Care Coordination Executive
3 weeks ago
About the Job:
We are seeking an experienced Director, Commercial Utilization Management to join our team at Blue Shield of California. This role offers the opportunity to make a meaningful impact on the lives of our members by ensuring they receive high-quality, cost-effective care.
Responsibilities:
- Develop and implement utilization management strategies that align with our clinical policies and goals.
- Lead teams of professionals to review and authorize medical services, ensuring that they are medically necessary and meet our quality standards.
- Analyze data to identify trends and patterns in healthcare utilization, and develop reports and recommendations to inform our utilization management decisions.
- Partner with physicians and other healthcare providers to develop effective care coordination strategies and improve patient outcomes.
- Manage operational teams and resources to ensure efficient and effective delivery of utilization management services.
- Stay up-to-date with regulatory requirements and industry developments, and ensure that our utilization management practices comply with all relevant laws and regulations.
Requirements:
- Minimum 10 years of experience in utilization management or a related field, including 6 years of management experience.
- Bachelor's degree in nursing or a related field, Master's degree or equivalent experience preferred.
- Current RN license in California required.
- Strong analytical and problem-solving skills, with ability to analyze complex data and develop actionable recommendations.
- Excellent communication and interpersonal skills, with ability to work effectively with diverse stakeholders, including physicians, patients, and other healthcare professionals.
- Experience with health plan operations and regulatory compliance a plus.
Pay Range:
The estimated salary for this role is $165,990 - $248,930 per year, based on your location (California) and experience.
-
Executive Assistant
3 weeks ago
Rancho Cordova, California, United States Randstad Full timeWe are seeking a highly skilled and experienced Executive Assistant to support our senior leadership team at Randstad. As an Executive Assistant, you will be responsible for providing administrative support, coordinating travel arrangements, and ensuring the smooth operation of our office.About the JobEstimated salary: $45,000 - $52,000 per yearLocation:...
-
Executive Assistant
3 weeks ago
Rancho Cordova, California, United States Randstad Full time**Job Title:** Executive Assistant**Company Overview:Randstad is a world leader in matching great people with great companies. Our experienced agents will listen carefully to your employment needs and then work diligently to match your skills and qualifications to the right job and company.We are seeking a detail-oriented and proactive Administrative...
-
Palliative Care Coordinator
3 weeks ago
Rancho Cordova, California, United States Applied Home Health and Hospice Full timeAbout the PositionWe are seeking a compassionate and skilled Palliative Care Coordinator to join our team at Applied Palliative and Hospice Services, Inc.Key Responsibilities:Coordinate the delivery of high-quality palliative care services to patients and their familiesDevelop and implement individualized care plans that establish goals based on nursing...
-
Nursing Care Coordinator
3 weeks ago
Rancho Cordova, California, United States Applied Home Health and Hospice Full timeJob OverviewWe are seeking a skilled nursing professional to join our team as a Nursing Care Coordinator. This is a dynamic opportunity for a registered nurse with experience in public health or home care nursing.The successful candidate will be responsible for providing high-quality, patient-centered care in the comfort of the patient's own home. Our team...
-
Rancho Cordova, California, United States Host Healthcare Full timeTravel Nursing Career OpportunityThe Nurse Care Coordinator travel nursing position entails providing comprehensive patient care and coordination services while traveling to various healthcare facilities. This role requires a Registered Nurse with expertise in clinical coordination, delivering exceptional patient outcomes.Host Healthcare prioritizes the...
-
Travel Nurse RN
2 weeks ago
Rancho Cordova, California, United States ICONMA, L.L.C. Full timeAbout the RoleWe are seeking a skilled Travel Nurse RN to join our team as a Care Coordination Specialist. This is an excellent opportunity for a motivated and experienced nurse to make a meaningful impact in long-term care.Job DescriptionThe Care Coordination Specialist will be responsible for providing high-quality patient care, ensuring effective...
-
Child Care Subsidy Coordinator
2 weeks ago
Rancho Cordova, California, United States Child Action, Inc Full timeJob Summary:We are seeking a highly organized and detail-oriented Child Care Subsidy Coordinator to join our team at Child Action, Inc. This role is responsible for conducting individual interviews with parents to determine eligibility and evaluate the need for subsidized child care.The ideal candidate will have excellent communication skills, be able to...
-
Nursing Care Coordinator Travel Opportunity
2 weeks ago
Rancho Cordova, California, United States GHR Healthcare Full timeAre you a skilled Registered Nurse looking to take your career to the next level? GHR Healthcare is seeking a talented Clinical Nurse Coordinator to join our team for a travel nursing opportunity in Rancho Cordova, California.About the PositionThis 12-hour night shift position offers a unique chance to work with a dedicated team and gain valuable experience...
-
Care Coordination Specialist
2 weeks ago
Rancho Cordova, California, United States Blue Shield of California Full timeJob DescriptionAt Blue Shield of California, we are seeking a highly skilled Care Coordination Specialist - Utilization Management to join our team.About the RoleThis is an exciting opportunity to work in a dynamic environment where you will play a critical role in ensuring that our members receive high-quality care while also promoting cost-effective...
-
Pet Care Front Desk Coordinator
4 weeks ago
Rancho Cordova, California, United States Dogtopia Full time**Job Description:We are seeking a pet care front desk coordinator to join our team at Dogtopia. In this role, you will be responsible for providing exceptional customer service, managing bookings and schedules, and maintaining a clean and safe environment for our customers and their pets.**Responsibilities include:Handling customer inquiries and resolving...
-
Healthcare Coordinator
2 weeks ago
Rancho Cordova, California, United States CVHCare Full timeJob Summary">We are seeking a highly organized and detail-oriented Healthcare Coordinator to join our team at CVHCare. This role will provide office support to our agency team, ensuring seamless transitions of patients to home care by providing essential documentation and coordinating with multiple service providers.Key Responsibilities:Provide...
-
Executive Construction Management Leader
11 hours ago
Rancho Cordova, California, United States RMA Companies Full timeCompany Overview:RMA Companies is a leading national provider of testing, inspection, and certification services, supporting innovation in new product development, quality assurance, and project delivery. We are committed to contributing to the sustainable development of the communities we serve.Job Summary:We are seeking an experienced Executive...
-
Government Relations Coordinator
4 weeks ago
Rancho Cordova, California, United States Child Action, Inc Full time**Job Title:** Government Relations CoordinatorWe are seeking a skilled and dedicated individual to join our team as a Government Relations Coordinator at Child Action, Inc. in San Francisco, CA. This is a full-time position with an estimated salary of $65,000 - $80,000 per year.About the Role:The Government Relations Coordinator will be responsible for...
-
Childcare Subsidy Program Coordinator
1 month ago
Rancho Cordova, California, United States Child Action, Inc. Full timeAre you passionate about supporting families and promoting early childhood education? We have an exciting opportunity for a Childcare Subsidy Program Coordinator to join our team at Child Action, Inc.!About the RoleThis is a non-exempt position responsible for conducting interviews with parents to determine eligibility and evaluate the need for subsidized...
-
Healthcare Coordinator
3 weeks ago
Rancho Cordova, California, United States Blue Shield of CA Full timeCompany Overview">Blue Shield of CA is a leading health insurance organization dedicated to providing high-quality healthcare services to its members. Our mission is to improve the health and well-being of our community by delivering innovative and cost-effective solutions.Salary">The estimated salary for this role is $104,615, based on industry standards...
-
Neurology Office Coordinator
2 weeks ago
Rancho Cordova, California, United States Neurology Clinic, PC Full timeJob OverviewWe are seeking a talented Neurology Office Coordinator to join our team at the Neurology Clinic, PC.In this role, you will be responsible for handling administrative and clinical duties, including performing routine tasks, communicating with insurance companies, and providing exceptional patient care.The ideal candidate will have previous...
-
Healthcare Assistant Coordinator
2 weeks ago
Rancho Cordova, California, United States Neurology Clinic, PC Full time**Career Opportunity**We are seeking a Healthcare Assistant Coordinator to join our team at Neurology Clinic, PC. As a valued member of our team, you will contribute to delivering exceptional patient care and support by performing various administrative and clinical tasks.**Responsibilities:**Perform a variety of administrative and clinical tasks, including...
-
Executive Support Specialist
2 weeks ago
Rancho Cordova, California, United States Veritas Accounting Full timeJob OverviewWe are a dynamic accounting firm, Veritas Accounting, that has been supporting small to medium-sized businesses for over 11 years. Our steady growth and commitment to excellence make us an attractive employer for ambitious professionals.The successful candidate will be responsible for providing administrative support to our team, ensuring...
-
Travel Healthcare Professional
2 weeks ago
Rancho Cordova, California, United States Host Healthcare Full timeWe are seeking a highly skilled Travel Healthcare Professional to join our team as a Clinical Nurse Coordinator in Rancho Cordova, California. This is an exciting opportunity to work with a reputable healthcare company and make a difference in the lives of patients.About the RoleThe successful candidate will be responsible for coordinating patient care...
-
Travel Nurse RN Clinical Coordinator
2 weeks ago
Rancho Cordova, California, United States Host Healthcare Full timeJob OverviewWe are seeking a skilled Registered Nurse to fill a 13-week travel nursing position in Rancho Cordova, California. As a Clinical Nurse Coordinator, you will be responsible for providing high-quality patient care and collaborating with the healthcare team.The ideal candidate will have experience in long-term acute care and possess excellent...