Your Role The Utilization Management team independently manages complex utilization and retrospective clinical reviews across multiple lines of business, assessing medical necessity, coding accuracy, treatment plans, discharge planning, and compliance requirements while supporting clinical consistency, process improvement, quality,
Your Role The Case Management team performs case management (CM) activities demonstrating clinical judgment and independent analysis, collaborating with members and those involved with members’ care including clinical nurses and treating MDs. The Case Management Nurse, Senior will report
Your Role The Behavioral Health Utilization Management (UM) team performs prior authorization and concurrent reviews for members by applying evidenced based guidelines, policies, and nationally recognized clinical criteria across multiple lines of business. The Manager, Behavioral Health
Roseville Coordinator Located in the metropolitan area of Sacramento, the Adventist Health corporate headquarters have been based in Roseville, California, for more than 40 years. In 2019, we unveiled our WELL-certified campus - a rejuvenating place
Job Title Plays a critical role in ensuring that patients receive high-quality care while efficiently utilizing medical resources. Job Description Located in the metropolitan area of Sacramento, the Adventist Health corporate headquarters have been based in
Job Description The Care Management team coordinates, educates, and advocates care for the Dual-Special Needs (DSNP) population with Blue Shield of California. The Case Management Nurse, Senior will report to the Manager of Care Management within Medical Care Solutions.
Job Description The Behavioral Health Utilization Management (UM) team performs prior authorization and concurrent reviews for members by applying evidenced based guidelines, policies, and nationally recognized clinical criteria across multiple lines of business. The Manager, Behavioral Health
Senior Manager of Care Management The Care Management team is looking for a leader who can lead and oversee our team to ensure the effective coordination of patient care across multiple settings. In this role you will be
Management Assistant As a Management Assistant, you will play a key role in supporting store operations by assisting managers with hiring, onboarding, and orientation processes. As a member of the Business Operations team, this position ensures a seamless
Medical Director, Utilization Management 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 Medical Director,
Business Management Intern City: Placerville State: CA Country/Region: US Description: Internship Posting: Business Management Intern Construction Industry About Us: At Diamond Pacific we are dedicated to delivering high-quality projects in residential, commercial, and infrastructure development. Our team is
Care Management Manager The Care Management team is looking for a leader with Care Management experience who can help design and lead our Population Health Management (PHM) Medi-Cal Care Management line of business. The Manager, Care Management will report to the Director
Process Training Specialist $24.20/ Hourly Hours: 8:00am to 4:30pm - Must be willing to be flexible! About the Role Performs process related training to current and new associate level employees within the Distribution Center. This position will serve
Roseville Coordinator Located in the metropolitan area of Sacramento, the Adventist Health corporate headquarters have been based in Roseville, California, for more than 40 years. In 2019, we unveiled our WELL-certified campus - a rejuvenating place
Wealth Management Advisor The Wealth Management Advisor focuses on driving deeper relationships with clients by developing comprehensive financial plans and wealth strategies intended to plan for future goals and cash flow needs through a sound and efficient savings,
Treasury Management Operations Support Depending on experience, you could be the next Treasury Management I, II or III. Please see below for more details and we look forward to connecting with you! Treasury Management Operations Support III: The TM
Business Process Consultant Great companies need great teams to propel their operations. Join the group that solves business challenges and enhances the way we work and grow. Working at Gainwell carries its rewards. Youll have an incredible
Wealth Client Management Consultant CAPTRUST is seeking a Wealth Client Management Consultant who will work with one to several financial advisors to service and retain wealth client relationships. The Client Management Consultant uses specialized knowledge and skills, obtained through
Technology Business Management Specialist, Principal The IT Applications Services team is seeking to hire a Technology Business Management Specialist, Principal. This is a vital role in developing strategies and strategic planning to support and implement the goals and
Complex Enterprise Simplification Leader This role leads complex, cross-enterprise simplification initiatives that address systemic sources of operational friction and experience breakdowns. Operating with a high degree of autonomy, the role shapes problem framing, solution design, and