Clinical Strategy and Programs Manager

About the RoleSolidigm is seeking a highly skilled University Relations and Internship Program Manager to join our team. In this role, you will be responsible for developing and executing our university relations and internship programs, ensuring they align with our company's values, workforce, and talent priorities.Key ResponsibilitiesBuild and maintain...

Clinical Quality Review Manager Job SummaryWe are seeking a highly skilled Clinical Quality Review Manager to join our team at Blue Shield of California. In this role, you will be responsible for overseeing the Clinical Quality Review team, ensuring operational compliance with timeliness and reporting requirements.Key Responsibilities:Provide supervision and...

Job SummaryThe Facilities Manager is responsible for overseeing the maintenance department and ensuring the upkeep of Turning Point Community Programs' facilities, whether leased or owned. This role requires a high degree of professional judgment and organizational commitment.Key Responsibilities:Supervise maintenance staff and ensure quality...

Job SummaryAs a Case Management Supervisor, you will oversee cases and manage the case management team for our program. This role requires strong clinical and organizational skills, as well as the ability to build rapport with a team.ResponsibilitiesSupervise cases within the assigned management team, providing direction, support, and counsel to team...

About the RoleThe Clinical Quality Review team at Blue Shield of California is seeking a seasoned leader to oversee the review of potential quality issues that impact our members, providers, and staff. As a key member of our Quality Management and Assurance team, you will work closely with medical directors to identify and address quality concerns, ensuring...

Job Description**Job Summary**This position plays a crucial role in overseeing all youth programming and family engagement activities at the YMCA of Memphis and the Midsouth. The Regional Program Director will create a positive atmosphere where everyone is respected and welcomed, building relationships with team members and community members alike.Key...

Your RoleThe Medical Management team at Blue Shield of California is dedicated to ensuring that our organization is at the forefront of medical, medication, and payment policy to accelerate the emergence of a value-based healthcare system in California. As the Medical Director, Utilization Management (CalPERS), you will report to the Vice President, Medical...

Job SummaryUnder the direction of the Manager for Continuing Care, the Registered Nurse (RN) will be responsible for planning and conducting needs assessments and evaluating orientation and staff development programs for staff and non-provider clinical staff.Key ResponsibilitiesDesigns and develops educational plans, researching and applying best practices,...

Job SummaryThis is a key position on the Employer Strategy & Relationships Team responsible for leading the development and execution of a market strategy to grow accretive contribution margin by developing, selling and implementing employer programs based on narrower network/program designs to help employers better control their health plan costs and plan...

Job DescriptionSouth Coast Children's Society is seeking a highly skilled Clinical Supervisor to lead the day-to-day clinical operations of our Wraparound Program. The successful candidate will be responsible for ensuring all clients receive services as indicated on their treatment plan, providing clinical group supervision, and remaining well-versed in...

Program Services Clinical CoordinatorMentor Community Services, a part of the Sevita family, provides community-based services for individuals with intellectual and developmental disabilities. Our mission is to empower every person to live a full, more independent life.About the RoleWe are seeking a skilled and compassionate Program Services Clinical...

Job SummaryWe are seeking a highly skilled Medical Director, Utilization Management to join our team at Blue Shield of California. The successful candidate will be responsible for leading our utilization management efforts, ensuring that our members receive high-quality, cost-effective care.Key ResponsibilitiesDevelop and implement utilization management...

Job SummaryAs a Medical Policy Utilization Management Nurse, you will play a critical role in ensuring the quality and cost-effectiveness of healthcare services for our members. You will be responsible for conducting clinical reviews of claims to determine medical necessity, coding accuracy, and compliance with medical policies and contracts.Key...

About the RoleThe Director of Medicare and Medi-Cal Utilization Management will play a critical role in the success of Blue Shield of California and the Utilization Management department in realizing its goals and objectives.Key ResponsibilitiesDevelop and implement utilization management strategies to ensure timely and cost-effective care for patients.Lead...

Job SummaryChild Action, Inc. (CAI) is a private, non-profit corporation dedicated to promoting the education and social welfare of children and families. We are seeking a highly organized and detail-oriented Program Supervisor to oversee the daily operations of an assigned unit, supervise staff, and ensure compliance with guidelines and regulations.Key...

Job SummaryWe are seeking a highly organized and detail-oriented Benefits and Leave Specialist to support the administration of employee benefits programs and leave of absences processes.Key ResponsibilitiesAssist the Benefits Manager in the administration of employee benefits programs, including health insurance, disability insurance, life insurance,...

Your RoleAs a key member of the Utilization Management team at Blue Shield of California, the Director, Medicare & Medi-Cal Utilization Management plays a critical role in delivering and collaborating on all aspects of utilization management and care coordination for our Medicare and Medi-Cal membership.This individual will lead the development of UM...

Job SummaryThis is a key position on the Employer Strategy & Relationships Team responsible for leading the development and execution of a market strategy to grow accretive contribution margin by developing, selling and implementing employer programs based on narrower network/program designs to help employers better control their health plan costs and plan...

Job SummaryWe are seeking a highly skilled Clinical Supervisor to join our team at Hannah's Children's Homes. The successful candidate will be responsible for coordinating clinical services, training new clinicians, and supervising the clinical staff.The ideal candidate will have a Master's degree or Ph.D. in psychology, sociology, or a related field, plus 2...

About the RoleThe Utilization Management Nurse, Senior will play a critical role in ensuring the quality and cost-effectiveness of healthcare services for our members.Key ResponsibilitiesConduct prospective, concurrent, and retrospective utilization reviews to determine medical necessity and ensure compliance with nationally recognized clinical...