Sr. Medical Director, Medical Policy

90899 Long Beach, California Blue Shield of California

Posted today

Job Viewed

Tap Again To Close

Job Description

Your Role

The Medical Management team ensures that Blue Shield is on the cutting edge of medical, medication, and payment policy to accelerate the emergence of a value-based health care system in California. The Sr. Medical Director, Medical Policy will report to the Chief Medical Officer. In this role you will be accountable for ensuring that all medical, medication, and payment policy initiatives are in aligned with the scientific evidence and professional guidelines. You will lead a team that delivers medical policy that adapts to new clinical innovations and supports medical payment operations, and training for staff in the accurate application of medical, medication, and payment policy, pricing, and coding.  In addition to chairing the BSC Pharmacy & Therapeutics, Medical and Payment Policy Committees, you will provide clinical leadership for all evidence-based medicine functions and partner closely with leaders of other business functions to develop strategies to ensure that Blue Shield members are receiving appropriate quality care.

Your Work

In this role, you will:

  • Provide clinical thought leadership for the design and implementation of clinical policy innovation initiatives such as Coverage with Evidence Development, and the development of robust and efficient approaches to developing policies for emerging classes of technology like molecular diagnostics and mobile/digital personal health devices
  • Chair the Medical Policy and Pharmacy and Therapeutics Committees
  • Provide clinical leadership and medical consultation for the Blue Shield of California (BSC) medication management process, including working closely with the Pharmacy Services team to promote safe, effective, and cost-efficient
  • Provide medical expertise in daily clinical rounds for drug authorization case review
  • Chair the Payment Policy Committee and provide clinical leadership for the BSC Payment Policy committee, overseeing and advising about payment policies and tactical approaches to ensure accurate coding of services
  • Consult with BSC legal team to support fraud and abuse investigations, provider arbitrations, regulatory inquiries and issues, and litigation related to clinical policy, coding, or pricing issues
  • Act as BSC’s representative to the Blue Cross Blue Shield Association (BCBSA) Technology Assessment process and the Medical Policy Panel
  • Participate on the California Technology Assessment Forum and other related activities
  • Partner with Network Management and Provider Partnership teams by providing subject matter expertise for contract and benefits coding decisions, including mandated benefits, provider contract language, provider DOFRs (division of financial responsibilities), and providing clinical perspective to resolve issues with BSC providers related to clinical policy, coding, and billing. 
  • Provide subject matter expertise for pricing of new, zero-dollar, and other exceptional claims
  • Present at IPA/MG and Provider education seminars regarding medical, medication and payment policy

Your Knowledge and Experience

  • Minimum of 2 years of previous medical leadership experience
  • Minimum of 5 years of direct patient care experience post residency 
  • Minimum of 8 years of experience developing evidence-based guidelines, medical policies or performing systematic reviews of the medical literature
  • Medical degree (M.D./D.O.) required. Master’s degree in epidemiology, health services or related degree is preferred
  • Completed residency preferably in adult based primary care specialty (e.g. Internal Medicine, Family Practice)
  • Maintain active, unrestricted California State Medical License required; Maintain active, unrestricted Medical License in all additional assigned states required
  • Maintain Board Certification in one of ABMS, ABOS, or AOA recognized specialty required (preferably Internal Medicine or Family Practice)
  • Has mastery level knowledge and skills within a specific technical or professional discipline with broad understanding of other areas within the job function
  • Outstanding verbal and written communication skills
  • Ability to lead through influence in a matrixed organization
  • Experience performing utilization management reviews is preferred
  • Experience in a health plan or managed care organization is preferred

#LI-JS3

View Now

Pharmacist, Principal-Medication Policy

90899 Long Beach, California Blue Shield of California

Posted today

Job Viewed

Tap Again To Close

Job Description

Your Role

The Medication policy team is primarily responsible for supporting the Blue Shield of California Pharmacy and Therapeutics (P&T) Committee process and supports the operational components of the Drug Authorization Program by ensuring that evidence based clinical criteria approved by the Blue Shield of California Pharmacy and Therapeutics Committee are implemented operationally in order to provide a quality, cost effective care. The Medication Policy pharmacist will report to the Senior Manager for Medication Policy. 

Your Work

In this role, you will:

  • Develop, analyze & monitor prescription drug, medical claims, and program data to identify opportunities to improve quality and cost of healthcare and to monitor/report performance and outcomes.
  • Develop project proposals for identified opportunities and support implementation.
  • Serve as a BSC Pharmacy Services contact and subject matter expert to stakeholders, and manage external relationships (vendors, clients) related to assigned work.
  • Support the operational implementation and maintenance of medication policies for drugs in the pharmacy and medical benefit.
  • Support the configuration of clinical rules in the automated prior authorization system for both pharmacy and medical benefit drugs.
  • Ensure compliance with various regulatory and quality accreditation requirements around drug utilization management in order to support safe, efficacious, and cost-effective prescribing.
  • Provide support for the development and maintenance of Blue Shield of California drug formulary for all product lines.
  • Provide pharmacotherapy expertise for the pharmacy program by supporting the Pharmacy and Therapeutics Committee, drug formulary, prior authorization, drug utilization review and physician reporting programs. 
  • Assist with the monitoring, tracking, and trending of coverage decisions derived from the Blue Shield P&T Committee formulary & utilization management decisions.



 

Your Knowledge and Experience

  • Requires a Doctor of Pharmacy (PharmD) degree.
  • Requires a currently active and unrestricted California Registered Pharmacist (RPh) license.
  • Requires at least 4 years of experience in clinical pharmacy.
  • Thorough clinical knowledge regarding therapeutic use of drugs. 
  • Excellent oral and written communication skills. 
  • Proficient with Microsoft related software applications. 
View Now

Sr. Device Software Engineer, Kuiper Government Solutions

91330 Legal, California KGS LLC

Posted today

Job Viewed

Tap Again To Close

Job Description

Project Kuiper is Amazon’s initiative to launch a constellation of 3,236 Low Earth Orbit (LEO) satellites to provide high-speed, low-latency broadband connectivity to unserved and underserved communities globally. Join our mission to close the digital divide and connect people, businesses, and governments in places where reliable connectivity has been a challenge.

We are breaking new ground with every device we design, from custom silicon to secure software, to enable innovative satellite and ground systems. Be part of a team that pushes the boundaries of satellite communications technology to make global connectivity a reality.

As a Senior Device Software Development Engineer on the Kuiper Government Solutions (KGS) team, you will design and develop embedded software for Kuiper’s satellite and ground systems. You’ll work on fault-tolerant, real-time platforms, collaborating closely with hardware, systems, and product teams to deliver secure, reliable, and high-performance solutions.

This is a unique opportunity to shape the next generation of space-based communication systems with minimal legacy constraints. Your work will directly support critical government initiatives, enabling secure and high-performance communication systems for U.S. and allied missions.

This role is based in Northridge, CA, or Redmond, WA, with U.S. relocation benefits. Onsite work is required 5 days a week.

This position requires that the candidate selected be a U.S. Citizen in order to comply with U.S. government-imposed requirements related to the nature of the work and/or where it will be performed.

Key job responsibilities
• Design, develop, and optimize embedded software for Kuiper’s satellite and ground terminal systems, focusing on fault-tolerant, real-time platforms.
• Leverage modern application frameworks for Embedded Linux and RTOS platforms to develop scalable, modular, and high-performance software.
• Implement and integrate software for data processing, device control, and networking protocols (e.g., TCP/IP, UDP).
• Develop low-level drivers for peripherals and interfaces, including I2C, SPI, PCIe, UART, and GPIO.
• Collaborate with hardware teams to support board bring-up and integration testing.
• Drive security initiatives, including bootloaders, cryptography, and secure Software Development Lifecycle (SDLC) practices.
• Debug and resolve complex hardware-software integration issues using tools like logic analyzers and oscilloscopes.
• Collaborate with cross-functional teams to ensure seamless hardware-software interaction and system reliability.
• Mentor junior engineers, conduct design reviews, and uphold high software quality standards.

About the team
Kuiper Government Solutions (KGS) is a multidisciplinary team developing targeted and scalable solutions for custom satellite and ground applications. KGS Device Software focuses on embedded software solutions for custom products supporting U.S. and allied government customers. We collaborate closely with hardware and systems teams to deliver secure, high-performance solutions for mission-critical applications.
BASIC QUALIFICATIONS - Bachelor's degree in computer science or equivalent
- 5+ years of non-internship professional software development experience
- 5+ years of programming with at least one software programming language experience
- 4+ years of leading design or architecture (design patterns, reliability and scaling) of new and existing systems experience
- Experience as a mentor, tech lead or leading an engineering team
- 3+ years of programming experience in C, C++, or Rust for resource-constrained systems
- Proficiency in debugging, optimization, and hardware-software system integration
- Excellent written and verbal communication skills
PREFERRED QUALIFICATIONS - Master's degree in computer science or equivalent
- 5+ years of full software development life cycle, including coding standards, code reviews, source control management, build processes, testing, and operations experience
- 3+ years of experience leading architecture and design for fault-tolerant, real-time systems
- Hands-on experience with Xilinx platforms, custom silicon development, cryptography, and secure Software Development Lifecycle (SDLC) practices
- In-depth knowledge of Linux kernel internals, including process scheduling, memory management, concurrency, synchronization, and networking subsystems
- Familiarity with networking protocols (e.g., TCP/IP, UDP) and low-level hardware interfaces such as I2C, SPI, and PCIe

Amazon is an equal opportunity employer and does not discriminate on the basis of protected veteran status, disability, or other legally protected status.

Los Angeles County applicants: Job duties for this position include: work safely and cooperatively with other employees, supervisors, and staff; adhere to standards of excellence despite stressful conditions; communicate effectively and respectfully with employees, supervisors, and staff to ensure exceptional customer service; and follow all federal, state, and local laws and Company policies. Criminal history may have a direct, adverse, and negative relationship with some of the material job duties of this position. These include the duties and responsibilities listed above, as well as the abilities to adhere to company policies, exercise sound judgment, effectively manage stress and work safely and respectfully with others, exhibit trustworthiness and professionalism, and safeguard business operations and the Company’s reputation. Pursuant to the Los Angeles County Fair Chance Ordinance, we will consider for employment qualified applicants with arrest and conviction records.

Our inclusive culture empowers Amazonians to deliver the best results for our customers. If you have a disability and need a workplace accommodation or adjustment during the application and hiring process, including support for the interview or onboarding process, please visit for more information. If the country/region you’re applying in isn’t listed, please contact your Recruiting Partner.

Our compensation reflects the cost of labor across several US geographic markets. The base pay for this position ranges from $151,300/year in our lowest geographic market up to $261,500/year in our highest geographic market. Pay is based on a number of factors including market location and may vary depending on job-related knowledge, skills, and experience. Amazon is a total compensation company. Dependent on the position offered, equity, sign-on payments, and other forms of compensation may be provided as part of a total compensation package, in addition to a full range of medical, financial, and/or other benefits. For more information, please visit . This position will remain posted until filled. Applicants should apply via our internal or external career site.
View Now

Sr. Device Software Engineer, Kuiper Government Solutions

91330 Legal, California KGS LLC

Posted today

Job Viewed

Tap Again To Close

Job Description

Project Kuiper is Amazon's initiative to launch a constellation of 3,236 Low Earth Orbit (LEO) satellites to provide high-speed, low-latency broadband connectivity to unserved and underserved communities globally. Join our mission to close the digital divide and connect people, businesses, and governments in places where reliable connectivity has been a challenge.

We are breaking new ground with every device we design, from custom silicon to secure software, to enable innovative satellite and ground systems. Be part of a team that pushes the boundaries of satellite communications technology to make global connectivity a reality.

As a Senior Device Software Development Engineer on the Kuiper Government Solutions (KGS) team, you will design and develop embedded software for Kuiper’s satellite and ground systems. You’ll work on fault-tolerant, real-time platforms, collaborating closely with hardware, systems, and product teams to deliver secure, reliable, and high-performance solutions.

This is a unique opportunity to shape the next generation of space-based communication systems with minimal legacy constraints. Your work will directly support critical government initiatives, enabling secure and high-performance communication systems for U.S. and allied missions.

This role is based in Northridge, CA, or Redmond, WA, with U.S. relocation benefits. Onsite work is required 5 days a week.

This position requires that the candidate selected be a U.S. Citizen in order to comply with U.S. government-imposed requirements related to the nature of the work and/or where it will be performed.

Key job responsibilities
• Design, develop, and optimize embedded software for Kuiper’s satellite and ground terminal systems, focusing on fault-tolerant, real-time platforms.
• Leverage modern application frameworks for Embedded Linux and RTOS platforms to develop scalable, modular, and high-performance software.
• Implement and integrate software for data processing, device control, and networking protocols (e.g., TCP/IP, UDP).
• Develop low-level drivers for peripherals and interfaces, including I2C, SPI, PCIe, UART, and GPIO.
• Collaborate with hardware teams to support board bring-up and integration testing.
• Drive security initiatives, including bootloaders, cryptography, and secure Software Development Lifecycle (SDLC) practices.
• Debug and resolve complex hardware-software integration issues using tools like logic analyzers and oscilloscopes.
• Collaborate with cross-functional teams to ensure seamless hardware-software interaction and system reliability.
• Mentor junior engineers, conduct design reviews, and uphold high software quality standards.

About the team
Kuiper Government Solutions (KGS) is a multidisciplinary team developing targeted and scalable solutions for custom satellite and ground applications. KGS Device Software focuses on embedded software solutions for custom products supporting U.S. and allied government customers. We collaborate closely with hardware and systems teams to deliver secure, high-performance solutions for mission-critical applications.
BASIC QUALIFICATIONS - Bachelor's degree in computer science or equivalent
- 5+ years of non-internship professional software development experience
- 5+ years of programming with at least one software programming language experience
- 4+ years of leading design or architecture (design patterns, reliability and scaling) of new and existing systems experience
- Experience as a mentor, tech lead or leading an engineering team
- 3+ years of programming experience in C, C++, or Rust for resource-constrained systems
- Proficiency in debugging, optimization, and hardware-software system integration
- Excellent written and verbal communication skills
PREFERRED QUALIFICATIONS - Master's degree in computer science or equivalent
- 5+ years of full software development life cycle, including coding standards, code reviews, source control management, build processes, testing, and operations experience
- 3+ years of experience leading architecture and design for fault-tolerant, real-time systems
- Hands-on experience with Xilinx platforms, custom silicon development, cryptography, and secure Software Development Lifecycle (SDLC) practices
- In-depth knowledge of Linux kernel internals, including process scheduling, memory management, concurrency, synchronization, and networking subsystems
- Familiarity with networking protocols (e.g., TCP/IP, UDP) and low-level hardware interfaces such as I2C, SPI, and PCIe

Amazon is an equal opportunity employer and does not discriminate on the basis of protected veteran status, disability, or other legally protected status.

Los Angeles County applicants: Job duties for this position include: work safely and cooperatively with other employees, supervisors, and staff; adhere to standards of excellence despite stressful conditions; communicate effectively and respectfully with employees, supervisors, and staff to ensure exceptional customer service; and follow all federal, state, and local laws and Company policies. Criminal history may have a direct, adverse, and negative relationship with some of the material job duties of this position. These include the duties and responsibilities listed above, as well as the abilities to adhere to company policies, exercise sound judgment, effectively manage stress and work safely and respectfully with others, exhibit trustworthiness and professionalism, and safeguard business operations and the Company’s reputation. Pursuant to the Los Angeles County Fair Chance Ordinance, we will consider for employment qualified applicants with arrest and conviction records.

Our inclusive culture empowers Amazonians to deliver the best results for our customers. If you have a disability and need a workplace accommodation or adjustment during the application and hiring process, including support for the interview or onboarding process, please visit for more information. If the country/region you’re applying in isn’t listed, please contact your Recruiting Partner.

Our compensation reflects the cost of labor across several US geographic markets. The base pay for this position ranges from $151,300/year in our lowest geographic market up to $261,500/year in our highest geographic market. Pay is based on a number of factors including market location and may vary depending on job-related knowledge, skills, and experience. Amazon is a total compensation company. Dependent on the position offered, equity, sign-on payments, and other forms of compensation may be provided as part of a total compensation package, in addition to a full range of medical, financial, and/or other benefits. For more information, please visit . This position will remain posted until filled. Applicants should apply via our internal or external career site.
View Now

Audit Manager - State & Local Government

90079 Los Angeles, California EXECUTIVE RESOURCE SYSTEMS

Posted today

Job Viewed

Tap Again To Close

Job Description

Audit Manager - State & Local Government

Reasonable work life balance - Hybrid work envirronment

The Manager is the liaison between the Partner, the client, and the professional staff. Managers are responsible for managing multiple auditing and accounting projects and client engagements simultaneously, in addition to scheduling, staffing and coordinating engagement workflow. Managers develop and train staff and make associations to develop new business for the Firm. Managers play a lead role in maintaining client relationships.

Responsibilities

    • Responsible for managing all phases of an audit or review engagement on multiple engagements at one time
    • Maintains contact with clients throughout the year; possesses a thorough knowledge of the client and all facets of the client's business and control systems; building and maintaining good client relationships
    • Apprises the engagement Director or Partner of all important developments on the client account; identifies any potential issues on each engagement and recommends solutions
    • Demonstrates proficiency in technical skills, work quality, and application of professional and Firm standards including those skills necessary for advising clients
    • Responsible for ensuring engagements are properly scheduled
    • Obtains and maintains a thorough understanding of SingerLewak's audit approach
    • Responsible for creating, tracking and adhering to budgets for assigned Assurance and Advisory engagements; responsible for investigating and explaining budget overruns to Director or Partner and actively looking for change order opportunities
    • Anticipates problem areas of engagement and questions that will arise
    • Reviews financial statements and other client deliverables
    • Directs, trains, supervises and reviews the work performed by senior accountants and staff accountants
    • Plays a pivotal role in staff performance evaluations, reviews and periodic counseling
    • Participates in the Firm's Business Development efforts
Qualifications
    • Minimum Qualifications:
    • Bachelor's degree in accounting or related field
    • At least five years of experience in public accounting - specifically in the public sector, including auditing state and local governments (i.e., cities, counties, special districts, etc.) in California and/or Oregon
    • Holds a current and valid CPA's license
    • Preferred Qualifications:
    • Ability to be a team leader and work as an effective member of a team
    • Ability to prioritize and complete assignments and efficiently and effectively meet deadlines
    • Possesses thorough knowledge of Generally Accepted Accounting Principles in the United States, Standards issued by the Governmental Accounting Standards Board, United States Generally Accepted Auditing Standards, and Government Auditing Standards issued by the Comptroller General of the United States
    • Cooperative and responsive to training, supervision and constructive feedback
    • Ability to direct, review and train staff, experienced staff and seniors
Working Conditions
    • Hybrid working environment (work from home, office, or client location)
    • Same day travel for work at clients' offices, meetings, and seminars, as needed
    • Occasional out-of-town travel with overnight stay for work at clients, meetings, or seminars
View Now

Material Handler for a government client-Hiring now!

90079 Los Angeles, California Helpmates Companies

Posted today

Job Viewed

Tap Again To Close

Job Description

Exciting Temporary Opportunity with a Trusted Government Agency Step into a rewarding role with a respected local government agency in Los Angeles! We're looking for a reliable and proactive Material Handler to join the dynamic team at City of LA Par Material Handler, Government, Client, Materials Handler, Handler, Manufacturing, Staffing

View Now
Be The First To Know

About the latest Government non profit Jobs in Federal !

 

Nearby Locations

Other Jobs Near Me

Industry

  1. request_quote Accounting
  2. work Administrative
  3. eco Agriculture Forestry
  4. smart_toy AI & Emerging Technologies
  5. school Apprenticeships & Trainee
  6. apartment Architecture
  7. palette Arts & Entertainment
  8. directions_car Automotive
  9. flight_takeoff Aviation
  10. account_balance Banking & Finance
  11. local_florist Beauty & Wellness
  12. restaurant Catering
  13. volunteer_activism Charity & Voluntary
  14. science Chemical Engineering
  15. child_friendly Childcare
  16. foundation Civil Engineering
  17. clean_hands Cleaning & Sanitation
  18. diversity_3 Community & Social Care
  19. construction Construction
  20. brush Creative & Digital
  21. currency_bitcoin Crypto & Blockchain
  22. support_agent Customer Service & Helpdesk
  23. medical_services Dental
  24. medical_services Driving & Transport
  25. medical_services E Commerce & Social Media
  26. school Education & Teaching
  27. electrical_services Electrical Engineering
  28. bolt Energy
  29. local_mall Fmcg
  30. gavel Government & Non Profit
  31. emoji_events Graduate
  32. health_and_safety Healthcare
  33. beach_access Hospitality & Tourism
  34. groups Human Resources
  35. precision_manufacturing Industrial Engineering
  36. security Information Security
  37. handyman Installation & Maintenance
  38. policy Insurance
  39. code IT & Software
  40. gavel Legal
  41. sports_soccer Leisure & Sports
  42. inventory_2 Logistics & Warehousing
  43. supervisor_account Management
  44. supervisor_account Management Consultancy
  45. supervisor_account Manufacturing & Production
  46. campaign Marketing
  47. build Mechanical Engineering
  48. perm_media Media & PR
  49. local_hospital Medical
  50. local_hospital Military & Public Safety
  51. local_hospital Mining
  52. medical_services Nursing
  53. local_gas_station Oil & Gas
  54. biotech Pharmaceutical
  55. checklist_rtl Project Management
  56. shopping_bag Purchasing
  57. home_work Real Estate
  58. person_search Recruitment Consultancy
  59. store Retail
  60. point_of_sale Sales
  61. science Scientific Research & Development
  62. wifi Telecoms
  63. psychology Therapy
  64. pets Veterinary
View All Government & Non Profit Jobs View All Jobs in Federal