RN Care Management Professional

6 days ago


Rancho Cordova, California, United States Blue Shield of California Full time
Job Title: RN Care Management Professional

**Job Description:** Blue Shield of California is seeking an experienced RN to join our Care Management team as a RN Care Management Professional. In this role, you will be responsible for performing first-level determination approvals, reviewing prior authorization requests, and developing member-centered documentation.

Estimated Salary: $90,000 - $115,000 per year

Key Responsibilities:
  • Ensure discharge (DC) planning at levels of care appropriate for the members' needs and acuity.
  • Determine post-acute needs of members including levels of care, durable medical equipment, and post-service needs.
  • Triages and prioritizes cases to meet required turn-around times and expedites access to appropriate care for members with urgent needs.

Requirements:
  • Bachelor's degree or equivalent experience.
  • Experience working with or for a managed healthcare plan preferred.
  • Effective time management skills and ability to define and act on priorities efficiently preferred.


  • Rancho Cordova, California, United States United Health Care Staffing Full time

    We are seeking a skilled Emergency Department RN to join our team at United Health Care Staffing.A strong candidate will have 2+ years of experience as an ER RN and be proficient in TeleTracking and Cerner. They must also be able to multitask, possess excellent customer service skills, and be knowledgeable about different departments/units.The ideal...


  • Rancho Cordova, California, United States Blue Cross and Blue Shield Association Full time

    About Blue Cross and Blue Shield AssociationAs a leading health insurance organization, our mission is to provide high-quality care to millions of members across the United States.Salary Range:$70,000 - $100,000 per yearJob Description:Federal Employee Program (FEP) Case Manager RoleWe are seeking an experienced Clinical Registered Nurse Case Manager to join...


  • Rancho Cordova, California, United States Planet Healthcare Full time

    Nurse Manager Travel Assignment in Cordova, AlaskaWe are seeking a qualified and experienced Registered Nurse (RN) to fill a nurse manager travel position in Cordova, Alaska.This is an excellent opportunity to work with a leading healthcare staffing agency, Planet Healthcare, and gain valuable experience in a fast-paced clinical environment. As a travel...


  • Rancho Cordova, California, United States Mercy Home Health Full time

    We are seeking a dedicated and compassionate Nursing Professional to join our team at Mercy Home Health. As a key member of our staff, you will be responsible for providing exceptional patient care in the comfort of their own homes.Job SummaryThis is a challenging yet rewarding opportunity for a skilled RN to make a meaningful difference in the lives of our...


  • Rancho Cordova, California, United States Blue Shield of California Full time

    Overview: Blue Shield of California seeks a skilled Utilization Management Nurse, Senior to review inpatient stays and ensure medical necessity compliance with state and federal regulations.About the Role:In this critical position, you will conduct clinical reviews, discharge planning, and present cases to our Medical Director. You will work closely with...


  • Rancho Cordova, California, United States Planet Healthcare Full time

    Job Title: Travel Healthcare ProfessionalWe are seeking a dedicated and experienced RN Manager to join our team as a travel healthcare professional. This is a 16-week assignment in Cordova, Alaska, working 36 hours per week with 12-hour shifts.About the RoleThis is a unique opportunity to work with Planet Healthcare, a global leader in clinical staffing.As...


  • Rancho Cordova, California, United States Planet Healthcare Full time

    Job Summary:Planet Healthcare seeks a dedicated Travel Nurse RN Manager for a challenging opportunity in Cordova, Alaska.About the Position:This position requires a highly skilled nursing professional with expertise in managing patient care and leading nursing staff.Key Responsibilities:Patient Care: Develop and implement effective treatment plans to achieve...


  • Rancho Cordova, California, United States Care Team Solutions Full time

    Are you a skilled Emergency Room nurse looking for a new challenge? We have an exciting opportunity for a Travel Nurse RN Specialist to join our team at Care Team Solutions.Salary and BenefitsThe salary for this position is approximately $98,632 per year, based on a 36-hour workweek and a 13-week contract. You will also receive access to our early pay...


  • Rancho Cordova, California, United States Blue Shield of CA Full time

    About Us">Blue Shield of CA is a leader in healthcare innovation, dedicated to improving the health and well-being of our community. Our team of experts works tirelessly to develop and implement cutting-edge solutions that meet the evolving needs of our members.Salary Range">The salary range for this role is $87,230 - $130,900, based on industry standards...

  • Healthcare Specialist

    4 weeks ago


    Rancho Cordova, California, United States Blue Shield of California Full time

    At Blue Shield of California, we are dedicated to providing exceptional care management services to our members. We are seeking a highly skilled and compassionate Healthcare Specialist - Care Management to join our team.About the RoleThis role will be responsible for ensuring that our members receive high-quality, cost-effective healthcare services. You will...


  • Rancho Cordova, California, United States Illumia Full time

    About Illumia HealthIllumia Health is a fast-growing part of Gentiva, an industry leader in hospice and palliative care. Our clinical teams serve as an extension of physicians' care, partnering with them and other specialists to offer advanced illness management, a specialized form of high-touch palliative care designed to provide relief from the symptoms...


  • Rancho Cordova, California, United States Medical Solutions Full time

    Job OverviewWe're seeking a talented travel healthcare professional RN for a 13-week assignment in Rancho Cordova, California. As a member of our team, you'll have the opportunity to work with a leading healthcare provider and enjoy a range of benefits.About the RoleThis is a Med Surg position requiring RN skills.You'll be working 36 hours per week on...


  • Rancho Cordova, California, United States Applied Home Health and Hospice Full time

    Job Summary:We are seeking an experienced Nursing Care Professional to join our team at Applied Home Health and Hospice. The successful candidate will have a strong background in nursing, excellent communication skills, and the ability to work independently with minimal supervision. In this role, you will provide high-quality nursing care to patients in...


  • Rancho Cordova, California, United States Synergy Medical Staffing Full time

    Overview of the JobSynergy Medical Staffing is seeking an experienced and skilled travel nurse to fill a temporary position in Rancho Cordova, California. This exciting opportunity allows you to broaden your professional horizons while gaining valuable experience working with different healthcare facilities nationwide.About Synergy Medical StaffingWe are a...


  • Rancho Cordova, California, United States Medical Solutions Full time

    Job Title:Traveling Healthcare Professional - Med Surg RNAbout the Opportunity:We are seeking a skilled Med Surg RN to join our team as a traveling healthcare professional in Rancho Cordova, California. This is an excellent opportunity for a dedicated nurse to provide high-quality patient care while exploring new locations and experiences.Key...


  • Rancho Cordova, California, United States Planet Healthcare Full time

    Job Title:Travel Nurse RN ManagerAbout the Job:We are seeking a skilled Travel Nurse RN Manager for a rewarding opportunity in Cordova, Alaska.This role requires a professional with expertise in nursing and management to oversee patient care and lead our team.Responsibilities:Nurse Management: Lead and mentor nursing staff to ensure high-quality patient...


  • Rancho Cordova, California, United States Metal Mart Full time

    Key ResponsibilitiesAs a Store Management Professional, your primary responsibilities will include:Hiring, Training, and Managing EmployeesHiring and training new employees to ensure they have the necessary skills to perform their duties effectively.Managing employee performance, providing feedback, and taking disciplinary action when necessary.Inventory...


  • Rancho Cordova, California, United States FPI Management, Inc. Full time

    Job SummaryFPI Management, Inc. is seeking an experienced Multifaceted Property Operations Manager to assist the Community Director with day-to-day property operations and managing assets to meet client goals.About FPI Management, Inc.We are a leading third-party 100% fee-managed Property Management company, managing over 850 communities across the nation...


  • Rancho Cordova, California, United States Voyage Healthcare Full time

    Emergency Department Travel Nursing Job in CaliforniaVoyage Healthcare is a leading healthcare provider seeking an experienced travel nurse for a rewarding opportunity in Rancho Cordova, California.Job Details:Specialty: Emergency DepartmentDiscipline: Registered Nurse (RN)Shift: 12-hour nightsDates: 13 weeks with 36 hours per weekWe're committed to...


  • Rancho Cordova, California, United States beBee Professionals Full time $65,000 - $85,000

    In our dynamic healthcare environment, we are seeking a dedicated Registered Nurse to provide exceptional patient care at our state-of-the-art facility in Rancho Cordova, USA.Job OverviewThis rewarding position involves collaborating with medical teams to deliver high-quality patient care and ensuring seamless treatment plans.Key ResponsibilitiesEvaluate and...