UNKNOWN

FEED

Reporting to the Utilization Operations Director, you will collaborate with Medical Directors, Clinical Pharmacists, Appeals & Grievances staff, and contracted provider groups to evaluate complex cases, ensure regulatory compliance, and support exceptional member outcomes. This role is ideal for a registered nurse with managed care experience who is passionate about ensuring members receive timely, clinically sound, and compliant reviews of appeals and grievances.

YEAR

Western Health Advantage

Appeals & Grievances Nurse

IRecruitee

ADAPTED_NOW

Leveraging our extensive, hands-on expertise in helping IPAs, ACOs and health systems achieve successful outcomes in risk contracts, our team of managed care experts draw insights from the analytic outputs that are tailored to each organization’s unique circumstances to interpret the data and recommend initiatives to help improve total cost and quality. FLSA StatusNon-ExemptSalary Range$26.00 - $30.00 per hourReports ToLicensed Clinical Social WorkerDirect ReportsNoneLocationSacramento, CATravelUp to 80%Work TypeRegularScheduleFull TimePosition Description: Educating members about ECM services, assisting them with enrollment and serving as the primary liaison between the member and any services they may need.

HOUR

COPE Health Solutions

Community Health Worker - Sacramento County

With locations across the U.S., we offer many opportunities for compassionate individuals who enjoy improving the quality of life of those around them, with numerous positions for varying levels of expertise, such as companion caregivers, certified aides and case managers. At HomeWell Care Services, we pride ourselves on providing the highest quality care for seniors and others needing individualized support and companionship at home.

HomeWell Franchising Inc

Caregiver - Part Time

Caregiver

The Novice Nurse Licensed Vocational Nurse ( Location Roseville, California.

The name Maxim Healthcare Services carries with it a rich tradition of providing superior medical staffing, home healthcare, and wellness services. Established in 1988 to address the nursing shortage, Maxim has since evolved to service nearly every sector of the healthcare industry. Among Maxim’s strongest competencies is the ability to successfully recruit across a broad range of healthcare specialties. <br><br>Maxim has earned a reputation for uncompromising dedication to customer service and the overall quality of all healthcare professionals staffed. It is engrained in the Maxim culture to strive for excellence through serving the needs of others. This is evident in Maxim’s ongoing efforts to assess and refine all management, clinical, and support processes. <br><br>This is an exciting time for Maxim, as the company has seen tremendous revenue and organizational growth over the past twenty years. We are dedicated to building and maintaining strong, trusting relationships with each teammate, candidate, patient, and client.

Maxim Healthcare Services Inc

LVN - New Grad

Whatever role you fill, when you represent Bridgestone, you are a valued teammate, and part of our larger mission to "Serve Society with Superior Quality", for that, we offer you more than just a competitive compensation; we will provide you: A supportive and engaging onboarding experience to ensure a smooth transition into our team. At Bridgestone, what really matters is to foster co-creation opportunities and empowering you to be creative and curious to make mobility safer, more efficient, and more sustainable for future generations.

Bridgestone Americas Inc

Store Manager CA - 017655

Our unique position as one of the country''s largest employers, coupled with our commitment to positively impact the lives of all Canadians, provides our colleagues a range of opportunities and experiences to help Canadians Live Life Well. / L'expérience et les connaissances d'un candidat ainsi que la région géographique dans laquelle le poste est situé peuvent être prises en compte dans la rémunération qu'un candidat reçoit pour ce poste.

Loblaw Companies Ltd

Pharmacy Manager

The jobs listed are examples of the typical kinds of positions that Costco may hire for when openings exist. The listing does not mean that any positions are currently open or available at Costco.

Costco Wholesale Corporation

RX Pharmacy Manager (Temporary)

[AW]-iCims

RX Assistant Manager (Exempt)

RX Assistant Manager

We value a diverse workforce - people who identify as women, non-binary or gender non-conforming, LGBTQIA+, American Indian or Native Alaskan, Black or African American, Hispanic or Latinx, Native Hawaiian or Other Pacific Islander, differently-abled, caretakers and parents, and veterans are strongly encouraged to apply. You have a deep understanding of government relations, including effective lobbying strategies, direct engagement, campaign approaches to issue management, managing external consultants, coordinating with counterparts at peer companies to build effective coalitions, and coordinating with industry trade associations to maximize their impact.

DoorDash Inc

Manager, Government Relations - West Region

From the exceptional service at the check-in counter to the departure gate, and even behind the scenes making sure your checked bags arrive with you, our Airport Operations team keeps operations at our airports running smoothly every single day. Must be flexible to work all shifts and, when necessary, available 7 days a week / 24 hours a day, including holidays and weekends, to take care of any operational and /or unforeseen situations.

United Airlines Inc

General Manager - Airport Operations

At PCG, all aspects of employment regarding recruitment, hiring, training, promotion, compensation, benefits, transfers, layoffs, return from layoff, company-sponsored training, education, and social and recreational programs are based on merit, business needs, job requirements, and individual qualifications. Coordinate effectively across programs, vendors, system integrators, business owners, technical teams, oversight entities, and client leadership to support integrated delivery in complex public sector environments.

Public Consulting Group Inc

IT Project Manager

Recognize members' right to self-determination as it relates to the ethical principle of autonomy, including the member/family''s right to make informed choices that may not align with targeted outcomes as determined by the healthcare team. Efficiently manage and maintain a caseload of members with high severity and intensity of service needs such as members experiencing chronic homelessness, members experiencing severe and persistent mental illness or polysubstance abuse.

At the Blue Cross and Blue Shield Association (BCBSA), we provide business strategy, technical support and consulting expertise to 36 Blue Cross and Blue Shield companies across the nation, employing more than 1,000 of the best strategic thinkers in the industry.  We are a Brand manager that sets quality control standards for the 36 independent companies that use the Blue Cross and Blue Shield Brands, and we serve as a trade association that represents these Blue companies. It is through our involvement that the Blues companies share a united vision and strategy while also benefiting from the local strength of all member companies.

Blue Cross and Blue Shield Association

Social Worker, Senior

FULL_TIME

Overview: Under the direction of the Director of Quality and Performance Improvement (QI/PI), the Manager of Performance Improvement is responsible for key initiatives within the QI/PI Department: The Partnership Improvement Academy and its associated programs; Strategic, organization-wide improvement initiatives; Focused quality improvement projects; Internal (Partnership staff/departments) quality improvement consultation and training. Work with other directors and managers across the QI department and Partnership as a whole on data and measurement related activities, including the Quality Improvement Program, Partnership Stars Dashboard, provider reporting tools, and internal dashboards and program evaluations.

Partnership HealthPlan of California

Manager of Performance Improvement

Under the the direction of the Behavioral Health Clinician Lead, the Behavioral Health Clinician 1 provides counseling services to individual patients, their families and significant others as well as group sessions by performing the following duties and responsibilities as described below. Candidates who demonstrate inclusive thinking and interpersonal awareness help strengthen our commitment to equitable and compassionate care for all.

One Community Health

Behavioral Health Clinician 1 (ASW)

Under the direction of the Behavioral Health Clinician Lead, the Behavioral Health Clinician 2 provides counseling services to individual patients, their families and significant others as well as group sessions by performing the following duties and responsibilities as described below. Candidates who demonstrate inclusive thinking and interpersonal awareness help strengthen our commitment to equitable and compassionate care for all.

Behavioral Health Clinician 2 (LCSW)

OTHER

The RN will coordinate member care, review medical necessity, support discharge planning, and collaborate with physicians and healthcare teams to promote quality care and appropriate use of healthcare resources. Job Summary Adventist Health is seeking an experienced Registered Nurse (RN) for a 13-week contract focused on case management and utilization management.

Hanker Systems

Registered Nurse (RN) – General

Ceipal

This position is responsible for ensuring high-quality, person-centered, recovery-oriented services while promoting clinical excellence, operational effectiveness, regulatory compliance, and collaboration across multidisciplinary teams and community partners. Partner with the Assistant Director and organizational leadership to strengthen service delivery, improve client outcomes, support strategic initiatives, and promote continuous improvement across the Intervention and Outpatient Services.

Kenneth Young Center

Manager of Adult Mental Health & Substance Use Services

The role requires regular face-to-face engagement with commissioners, local authority representatives, healthcare partners, community stakeholders and delivery teams to maintain strong working relationships, support service development, review performance and identify opportunities for continuous improvement and innovation. • Undertake regular face-to-face meetings with commissioners, local authority representatives, Integrated Care System partners, subcontractors and other key stakeholders to review performance, strengthen partnerships and support contract growth and sustainability.

MAXIMUS provides business services to help governments operate health and human services programs, mostly at the state and national levels. The company's health services segment offers outsourced program management and administrative services,

Care Manager Jobs in Sacramento, CA

Appeals & Grievances Nurse Western Health Advantage

Community Health Worker - Sacramento County COPE Health Solutions

Caregiver - Part Time HomeWell Franchising Inc

Caregiver HomeWell Franchising Inc

LVN - New Grad Maxim Healthcare Services Inc

Store Manager CA - 017655 Bridgestone Americas Inc

Pharmacy Manager Loblaw Companies Ltd

RX Pharmacy Manager (Temporary) Costco Wholesale Corporation

RX Assistant Manager (Exempt) Costco Wholesale Corporation

RX Assistant Manager Costco Wholesale Corporation

Manager, Government Relations - West Region DoorDash Inc

General Manager - Airport Operations United Airlines Inc

IT Project Manager Public Consulting Group Inc

Social Worker, Senior Blue Cross and Blue Shield Association

Manager of Performance Improvement Partnership HealthPlan of California

Behavioral Health Clinician 1 (ASW) One Community Health

Behavioral Health Clinician 2 (LCSW) One Community Health

Registered Nurse (RN) – General Hanker Systems

Manager of Adult Mental Health & Substance Use Services Kenneth Young Center

Service Manager Maximus

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