. For member services, call (866) 321-9650 or visit Express Scripts. As defined in Health and Safety Code Section 1385.001, a “pharmacy benefit manager” is a person, business, or other entity that, pursuant to a contract with a health care service plan, manages the prescription drug coverage provided by the health care service plan. Learn about Blue Shield Of California 401K Plan, including a description from the employer, and comments and ratings provided anonymously by current and former Blue Shield Of California employees. 1 Blue Shield Of California Pharmacy Benefits Management Rx Network Technician interview questions and 1 interview reviews. Prime Therapeutics serves as Blue Cross' Pharmacy Benefit Manager. Average Blue Shield of California Operations Manager yearly pay in the United States is approximately $133,295, which is 100% above the national average. The program provides opportunities to develop proficient clinical, project management, analytical, and leadership skills, and is customized based on the resident’s professional goals. P.O. Benefit Summary (For groups of 300 and above) (Uniform Health Plan Benefits and Coverage Matrix) Blue Shield of California Effective: July 1, 2017 THIS MATRIX IS INTENDED TO BE USED TO HELP YOU COMPARE COVERAGE BENEFITS AND IS A SUMMARY ONLY. Express Scripts is the largest independent manager of pharmacy benefits in the United States and one of the country’s largest pharmacies, serving more than 85 million people. 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