Case Management

Your Role 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 Senior Manager of Care Management - PHM. In this role you will act as the practice and operational leader...

Your Role The Care Management team will serve to support the mission of the department, which is to provide support to patients in maintaining health and wellness in the outpatient setting. The Nurse Consultant will report to the Manager of Care Management for the Population Health Management Medi-Cal Team. In this role, you will ensure that services are...

Your Role The Federal Employee Program (FEP) Care Management team performs integrated case management (CM) and disease management (DM) activities demonstrating clinical judgment and independent analysis, collaborating with members and those involved with their care including a multidisciplinary team and the member’s treating physicians. The Registered...

Your Role The Medical Care Solutions team manages the clinical operations including utilization management, care management and clinical programs. The Product Manager will initially report to the Vice President of Medical Care Solutions. In this role you will be responsible for setting product vision and strategy via understanding of customer needs and...

Your Role The Medical Director, Operations - Federal Employee Program, is a key member of the Medical Management and Operations staff within Health Care Services. This is a front-line utilization management position that has core responsibilities in the areas of inpatient concurrent review, pre and post service utilization review, and collaboration with RN...

Your Role The Medical Director provides clinical leadership within the Office of the CMO for Blue Shield Promise Health Plan, which includes management of the physician processes in support of utilization management and transactional functions. These functions include performance of preservice, concurrent, retrospective utilization review, Appeals and...

Overview: *All positions are located in Fresno/Clovis CA*OverviewWe are looking for an RN Risk Management Coordinator to join our growing team. In this fast-paced environment, you will have the opportunity to collaborate with a close-knit team, all while caring for a wide acuity of patients. As the management coordinator, you will provide in-depth clinical...

Your Role The Behavioral Health Utilization Management team performs prospective utilization review for our members and correctly applies the guidelines for nationally recognized levels of care. They collaborate directly with the Member, Member's Family, and Interdisciplinary Care Team to achieve consensus and promote positive Member health outcomes...

Overview: With over 150 years of experience, CoolSys is the market-leading indoor environment solutions company. Our full spectrum of best-in-class services includes HVAC & refrigeration installations, remodels, service & maintenance; and energy solutions, including controls and lighting. CoolSys serves customers in the retail, commercial, food service,...

Your Role: The Senior level Developer of the Client Personalization team is responsible for application service level achievement and customer satisfaction of Blue Shield of California’s Salesforce Health Cloud capabilities. This developer creates, configures, and manages Salesforce applications and related components and will be accountable for...

Your Role The Medical Director, Commercial is a key member of the Medical Management and Operations staff within Health Care Services. This is a front-line utilization management position that has core responsibilities in the areas of pre and post service utilization review, and collaboration with RN Case and disease managers. This director position will...

Your Role 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 Senior Manager of Care Management - PHM. In this role you will act as the practice and operational leader...

Your Role 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 Senior Manager of Care Management - PHM. In this role you will act as the practice and operational leader...

Your Role   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 Senior Manager of Care Management - PHM. In this role you will act as the practice and operational...

Your Role   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 Senior Manager of Care Management - PHM. In this role you will act as the practice and operational...

Company DescriptionPinnacle Case Management Solutions, LLC provides nurse case management services to employers, third-party administrators, and insurance carriers in the Workers' Compensation industry. Our dedicated team of nurses support all parties involved in the recovery process, including the claim examiner, employer, provider, and injured worker. We...

Your Role The Federal Employee Program (FEP) team performs integrated case management (CM) and disease management (DM) activities demonstrating clinical judgment and independent analysis, collaborating with members and those involved with members’ care including clinical nurses and treating physicians. The Behavioral Health Registered Nurse Case Manager...

Your RoleThe Federal Employee Program (FEP) team performs integrated case management (CM) and disease management (DM) activities demonstrating clinical judgment and independent analysis, collaborating with members and those involved with members’ care including clinical nurses and treating physicians. The Behavioral Health Registered Nurse Case Manager...

Your Role The Federal Employee Program (FEP) team performs integrated case management (CM) and disease management (DM) activities demonstrating clinical judgment and independent analysis, collaborating with members and those involved with members’ care including clinical nurses and treating physicians. The Behavioral Health Registered Nurse Case Manager...

Company DescriptionPinnacle Case Management Solutions, LLC provides nurse case management services to employers, third-party administrators, and insurance carriers in the Workers' Compensation industry. Our dedicated team of nurses support all parties involved in the recovery process, including the claim examiner, employer, provider, and injured worker. We...

Your RoleThe Care Management team will serve to support the mission of the department, which is to provide support to patients in maintaining health and wellness in the outpatient setting. The Nurse Consultant will report to the Manager of Care Management for the Population Health Management Medi-Cal Team. In this role, you will ensure that services are...

Your Role The Care Management team will serve to support the mission of the department, which is to provide support to patients in maintaining health and wellness in the outpatient setting. The Nurse Consultant will report to the Manager of Care Management for the Population Health Management Medi-Cal Team. In this role, you will ensure that services are...

Your Role The Care Management team will serve to support the mission of the department, which is to provide support to patients in maintaining health and wellness in the outpatient setting. The Nurse Consultant will report to the Manager of Care Management for the Population Health Management Medi-Cal Team. In this role, you will ensure that services are...

Your Role The Federal Employee Program (FEP) Care Management team performs integrated case management (CM) and disease management (DM) activities demonstrating clinical judgment and independent analysis, collaborating with members and those involved with their care including a multidisciplinary team and the member’s treating physicians. The Registered...

Your Role The Federal Employee Program (FEP) Care Management team performs integrated case management (CM) and disease management (DM) activities demonstrating clinical judgment and independent analysis, collaborating with members and those involved with their care including a multidisciplinary team and the member’s treating physicians. The Registered...

TotalMed Case Management Staffing is seeking a travel nurse RN Case Management for a travel nursing job in Sacramento, California. Job Description & Requirements Specialty: Case Management Discipline: RN Start Date: 06/17/2024 Duration: 24 weeks 40 hours per week Shift: 8 hours, days Employment Type: Travel We are seeking a Case Manager-Registered...

TotalMed Case Management Staffing is seeking a travel nurse RN Case Management for a travel nursing job in Fremont, California. Job Description & Requirements Specialty: Case Management Discipline: RN Start Date: ASAP Duration: 13 weeks 40 hours per week Shift: 8 hours, days Employment Type: Travel We are seeking a Case Manager-Registered Nurse...

TotalMed Case Management Staffing is seeking a travel nurse RN Case Management for a travel nursing job in Sacramento, California. Job Description & Requirements Specialty: Case Management Discipline: RN Start Date: ASAP Duration: 13 weeks 40 hours per week Shift: 8 hours, days Employment Type: Travel We are seeking a Case Manager-Registered...

TotalMed Case Management Staffing is seeking a travel nurse RN Case Management for a travel nursing job in Sacramento, California. Job Description & Requirements Specialty: Case Management Discipline: RN Start Date: 06/17/2024 Duration: 13 weeks 40 hours per week Shift: 8 hours, days Employment Type: Travel We are seeking a Case Manager-Registered...

TotalMed Case Management Staffing is seeking a travel nurse RN Case Management for a travel nursing job in Glendale, California. Job Description & Requirements Specialty: Case Management Discipline: RN Start Date: ASAP Duration: 13 weeks 40 hours per week Shift: 8 hours, days Employment Type: Travel We are seeking a Case Manager-Registered Nurse...

TotalMed Case Management Staffing is seeking a travel nurse RN Case Management for a travel nursing job in Novato, California. Job Description & Requirements Specialty: Case Management Discipline: RN Start Date: 06/10/2024 Duration: 13 weeks 40 hours per week Shift: 8 hours, days Employment Type: Travel We are seeking a Case Manager-Registered...