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Full Time
6/22/2025
Riverside, CA 92506
(29.7 miles)
At Gentle Dental, we value our teammate’s smile as much as our patient’s smile. Our vision is to provide exceptional, lifelong, integrated oral healthcare services. We enhance the quality of our patients’ lives by providing accessible oral healthcare, which is paramount to overall health and well-being. We focus on a commitment to patient care, operational and clinical excellence, personal accountability, building relationships, and seeking out innovative and creative approaches to support our patients and teams. We are hiring immediately for full and part time positions in our dental offices and are seeking teammates who care, listen, and are motivated to help our patients and communities. Come join our team and make a difference in the lives of the people in your community! Schedule: Part-time Pay Information: $20.00 - $24.00 per hour/DOE Benefits Employee Assistance ProgramBasic life, AD&D, and long-term disability insurance401k plan and deferred compensation planReferral Bonuses ($2K-5K depending on role) Office Location Gentle Dental Riverside3630 Central Ave.Suite 6Riverside, CA 92506, USA Required Qualifications Registered Dental Assistant (RDA) RequiredX-Ray Certification RequiredCertificate from a Dental Assisting ProgramValid health care provider CPR/BLS Certificate Qualifications that Increase Starting Pay ExperienceEFDA CertBilingual Spanish Equal Opportunity Employer This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.
Full Time
6/10/2025
Long Beach, CA 90899
(22.8 miles)
Your Role The Behavioral Health (BH) Utilization Management (UM) team performs prospective, concurrent, retrospective utilization reviews and first level determinations for members using BSC evidenced based guidelines, policies, and nationally recognized clinical criteria across multiple lines of business. The Behavioral Health Utilization Management, Consultant (Lead), will report to the Manager of Behavioral Health Utilization Management (BH UM). In this role you will support the clinicians with daily operations, provide coaching, and serve as the subject matter expert for the BH UM team as they conduct clinical reviews of mental health and substance use authorization requests at various levels of care for medical necessity.Your WorkIn this role, you will:Facilitate communication between leadership, Medical Directors, and non-clinical leads to address line staff questions and issues; escalate matters to management with recommendations or consultation as neededLead onboarding/training of incoming staff, provide proactive and guided support through the onboarding processMaintain and gain knowledge of behavioral health utilization management through team and departmental expansion as neededAct as subject matter expert to review and evaluate the effectiveness of operational workflows to identify problems and develop improvements, modifications, and enhancementsDevelop and evaluate tools and materials that enhance operating efficiency, accuracy, and technical skill levels of unit staffAssist with audit readiness in collaboration with internal BSC partnersPerform advanced or complicated prior authorization and concurrent utilization reviews and first level determinations for members using non-profit association guidelines ensure discharge (DC) planning at levels of care appropriate for the members needs and acuity; prepare and present cases to Medical Director (MD) for oversight and necessity determinationIdentify process and control improvement opportunities and provide recommendations that help improve the effectiveness, efficiency and/or economic value of a control or processProvide guidance, coaching and training on internal behavioral health utilization management processes to other employees across the company as appropriateLead, manage, and execute other special projects and team initiatives as assignedLead team huddles/meetings to support processes and collaboration of team membersSupport team through consistent and successful caseload management and workload to achieve team goals, regulatory timelines, and accreditation standardsYour Knowledge and ExperienceCurrent unrestricted CA license (LCSW, LMFT, LPCC, PhD/PsyD or RN with Behavioral Health experience) requiredAdvanced degree commensurate with field is preferredRequires at least seven (7) years of prior experience in healthcare related fieldExperience operating in a lead role or equivalent leadership training is preferredFive (5) years conducting Behavioral Health Utilization Management for a health insurance plan or managed care environment preferredDeep knowledge of Behavioral Health Utilization Management including ability to apply and interpret admission and continued stay clinical against nonprofit association guidelinesFamiliarity with medical terminology, diagnostic terms, and treatment modalities including ability to comprehend psychiatric evaluations, clinical notes, and lab resultsProficient with Microsoft Excel, Outlook, Word, Power Point, and the ability to learn and utilize multiple systems/databasesExcellent analytical, communication skills, written skills, time management, and organizational skillsPossess outstanding interpersonal, organizational, and communication skills, positive attitude, and high level of initiativeAbility to identify problems and works towards problem resolution independently, seeking guidance as needed
Full Time
6/19/2025
Gardena, CA 90247
(32.4 miles)
Physical Therapist - RehabWe are seeking a dedicated Physical Therapist to join our rehabilitation team. In this role, you will help patients recover from injuries or illnesses by improving their movement, reducing pain, and restoring functionality through personalized therapy programs.Key Responsibilities:Evaluate patients to assess their physical conditions and develop individualized treatment plans.Implement therapeutic exercises, manual therapy techniques, and specialized equipment to aid recovery.Educate patients and caregivers on techniques to improve mobility and prevent future injuries.Collaborate with other healthcare professionals to ensure comprehensive care for patients.Monitor patient progress and adjust treatment plans as necessary to achieve optimal outcomes.Document patient evaluations, treatments, and progress in compliance with healthcare regulations.Work Environment:Work in rehabilitation centers, hospitals, outpatient clinics, or private practices specializing in physical therapy.Engage in a dynamic, hands-on environment that requires physical activity and patient interaction.Benefits:Competitive salary and comprehensive benefits package.Opportunities for professional growth through training and certifications.A supportive work environment focused on collaboration and innovation in patient care delivery.*This information is based on the Bureau of Labor Statistics (BLS). Actual job responsibilities may vary by location.*
Full Time
6/22/2025
Rancho Cucamonga, CA 91730
(31.0 miles)
At Gentle Dental, we value our teammate’s smile as much as our patient’s smile. Our vision is to provide exceptional, lifelong, integrated oral healthcare services. We enhance the quality of our patients’ lives by providing accessible oral healthcare, which is paramount to overall health and well-being. We focus on a commitment to patient care, operational and clinical excellence, personal accountability, building relationships, and seeking out innovative and creative approaches to support our patients and teams. We are hiring immediately for full and part time positions in our dental offices and are seeking teammates who care, listen, and are motivated to help our patients and communities. Come join our team and make a difference in the lives of the people in your community! Schedule: Part-Time Benefits Employee Assistance ProgramBasic life, AD&D, and long-term disability insurance401k plan and deferred compensation planReferral Bonuses ($2K-5K depending on role) Office Location: This is a traveling position around Southern CA (San Bernardino County, Orange County, San Diego area) Gentle Dental Foothill8880 E. Foothill Blvd.Rancho Cucamonga, CA 91730, USA Pay Information $18.00 - $24.00 per hr/DOE Required Qualifications Board-approved 8-hour infection control courseCertificate from an Accredited Dental Assisting ProgramValid health care provider CPR/BLS Certificate1+ years of experience Qualifications that Increase Starting Pay ExperienceX-Ray CertificationBilingual SpanishExpanded Functions CertifiedRegistered Dental Assistant (RDA) when applicable Equal Opportunity Employer This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.
Full Time
6/10/2025
Long Beach, CA 90899
(22.8 miles)
Your Role Reporting to the Chief Medical Officer, the Senior Medical Director, Clinical Strategy will define the vision and priorities for Blue Shield of California’s strategy to deliver best in class clinical outcomes for our members while working to ensure that health care is affordable. In this role you will be accountable for working in partnership with other leaders to deliver best in class clinical programs and align our value-based care models to meet our clinical strategy objectives. Your WorkIn this role, you will:Develop a clinical strategy framework and guiding principles, grounded in data on population health outcomes and cost, to deliver Best in Class clinical outcomes for Blue Shield of California membersDefine the organization’s overall clinical strategy, as relates to priorities, partnerships, and key measures of success to improve member experience, population health and affordability, inclusive of primary care and specialty careCo-chair the Clinical Program Review and Governance Committee with the Chief Medical Officer to ensure that all clinical programs are delivering expected clinical and cost of care outcomes for our membersWork with teams performing vendor management to ensure that contracts include appropriate metrics to ensure programs are meeting operational targets to achieve clinical objectivesCollaborate with the Health Economics team to develop the methodology to evaluate the effectiveness and lead a process to ensure robust evaluation of all clinical programsCollaborate with business leaders to ensure that the clinical strategy and clinical programs are meeting business, client, and member needsCreate an environment of accountability and continuous quality improvement to ensure that all clinical programs continue to meet and exceed objectives necessary to deliver best in class clinical outcomes for Blue Shield of California membersCommunicate internally and externally the vision and strategy to transform healthcare to deliver Best in Class clinical outcomes for Blue Shield of California membersYour Knowledge and ExperienceMinimum of 2 years of previous medical leadership experienceMinimum of 5 years of direct patient care experience post residencyMinimum 4 years experience in observational study design and execution and/or clinical program evaluationMedical degree (M.D./D.O.)Maintain active, unrestricted California State Medical License required; Maintain active, unrestricted Medical License in all additional assigned states requiredMaintain Board Certification in one of ABMS, ABOS, or AOA recognized specialty requiredOutstanding verbal and written communication skillsAbility to lead through influence in a matrixed organizationMasters or PhD in Health Services Research, Epidemiology, Biostatistics or similar field preferredExperience in a health plan or managed care organization is preferred
Full Time
6/10/2025
Long Beach, CA 90899
(22.8 miles)
Your Role The Medical Management team ensures that Blue Shield is on the cutting edge of medical, medication, and payment policy to accelerate the emergence of a value-based health care system in California. The Sr. Medical Director, Medical Policy will report to the Chief Medical Officer. In this role you will be accountable for ensuring that all medical, medication, and payment policy initiatives are in aligned with the scientific evidence and professional guidelines. You will lead a team that delivers medical policy that adapts to new clinical innovations and supports medical payment operations, and training for staff in the accurate application of medical, medication, and payment policy, pricing, and coding. In addition to chairing the BSC Pharmacy & Therapeutics, Medical and Payment Policy Committees, you will provide clinical leadership for all evidence-based medicine functions and partner closely with leaders of other business functions to develop strategies to ensure that Blue Shield members are receiving appropriate quality care.Your WorkIn this role, you will:Provide clinical thought leadership for the design and implementation of clinical policy innovation initiatives such as Coverage with Evidence Development, and the development of robust and efficient approaches to developing policies for emerging classes of technology like molecular diagnostics and mobile/digital personal health devicesChair the Medical Policy and Pharmacy and Therapeutics CommitteesProvide clinical leadership and medical consultation for the Blue Shield of California (BSC) medication management process, including working closely with the Pharmacy Services team to promote safe, effective, and cost-efficientProvide medical expertise in daily clinical rounds for drug authorization case reviewChair the Payment Policy Committee and provide clinical leadership for the BSC Payment Policy committee, overseeing and advising about payment policies and tactical approaches to ensure accurate coding of servicesConsult with BSC legal team to support fraud and abuse investigations, provider arbitrations, regulatory inquiries and issues, and litigation related to clinical policy, coding, or pricing issuesAct as BSC’s representative to the Blue Cross Blue Shield Association (BCBSA) Technology Assessment process and the Medical Policy PanelParticipate on the California Technology Assessment Forum and other related activitiesPartner with Network Management and Provider Partnership teams by providing subject matter expertise for contract and benefits coding decisions, including mandated benefits, provider contract language, provider DOFRs (division of financial responsibilities), and providing clinical perspective to resolve issues with BSC providers related to clinical policy, coding, and billing.Provide subject matter expertise for pricing of new, zero-dollar, and other exceptional claimsPresent at IPA/MG and Provider education seminars regarding medical, medication and payment policy Your Knowledge and ExperienceMinimum of 2 years of previous medical leadership experienceMinimum of 5 years of direct patient care experience post residencyMinimum of 8 years of experience developing evidence-based guidelines, medical policies or performing systematic reviews of the medical literatureMedical degree (M.D./D.O.) required. Master’s degree in epidemiology, health services or related degree is preferredCompleted residency preferably in adult based primary care specialty (e.g. Internal Medicine, Family Practice)Maintain active, unrestricted California State Medical License required; Maintain active, unrestricted Medical License in all additional assigned states requiredMaintain Board Certification in one of ABMS, ABOS, or AOA recognized specialty required (preferably Internal Medicine or Family Practice)Has mastery level knowledge and skills within a specific technical or professional discipline with broad understanding of other areas within the job functionOutstanding verbal and written communication skillsAbility to lead through influence in a matrixed organizationExperience performing utilization management reviews is preferredExperience in a health plan or managed care organization is preferred#LI-JS3
Full Time
6/26/2025
Los Angeles, CA 90033
(34.9 miles)
Respiratory Therapist - NICUWe are seeking a skilled Respiratory Therapist to join our Neonatal Intensive Care Unit (NICU) team. In this role, you will provide specialized respiratory care to premature or critically ill newborns, ensuring their breathing needs are met with precision and compassion.Key Responsibilities:Administer oxygen therapy, ventilator support, and other respiratory treatments to neonates in the NICU.Monitor vital signs and adjust respiratory support based on the infant's condition.Collaborate with neonatologists and NICU staff to develop individualized care plans for each patient.Perform diagnostic tests such as blood gas analysis to evaluate lung function.Educate parents on respiratory equipment and techniques to prepare for discharge when appropriate.Maintain accurate documentation of treatments provided and patient progress.Work Environment:Work in a fast-paced NICU environment that requires critical thinking and attention to detail.Collaborate closely with a multidisciplinary team dedicated to neonatal care.Be prepared for rotating shifts, including nights, weekends, and holidays, as required in critical care settings.Benefits:A competitive salary with comprehensive benefits options available.A focus on professional growth through training opportunities and certifications in neonatal respiratory care.A supportive workplace culture that values teamwork and innovation in patient care delivery systems.*This information is based on the Bureau of Labor Statistics (BLS). Actual job responsibilities may vary by location.*
Full Time
6/10/2025
Long Beach, CA 90899
(22.8 miles)
Your Role The Medical Director, National Accounts position is dedicated to supporting the promotion of growth and increased market share of the National Accounts and the Administrative Services Only (ASO) business. This includes strategic clinical and healthcare cost management guidance for the existing Blue Shield of CA book of business. This position will report directly to the VP, CMO, Commercial Markets. This position provides clinical direction to the sales team and sales processes and interacts directly with employers and consultants. This role will be at the center of driving strategy for how to reduce cost of care, while providing client advisory services, increasing engagement, and improving the quality of care & population health for our employers’ membership.Your Work In this role, you will: Lead client and producer facing activities including finalist presentations and account services meetings, broker and consultant meetings, meetings with Mercer, WTW, Aon, etc. Actively participate in and guide the preparations and the actual client meetings. Other activities include interpreting clinical data for employers at regular or pre-determined intervals, reviewing cost/spending trends, making recommendations on improving member engagement and population health. You will work diligently both internally and externally to develop, refine, and expertly communicate the BSC Clinical Value Proposition.Work collaboratively with other Healthcare Solutions and BSC staff to quickly resolve client service issues, with particular emphasis on clinical issues. Be available to talk with key account members about their issues and the solutions.Act as a strategic thought-partner for key clients (e.g. UC, Stanford, CalPERS) who want best-in-class medical, health and wellness programs.Responsible for the planning, development, and leading the delivery of Healthcare Solutions related materials to clients, producers and business associations that describe and explain the operational details and value of Healthcare Solutions capabilities, services and programs. Includes working with the Health Data Reporting teams to analyze data trends and develop external customer reports.Support other ASO Line of Business activities such as: business planning, business development, and designing and implementing innovations to address market needs.Your Knowledge and Experience Medical Degree (M.D./D.O.)Completed residency preferably in adult based primary care specialty (e.g. internal medicine, family practice)Active, unrestricted California State Medical LicenseMinimum 10 years managed care experience requiredAt least five years clinical experience requiredExperience with California managed care marketplace is requiredPrevious experience in national, complex account management support is requiredExperience supporting Administrative Services Only (ASO) lines of business is preferredPrevious experience in a similar sales role preferredPrior experience as a people manager preferredExcellent verbal and written communication skills, including ability to speak comfortably and extemporaneously to diverse audiencesAbility to explain program, clinical, operational, and quantitative information in a business-like, clear, coherent, and comprehensible wayStrong quantitative and analytic skills working with claims, operational, and clinical data and reportsExcellent interpersonal communication skills, including active listening, self-management and awareness, emotional intelligence, and ability to flex interpersonal style situationalDemonstrated ability to model a collaborative approach with internal and external stakeholdersStrong negotiation and creative problem-solving skillsStrong skills with Microsoft Office Suite, including PowerPoint, Excel, Word and Outlook
Full Time
6/10/2025
Long Beach, CA 90899
(22.8 miles)
Your Role The Network Contracting and Trend Analytics (NTA) team supports the Network Management team with analytical and financial modeling for provider contracting and network development activities for Blue Shield of California. The Senior Principal, Medical Informatics of NTA will report to the Senior Director of NTA. In this role you will be responsible for behavioral health finance analytics including measurement of internal cost of healthcare and reporting, analytics supporting coordination of care opportunities, and oversight of provider contracting analytics. Our leadership model is about developing great leaders at all levels and creating opportunities for our people to grow – personally, professionally, and financially. We are looking for leaders that are energized by creative and critical thinking, building and sustaining high-performing teams, getting results the right way, and fostering continuous learning.Your Work In this role, you will: Develop the financial management and modeling best practices, specifically for Behavior Health as we move to an in-sourced environmentImplement on-going behavior health costs analysis and trendsBe responsible for CoHC - Behavior HealthBe the lead on modeling the financial aspects. Example, evaluating the financial aspects of care activities such as hospital ER vs behavioral health servicesLead all financial aspects in developing Value-Based Contracting, specifically in Behavior Health marketplace.Be accountable for development of the financial contractual arrangements and the implementation of these providers, which we are bringing in house Your Knowledge and Experience Requires a college degree or equivalent experienceMPH, MBA, MS, MA, RN, or RHIA preferredRequires 10 years of relative experienceRequires a minimum of 5 years’ experience in Health Care (managed care, academic, or gov't payer)Requires contracting in healthcare with a behavioral health specialtyRequires experience developing programs that will translate into CoHC savings specifically in extensive vendor knowledge of financial healthcare within behavioral healthRequires experience with behavioral health financial reporting and modelingRequires one to be comfortable with an ever changing business model that is continually seeking the optimal solution in the behavioral health spaceRequires a SAS Certified Base Programmer Credential or equivalent or a SAS Certified Advanced Programmer Credential or equivalent
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