There are a variety of professionals who make our dream work every day at Blue Shield of California. From doctors and nurses to lawyers, actuaries, and business leaders, everyone has an important role to fill in supporting our mission of ensuring that all Californian’s have access to high-quality health care at an affordable price. To help shed light on some of the work our legal team does, we are highlighting Rosario Martinez, manager of the Special Investigations Unit (SIU).
What brought you to Blue Shield?
“I started working for Care1st Health Plan in 2011, which later became Blue Shield of California Promise Health Plan. When I transitioned to Blue Shield Promise, I felt humbled to be part of this organization and a manager for Blue Shield Promise SIU. I will never forget how welcoming the employees were when I transitioned to Blue Shield. I received several welcome emails and cards. I even received an email that said, “Welcome to the family," which I thought was pretty cool. Fast forward to 2023, I recently returned from a sabbatical (a benefit Blue Shield provides after every five years of employment), and the time has just flown by. I was able to step away, refresh and spend time with my family.”
Have you always worked in health care?
“No, it’s interesting how different opportunities come your way when you least expect them. I graduated from California State University, Long Beach, with a Bachelor of Science degree, majoring in Criminal Justice with a minor in Sociology. I have always been interested in investigations and was very fortunate to land a few jobs during college and shortly afterwards that enhanced my investigative and leadership skills. I had the opportunity to work for an agency within the fraud division and that was where my interest in health care, in particular health care fraud investigations, began.”
What are some recent projects and accomplishments that have been made by your team?
“My team works hard every day, from triaging referrals, conducting investigations, and ensuring compliance with all regulatory requirements. We’ve had a few obstacles which we overcame along the way, but my team always remains positive and agile. We’ve had amazing support from our SIU team, from management, investigators, analysts and prepayment. Knowing that you have support within your team to step in and help with projects or audits is, I feel, an accomplishment.”
What are some strategies you use to help support and empower your team, boost productivity, and achieve benchmarks and meaningful outcomes?
“I encourage my team to share their thoughts, ideas, and provide feedback, knowing that I’m there to listen. Keeping the lines of communication open and transparent is key. We have monthly team huddles and one-on-one’s where we collaborate, discuss referrals, cases, special projects and prioritize next steps.
I also provide learning opportunities, such as taking on projects or new types of cases that enable my team to have hands-on experience—assisting with their professional development. This is followed up with feedback and recognition, which results in meaningful outcomes. Having a positive mindset has also empowered the team to ensure we get sustainable results the right way.”
How has Blue Shield supported your professional growth and development?
“Before coming to Blue Shield, I had not worked for a company that encouraged professional growth and development. It’s amazing to see the professional growth and development resources available to Blue Shield employees. Our senior SIU director, Jonnie Massey, also strongly supports training and professional development. I’ve attended several management training courses, webinars, and LinkedIn Learning courses that have contributed to my professional growth. I look forward to obtaining my master's degree, along with certifications utilizing Blue Shield’s resources to support my professional growth.”
What are your future career goals?
“My future career goal is to continue to grow professionally and enhance my leadership skills. I enjoy what I do and look forward to continuing to work for Blue Shield.”
What advice would you give to a legal professional whose goal is to join the Special Investigations Unit at Blue Shield?
“You will never stop learning in this ever-changing healthcare space as new fraud schemes and trends emerge. We have a great SIU team who works together to combat health insurance fraud, waste and abuse. Each team member contributes to our mission.”
Do you have any advice for prospective candidates considering a role at Blue _Shield?
“Blue Shield is an amazing company to work for. They really care about their employees and members, and truly live their values of being human, honest, and courageous each day. The ability to do meaningful work for a company that truly follows its mission and values makes coming to work every day worth it.”
If you would like to join a team that values your ideas and welcomes transparent, honest communication, we have a variety of career opportunities available, including leadership and legal roles. Explore our open job opportunities and apply!
