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Management Jobs
Full Time
6/10/2025
El Dorado Hills, CA 95762
(18.0 miles)
Your Role The Facility Compliance Review (FCR)team reviews post service prepayment facility claims for contract compliance, industry billing standards, medical necessity and hospital acquired conditions/never events. The Utilization Management Nurse, Seniorwill report to the Senior Manager, Facility Compliance Review. In this role you will be reviewing medical documents and applying clinical criteria to establish the most appropriate level of care. This role will be focusing primarily on inpatient psych reviews for Residential Treatment and Detox. Also, you will be reviewing hospital itemized bills for a comprehensive line-by-line audit and manual claims processing on exceptions to ensure that appropriate billing practices are followed based on facility specific contract language. These exceptions may include medical necessity, DRG validation, stop loss, trauma, ER, burns, implants, NICU, transplants, hospital acquired conditions/never events and aberrant billing.Your Work In this role, you will: Perform retrospective utilization reviews and first level determination approvals for members using BSC evidenced based guidelines, policies and nationally recognized clinal criteria across lines of business or for a specific line of business such as Medicare and FEPConducts clinical review of claims for medical necessity, coding accuracy, medical policy compliance and contract compliancePrepare and present cases to Medical Director (MD) for medical director oversight and necessity determinationand communicate determinations to providers and/or members to in compliance with state, federal and accreditation requirementsDevelop and review member centered documentation and correspondence reflecting determinations in compliance with regulatory and accreditation standardsandidentifypotential quality of care issues, service or treatment delays and intervenes or as clinically appropriateClearly communicates, is collaborative, while working effectively and efficientlyReview itemizations for coding logic using industry standards as well as CMS guidelinesTriages and prioritizes cases to meet required turn-around timesIdentifies potential quality of care issues, service or treatment delays as clinically appropriate.Clinical judgment and detailed knowledge of benefit plans used to complete review decisionsYour Knowledge and Experience Requires a bachelor's degree or equivalent experienceRequires a current California RN LicenseRequires at least 5 years of prior relevant experiencePrevious Inpatient Psych experience preferredRequires strong attention to detail to include ability to analyze claim data analyticsRequires independent motivation, strong work ethic and strong computer navigations skillsPsych claims review experience preferred
Full Time
6/1/2025
Sacramento, CA 95834
(5.8 miles)
Description & Requirements Description Compensation:$26 - $32 Per Hour- Full time, based upon experiencePromotion opportunity to Program Supervisor (salaried) based upon experienceBenefits of Working at Intercare:Monthly Bonuses!Flexible work schedule with a focus on work/life balance; Manage your own scheduleMileage reimbursement, a company computer and cell phoneEducation tuition reimbursement program (Masters & BCBA)!Leadership training and CEUs - we will teach how to become a better leader!Medical, Dental, and Vision insuranceGenerous time off policy (vacation, sick time, and holidays)Company 401k PlanOutstanding mentorship and supportive environment for continual learningRequired Credentials/Experience:Completed Bachelor’s degree and either of the following:12 semester units of ABA course work with one (1) year experience implementing and/or designing ABA programmingTwo (2) years of experience designing or implementing ABA programsStrong ABA and clinical skillsExcellent written and spoken communication, time management skills, and interpersonal skillsAbility to give and receive constructive feedback with a team player attitudeBilingual skills valuedJob DescriptionIntercare Therapy provides evidence-based behavioral therapies that help children overcome challenges related to autism spectrum disorders. Our mission is to optimize the independence and quality of life of our clients and their families. We love what we do, and we are seeking team members who share our passion for improving the lives of children and families affected by autism.AProgram Managerserves in the field as the onsite case supervisor and leader, mastering daily case management skills, including developing and overseeing clinical programs, supervising BIs and providing education and training for client caregivers. You must be willing to drive 30 to 60 miles a day, andable to supervise client sessions anytime between 8AM and 6PM on weekdays, and occasionally on weekends.We are proud to be the highest rated established ABA organization on Glassdoor! Check out our rankings and reviews on Glassdoor!Learn more about us on You Tube!This position may require the candidate be fully vaccinated for COVID-19 in accordance with all vaccination requirements set forth by Intercare funding sources and pursuant to any guidelines from the California Department of Health.Closing:If you have experience in any of the following fields, we encourage you to apply:Behavior Analyst, Autism, Social Learning, Social Skills, Developmental Condition, Psychology, Sociology, Social Services, Children, ABA, Applied behavior analysis, BCBAIntercare Therapy will consider for employment qualified applicants with criminal histories in a manner consistent with the requirements of the Los Angeles Fair Chance Initiative for Hiring (Ban the Box) Ordinance.Intercare Therapy supports a diverse workforce and is an Equal Opportunity Employer.
Full Time
6/1/2025
Fair Oaks, CA 95628
(7.3 miles)
When you join Sunrise Senior Living, you will be able to use your unique skills to empower residents to live longer, healthier, and happier lives. Not only will you build meaningful relationships with residents, their families, and team members alike, you will also gain joy in serving others and deep fulfillment in your work. Explore how you can follow your passions and shed light on meaningful ways to serve, grow, and shine together. Sunrise Senior Living was again certified as a Great Place to Work® by Activated Insights. This is the 8th time Sunrise has received this top culture and workplace designation, highlighting the special place Sunrise is to be a part of. COMMUNITY NAME Sunrise of Fair Oaks Job ID 2025-228666 JOB OVERVIEW The LPN Medication Care Manager is responsible for providing the highest degree of quality care and services by administering medication and treatments in a safe organized manner. Responsibilities include but are not limited to administration of medications, documentation of medication administration, conducting SHUs, and providing resident care while demonstrating the Mission for Sunrise Senior Living, "to champion the quality of life for all seniors" in accordance with federal, state/provincial, and local laws, standards and regulations and Sunrise Senior Living policies to promote the highest degree of quality care and services to our residents. RESPONSIBILITIES & QUALIFICATIONS Responsibilities:As a part of the Sunrise team, supporting our Mission, Principles of Service and Core Values is a fundamental part of this job. Our foundational belief is the sacred value of human life. The unique responsibilities for this role include but are not limited to the essential functions listed as follows:Medication Administration:Provides the highest degree of quality care and services by administering medication and treatments in a safe organized manner.Reviews, reads, notates, and initializes Daily Log to document and learn about pertinent information about residents.Receives medication updates from Resident Care Director (RCD) or Wellness Nurse.Administers, assists with, and observes medications and treatments for each resident using the medication administration record and the Six Rights of Medication Pass ("Right" resident, medication, dosage, time, route, right to refuse).Ensures that medications are passed according to times.Documents and initials as medications are given and ensures that appropriate documentation is completed for refusal or missed doses.Maintains confidentiality of all resident information including resident medication among other residents.Reports all resident concerns made while administering the medication to the RCD or Wellness Nurse.Restocks medication cart after all medication passes.Assists in checking medication regardless of packaging system.Assesses the residents to determine need for "as needed medication" and appropriately documents and reports to supervisor.Counts all narcotics with another Medication Care Manager (MCM) or Lead Care Manager (LCM) each shift.Maintains and cleans the Medication Room, medication carts and treatment carts for neatness, cleanliness, availability of medications, and expired medications.Follows re-fill process for medications.Helps residents maintain independence and promotes dignity and physical safety of each resident adhering to the Sunrise Principles of Service.Strives to understand and respond to each resident with empathy, always remaining mindful of the resident's unique communication patterns, history, and basic human needs.Practices routinely good standard care precautions of cleanliness, hygiene, and health .Audits medication carts.Resident Care:Notifies RCD of any resident and/or family concerns through the LEAD process.Attends and actively participates in daily Cross Over meetings facilitated by the LCM.Conducts Service and Health Updates as directed by RCD.Participates in the development of the Individualized Service Plans (ISP)/Individualized Care Plans (ICP) and monthly updates.Transcribes orders.Risk Management and General Safety:Partners with community team to ensure community is in compliance with OSHA/British Columbia Workers Compensation Act and Occupational Health and Safety Regulation requirements, promoting Risk Management programs and policies, and adhering to safety rules and regulations.Practices safety procedures at all times including Personal Protective Equipment (PPE), fire extinguishers, Safety Data Sheets (SDS), and Lockout Tagout procedures.Reports all accidents/incidents immediately.Reports all unsafe and hazardous conditions/equipment immediately.Ensures any cords, carts, equipment, and other hazards are always kept out of the way, not blocking exits and in compliance with fire codes.Complies with all infection control techniques, placement of bio-hazard containers, removal techniques, procedures, and policies.Understands and practices the proper method of attending to and disposing of, and the possibility of exposure to, blood borne pathogens, bodily fluids, infectious waste, sharp sticks, and hazardous materials.Reports occupational exposures to blood, body fluids, infectious materials, sharp sticks and hazardous chemicals immediately.Ensures oxygen tanks are stored safely, exchanges guest/resident's tanks when empty and monitors to make sure liters of oxygen are at prescribed levels.Training and Contributing to Team Success:Actively participates as a member of a team and commits to working toward team goals.Demonstrates in daily interactions with others, our Team Member Credo.Commits to serving our residents and guests through our Principles of Service.Contributes to the overall engagement programs and processes (customer and team member engagement) including participating in the team member engagement survey and engagement improvement planning workshops.Attends regular meetings; Town Hall, Department Team, Cross Over, Medication Technician and others as directed by the Supervisor/Department Coordinator.Attends regular training by RCD and neighborhood coordinators.May be designated as shift supervisor.May supervise other medication care managers.Maintains compliance in assigned required training and all training required by state/province or other regulating authorities as applicable to this role to ensure that Sunrise standards are always met.Qualifications:To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed throughout this job description are representative of the knowledge, skills, and abilities required.LPN, LVN, or state/province specific licensed nurse credential.In states/provinces where appropriate, must maintain certifications.Maintain the following certifications and ongoing training and re-education as required by Sunrise and state/provincial regulations:CPR and First AidMust be at least 18 years of age.Previous experience working with seniors preferred.Desire to serve and care for seniors.Ability to make choices and decisions and act in the resident's best interest.Ability to react and remain calm in difficult situations.Ability to handle multiple priorities.Possess written and verbal skills for effective communication and level of understanding.Demonstrates good judgment, problem solving and decision-making skills.As applicable, all Sunrise team members who drive a Sunrise vehicle must sign the Driver job description and understand the key essential duties for safety and regulatory compliance. ABOUT SUNRISE Ready to take the next step and make a bigger impact than you ever imagined As part of our team, you will help brighten the future for everyone at Sunrise and beyond. That is why we make it a priority to celebrate the unique ways you bring moments of togetherness and joy to everyone you serve. And when combined with the support, benefits, and growth opportunities we offer, the result is a career that PositivelyShines with everything you need to reach your goals - at work and in your life. We also offer benefits and other compensation that include: Medical, Dental, Vision, Life, and Disability Plans Retirement Savings Plans Employee Assistant Program / Discount Program Paid time off (PTO), sick time, and holiday pay Daily Pay offered to get paid within hours of a shift (offered in the U.S. only) Tuition Reimbursement In addition to base compensation, Sunrise may offer discretionary and/or non-discretionary bonuses. The eligibility to receive such a bonus will depend on the employee's position, plan/program offered by Sunrise at the time, and required performance pursuant to the plan/program. Some benefits have eligibility requirements Apply today to learn why Sunrise Senior Living is a certified Great Place to Work® PRE-EMPLOYMENT REQUIREMENTS Sunrise considers the health and safety of its residents, family members, and team members to be one of its highest priorities. Employment with Sunrise is conditioned on completing and passing a drug test (which does not include marijuana), participating in testing requirements (e.g. Tuberculosis Test, Physical Evaluation). Covid-19 and Influenza vaccination is only required to the extent mandated by applicable federal, state, and local laws and authorities. COMPENSATION DISCLAIMER Selected candidates will be offered competitive compensation based on geographic location of community/office, skills, experience, qualifications, and certifications/licenses (where applicable).
Full Time
6/1/2025
Vacaville, CA 95687
(37.1 miles)
We want you to help us shape the future of shopping experiences and deliver on our purpose of connecting people with the products and experiences that enrich their lives. Joining Advantage Solutions means joining a network of 65,000 teammates serving 4,000+ brands and retail customers across 40+ countries. All the while, being provided the opportunities, support, and enrichment you need to grow your career.In this position, you'll drive sales by engaging customers and bringing brands to life by providing live events and sampling to consumers where they live and shop. Additionally, you will provide support to management as needed.What we offer:Competitive wages; $18.72 per hourGrowth opportunities abound – We promote from withinNo prior experience is required as we provide training and team support to help you succeedAdditional hours may be available upon requestWe offer benefits that can be customized to meet your family’s needs, including medical, dental, vision, life insurance, supplemental voluntary plans, wellness programs, and access to discounts through Associate PerksNow, about you:Are comfortable interacting with customers and management in a friendly, enthusiastic, and outgoing mannerAre 18 years or olderAvailable to work 2-3 shifts per week, including weekendsCan lift up to 50 lbs. on a regular basis and stand for up to 6 hoursAre comfortable preparing, cooking, and cleaning work area and equipmentHave reliable transportation to and from work locationDemonstrate excellent customer service and interpersonal skills with our clients, customers and team membersAre a motivated self-starter with a strong bias for action and resultsWork independently, but also possess successful team building skillsHave the ability to perform job duties with a safety-first mentality in a retail environmentIf this sounds like you, we can’t wait to learn more about you. Apply Now!
Full Time
6/1/2025
Fairfield, CA 94533
(43.8 miles)
Right At School – a place to be a kid!Program ManagerRight At School provides local school districts before and after school extended day programs with a focus on disguised learning activities and daily enrichment dedicated to the success of all students!Right At School's mission emphasizes a commitment to inspire a love of learning, support schools, and give families peace of mind. We do this by building a team of mission-driven individuals, who are passionate about fostering a love of learning and creating safe, engaging experiences for children. Our vision is to bring exceptional, affordable programs to as many students, families, and schools as possible while providing a safe environment for children to explore and grow.Program Manager Pay Rate: $25 - $28 (based on education and experience)You’ll drive the mission by:Safety & Joy: Exhibits role model qualities ensuring safety and joy standards are met by supporting a clear understanding of the roles and responsibilities to a team of staff members. Supports operational efficiency by keeping site documents and licensing standards up to date. Outlines attendance protocols, behavior policies, safety procedures, and ensures program tasks are completed effectively. ;Continual coaching, fostering respectful relationships among staff to address any challenges or issues promptly to maintain team cohesion, and productivity.Safety Assurance: Consistently support and report on safety protocols to ensure the well-being of all participants. Identify and mitigate any potential risks within the program environment.Effective Communication: Engage meaningfully with families, client partners, peers, and children to support effective communication and relationship building. Respond promptly to emails, text messages, and inquiries during program hours to ensure transparency and trust. Communicate and collaborate regularly with the Area Manager to support outlined program goals and assist in implementing changes or processes as guided.Documentation and Compliance: Maintain accurate records for student check-ins and check-outs. Ensure “name to face” attendance procedures are completed per company policy.Daily Routine: Implement daily activities, fitness fun, and curriculum while providing a safe and engaging environment.Ideal Candidates will have the following:Experience with working amongst competing priorities and delivering quality service to all stakeholdersHigh school diploma or GED completedExperience working with children and knowledge of unique and special needsCoursework or training in child development and/or related fieldCommunication skills; oral, written, and visual with adults and childrenAbility to model professional standards when dealing with students, parents, staff, and communityFamiliarity with Google technology software or willingness to learnCalifornia Requirements:Ability to meet state-specific requirements;LIVE Scan fingerprint background checkMandated Reporter training18+ years of ageProof of High School diploma/GED requiredFirst Aid and CPR-in-person EMSA 16 Hr Prevention Health required or willing to acquireCleared tuberculosis testBenefits Offered with Right At School:Health & Wellness: Medical/Virtual Care, Dental and Vision Insurance PlansPet Health: Pet discount programs and pet insurancePhysical Wellness: Supplemental Insurance (e.g. Short & Long Term Disability)Financial Wellness: 401(k) with Company match & free financial coachingProtection & Support: Legal service, identity theft, and Transit/parking savings plans, Employee Assistance ProgramChildcare: Free or discounted enrollment in our before/after school programs is offered to Right At School team members within participating facilitiesAdditional Perks: Free NAA Professional Membership, TicketsAtWork Perks Program, and Cell phone discounts*All benefits and perks available, have their own eligibility criteria that must be met.Right At School is an Equal Opportunity employer. All qualified applicants will receive consideration for employment without regard to race, national origin, age, sex, religion, disability, sexual orientation, marital status, military or veteran status, gender identity or expression, or any other basis protected by local, state, or federal law.
Part Time
6/8/2025
SACRAMENTO, CA 95827
(8.7 miles)
Before you apply to a job, select your language preference from the options available at the top right of this page.Explore your next opportunity at a Fortune Global 500 organization. Envision innovative possibilities, experience our rewarding culture, and work with talented teams that help you become better every day. We know what it takes to lead UPS into tomorrow—people with a unique combination of skill + passion. If you have the qualities and drive to lead yourself or teams, there are roles ready to cultivate your skills and take you to the next level.Job Description:Job SummaryThis position trains and supervises Package Handlers and Clerks on safety, productivity, and various job-related tasks. This position holds teams accountable for attendance and submits timecards.Responsibilities:Develops and maintains good working relationships with employees, management and customers.Facilitates training with new and current employees.Conducts and participates in group meetings.Coordinates evaluations with management.Determines best solutions for package concerns.Supervises daily activities of package handlers and clerks to ensure all assigned duties are accomplished safely and timely.Understands and consistently demonstrates UPS's high ethical standards and code of conduct.Qualifications:Ability to lift 70 lbs./32 kgs.Availability to work flexible shift hours, up to 5 days per weekStrong problem solving skills, with ability to multitaskStrong oral and written communication skillsWorking knowledge of Microsoft OfficeAbility to work in a fast-paced warehouse environmentBachelor's Degree or International equivalent - PreferredManagement experience - PreferredEmployee Type:PermanentUPS is committed to providing a workplace free of discrimination, harassment, and retaliation.Other Criteria: UPS is an equal opportunity employer. UPS does not discriminate on the basis of race/color/religion/sex/nationalorigin/veteran/disability/age/sexual orientation/gender identity or any other characteristic protected by law.Basic Qualifications:Must be a U.S. Citizen or National of the U.S., an alien lawfully admitted for permanent residence, or an alien authorized to work in the U.S. for this employer.Pay Range:Our compensation reflects the cost of labor across several US geographic markets. The base pay for this position ranges from $25.70/hr to $41.80/hr. Pay is based on several factors including but not limited to, market location and may vary depending on job-related knowledge, skills, and education/training and a candidate’s work experience. Hired applicants are offered annual short-term and/or long-term incentive compensation programs, subject to applicable eligibility requirements. Payments under these annual programs are not guaranteed and are dependent upon a variety of factors including, but not limited to, individual performance, business unit performance, and/or the company’s performance. The company offers the following benefits for this position, subject to applicable eligibility requirements. Medical/prescription drug coverage, Dental coverage, Vision coverage, Flexible Spending Account, Health Savings Account, Dependent Care Flexible Spending Account, Basic and Supplemental Life Insurance & Accidental Death and Dismemberment, Disability Income Protection Plan, Employee Assistance Program, 401(k) retirement program, Vacation, Paid Holidays and Personal time, Paid Sick and Family and Medical Leave time as required by law, and Discounted Employee Stock Purchase Program.
Full Time
5/28/2025
Woodland, CA 95776
(16.7 miles)
HomeGoodsAt TJX Companies, every day brings new opportunities for growth, exploration, and achievement. You’ll be part of our vibrant team that embraces diversity, fosters collaboration, and prioritizes your development. Whether you’re working in our four global Home Offices, Distribution Centers or Retail Stores—TJ Maxx, Marshalls, Homegoods, Homesense, Sierra, Winners, and TK Maxx, you’ll find abundant opportunities to learn, thrive, and make an impact. Come join our TJX family—a Fortune 100 company and the world’s leading off-price retailer.Job Description:Opportunity: Grow Your CareerResponsible for executing receiving and merchandising standards while ensuring Associates are processing efficiently and effectively, and working as a team. Ensures an excellent customer experience by engaging and interacting with all customers, and maintaining a clean and organized store. Role models exceptional customer service.Creates a positive internal and external customer experiencePromotes a culture of honesty and integrity; maintains confidentialityOrchestrates truck delivery, prioritizing the processing of merchandise onto the sales floorTrains and mentors Associates on established merchandising and processing principlesEnsures merchandise is properly tagged, hung, secured, and codedCommunicates with the Coordinator on Duty to ensure efficient flow of goods to sales floorEnsures Associates complete tasks and activities according to store plan; prioritizes as neededMonitors productivity of team and coaches as necessaryOrganizes and rotates back stock for easy replenishmentMaintains and upholds merchandising philosophy and signage standardsMaintains all organizational, cleanliness and recovery standards for the backroom areaEnsures compliance with recycling and, where applicable, hazardous waste programsCommunicates accurately and effectively with management and Associates when setting and addressing priorities; provides progress updatesProvides and accepts recognition and constructive feedbackPartners with Management on Associate training needs to increase effectivenessEnsures adherence to all labor laws, policies, and proceduresPromotes credit and loyalty programsSupports and participates in store shrink reduction goals and programsPromotes safety awareness and maintains a safe environmentOther duties as assignedWho We’re Looking For: You.Able to work a flexible schedule, including nights and weekendsSuperior communication and organizational skills with attention to detailCapable of multi-taskingAble to respond appropriately to changes in direction or unexpected situationsTeam player, working effectively with peers and supervisorsCapable of lifting heavy objects with or without reasonable accommodationAble to train others1 year retail and 6 months of leadership experienceBenefits include: Associate discount; EAP; smoking cessation; bereavement; 401(k) Associate contributions; child care & cell phone discounts; pet & legal insurance; credit union; referral bonuses. Those who meet service or hours requirements are also eligible for: 401(k) match; medical/dental/vision; HSA; health care FSA; life insurance; short/long term disability; paid parental leave; paid holidays/vacation/sick; auto/home insurance discounts; scholarship program; adoption assistance. All benefits are provided in accordance with and subject to the terms of the applicable plan or program and may change from time to time. Contact your TJX representative for more information.In addition to our open door policy and supportive work environment, we also strive to provide a competitive salary and benefits package. TJX considers all applicants for employment without regard to race, color, religion, gender, sexual orientation, national origin, age, disability, gender identity and expression, marital or military status, or based on any individual's status in any group or class protected by applicable federal, state, or local law. TJX also provides reasonable accommodations to qualified individuals with disabilities in accordance with the Americans with Disabilities Act and applicable state and local law.Address:2155 Bronze Star Drive Suite 200Location:USA HomeGoods Store 0078 Woodland CAThis position has a starting pay range of $17.50 to $18.00 per hour. Actual starting pay is determined by a number of factors, including relevant skills, qualifications, and experience.
Full Time
5/28/2025
Yuba City, CA 95993
(32.8 miles)
MarshallsAt TJX Companies, every day brings new opportunities for growth, exploration, and achievement. You’ll be part of our vibrant team that embraces diversity, fosters collaboration, and prioritizes your development. Whether you’re working in our four global Home Offices, Distribution Centers or Retail Stores—TJ Maxx, Marshalls, Homegoods, Homesense, Sierra, Winners, and TK Maxx, you’ll find abundant opportunities to learn, thrive, and make an impact. Come join our TJX family—a Fortune 100 company and the world’s leading off-price retailer.Job Description:Opportunity: Grow Your CareerResponsible for executing receiving and merchandising standards while ensuring Associates are processing efficiently and effectively, and working as a team. Ensures an excellent customer experience by engaging and interacting with all customers, and maintaining a clean and organized store. Role models exceptional customer service.Creates a positive internal and external customer experiencePromotes a culture of honesty and integrity; maintains confidentialityOrchestrates truck delivery, prioritizing the processing of merchandise onto the sales floorTrains and mentors Associates on established merchandising and processing principlesEnsures merchandise is properly tagged, hung, secured, and codedCommunicates with the Coordinator on Duty to ensure efficient flow of goods to sales floorEnsures Associates complete tasks and activities according to store plan; prioritizes as neededMonitors productivity of team and coaches as necessaryOrganizes and rotates back stock for easy replenishmentMaintains and upholds merchandising philosophy and signage standardsMaintains all organizational, cleanliness and recovery standards for the backroom areaEnsures compliance with recycling and, where applicable, hazardous waste programsCommunicates accurately and effectively with management and Associates when setting and addressing priorities; provides progress updatesProvides and accepts recognition and constructive feedbackPartners with Management on Associate training needs to increase effectivenessEnsures adherence to all labor laws, policies, and proceduresPromotes credit and loyalty programsSupports and participates in store shrink reduction goals and programsPromotes safety awareness and maintains a safe environmentOther duties as assignedWho We’re Looking For: You.Able to work a flexible schedule, including nights and weekendsSuperior communication and organizational skills with attention to detailCapable of multi-taskingAble to respond appropriately to changes in direction or unexpected situationsTeam player, working effectively with peers and supervisorsCapable of lifting heavy objects with or without reasonable accommodationAble to train others1 year retail and 6 months of leadership experienceBenefits include: Associate discount; EAP; smoking cessation; bereavement; 401(k) Associate contributions; child care & cell phone discounts; pet & legal insurance; credit union; referral bonuses. Those who meet service or hours requirements are also eligible for: 401(k) match; medical/dental/vision; HSA; health care FSA; life insurance; short/long term disability; paid parental leave; paid holidays/vacation/sick; auto/home insurance discounts; scholarship program; adoption assistance. All benefits are provided in accordance with and subject to the terms of the applicable plan or program and may change from time to time. Contact your TJX representative for more information.In addition to our open door policy and supportive work environment, we also strive to provide a competitive salary and benefits package. TJX considers all applicants for employment without regard to race, color, religion, gender, sexual orientation, national origin, age, disability, gender identity and expression, marital or military status, or based on any individual's status in any group or class protected by applicable federal, state, or local law. TJX also provides reasonable accommodations to qualified individuals with disabilities in accordance with the Americans with Disabilities Act and applicable state and local law.Address:1130 Harter RdLocation:USA Marshalls Store 0157 Yuba City CAThis position has a starting pay range of $17.50 to $18.00 per hour. Actual starting pay is determined by a number of factors, including relevant skills, qualifications, and experience.
Full Time
5/23/2025
Sacramento, CA 95834
(6.6 miles)
About the RoleAs Beauty Lead Advisor, you will drive sales through an authentic passion for beauty and engage clients by identifying their needs with a consultative approach. You will maintain expert knowledge of top beauty brands, execute merchandise sets, replenishment and visual standards according to Sephora at Kohl’s standards and ensure an excellent overall client experience.What You’ll DoBuild strong client loyalty and influence clients by identifying their needs and suggesting products to drive sales, including the opportunity to upsell productsDevelop and expand knowledge of the beauty industryProvide credibility to the client through knowledge of products and beauty trendsInspire clients through demonstrating products and application of productsUnderstand and execute the sales plans to support and meet goalsExecute and maintain all Sephora visual merchandising and operational standards, including merchandise sets, tester maintenance and department cleanliness and hygiene standardsEnsure timely and consistent sales floor replenishment to drive sales and enhance the customer experienceActively engage and complete all required training to expand knowledgeSupport omni-processing within the departmentSupport inventory management from receipt to sale, including freight processing, back stocking, inventory counts and price changesAll associates are responsible for:Acting with integrity and honesty and fostering teamwork in an engaged and inclusive cultureExercising good judgment and discernment when making decisions; taking appropriate partners as neededSupporting and executing safety and shortage reduction programs following company guidelinesAccomplishing multiple tasks within established timeframesFollowing company policies, procedures, standards and guidelinesMaintaining adherence to company safety policies for the safety of all associates and customersReceiving, understanding and proactively responding to direction from leaders and other company personnelOther responsibilities as assigned What Skills You HaveRequiredAuthentic passion for beauty Client-facing retail or service industry experienceExcellent written and verbal communication skills with the ability to influence in a clear and concise mannerAvailability to work days, nights, weekends and holidaysPay Range: $19.60 - $27.45Kohl’s offers a variety of benefits to associates depending on full-time/part-time status and work hours, including: WORK LIFE BALANCE (PTO, Vacation Buy Program, Parental Leave), HEALTH & WELLNESS (Medical, Dental, Vision and other short and long term disability programs, Emergency health and wellness programs such as Accident Protection Plans, Critical Illness Plans and more), SAVINGS & RETIREMENT BENEFITS (401k, Flexible Spending Accounts and associate discount programs with Kohl’s partners), INSURANCE PROGRAMS (Life Insurance for you, your family or your pet, as well as other protection programs), and LIFE EVENTS (Legal and adoption assistance benefits).
Part Time
5/15/2025
Sacramento, CA 95841
(2.8 miles)
$24.75 to $42.05 / hr
The pay range per hour is $24.75 - $42.05Pay is based on several factors which vary based on position. These include labor markets and in some instances may include education, work experience and certifications. In addition to your pay, Target cares about and invests in you as a team member, so that you can take care of yourself and your family. Target offers eligible team members and their dependents comprehensive health benefits and programs, which may include medical, vision, dental, life insurance and more, to help you and your family take care of your whole selves. Other benefits for eligible team members include 401(k), employee discount, short term disability, long term disability, paid sick leave, paid national holidays, and paid vacation. Find competitive benefits from financial and education to well-being and beyond at .ALL ABOUT TARGETWorking at Target means helping all families discover the joy of everyday life. We bring that vision to life through our values and culture. ALL ABOUT SPECIALTY SALES A team of specialized consultants who understand what it means to meet our guests where they are at and deliver for them through strong operations, incredible guest experience and compelling visual merchandising presentations that inspire guests and build the basket. Teams in Apparel and Accessories (A&A), Home, Baby, Beauty and Electronics prioritize guest experience while blending completion of tasks that ensure product is available and easy to shop – pulling, filling, pricing, setting, staging and maintaining the sales floor and the backroom.At Target, we believe in our leaders having meaningful experiences that help them build and develop skills for a career. The role of a Specialty Sales Team Leader can provide you with the skills and experience of:Guest service fundamentals and experience; building a guest first culture on your teamRetail business fundamentals retail including department sales trends, inventory management, guest shopping patterns, pricing and promotions strategiesPlanning department(s) daily/weekly workload to support business priorities and deliver sales goalsLead multiple businesses balancing team member expertise and effectively leading teams in each departmentLeading a team of hourly team members; including skills in interviewing, developing, coaching, evaluating and retaining talent.As a Specialty Sales Team Leader, no two days are ever the same, but a typical day will most likely include the following responsibilities:Demonstrate a service culture that prioritizes the guest service experience. Model, train and coach team member expectations to deliver onour GUEST service model culture.Demonstrate inclusivity by valuing diverse voices and approaches, being authentic and respectful, and creating equitable experiences.Plan daily/weekly workload at the direction of your direct leader,and execute the sameto deliver on department and store sales goals and guest engagement; including planning merchandising sets,make changes and updates to merchandisesets (planograms), sales plans, eventsand promotions.Lead and demonstrate a culture of executing all best practices as outlined with team onboarding and learning; help close skill gaps through development, coaching and team interactions.With direct leader guidance, develop, coach, and lead a team of consultants who are knowledgeable and passionate.Assign daily tasks to TMs based on planned workload and guest traffic patterns, ensuring alignment with weekly and monthly business priorities set by your direct leader.Encourage team to use tools available in their department (i.e. the fitting room, testers, displays) as an opportunity to welcome, inspire and influence guests by providing personalized recommendations to complete their purchase.With direct leader guidance, partner with third party vendors to ensure brand standards and merchandising are being met and areas are full and maintained.Support team's execution of changes and updates to merchandise sets, andvisual presentations for defined categories.Create inspiring visual moments by ensuring product is organized, signedcorrectly and merchandised to support seasonal trends.Support your direct leader in leading assigned departmentareabackroom processes, organization, layout and replenishment of the salesfloor to ensure product is available for guests.Participate in team hiring and onboarding processes.Leadyour team in prioritizing the guest experience by ensuring the fitting rooms are welcoming, clean and safe if applicable to your assigned areas of responsibility.Support your direct leader in establishing clear goals and expectations and hold team members accountable to expectations.Demonstrate a culture of ethical conduct, safety and compliance;lead and hold the team accountable to work in the same way.Lead and demonstrate a safety culture through modeling and recognizing safe behaviors,identifying and correcting hazards, holding team accountable to following safety expectations, assisting with incident response, and reporting/investigating injuries timely and accurately.Model the execution of physical security processes in order to enhance the instore security culture.Support merchandise protection strategies across the total store; including ordering, storage and application as directed by best practices.If applicable, as a key carrier, follow all safe and secure training and processes.Address all store emergency and compliance needs.Support guest services such as back-up cashier, order pick up (OPU) and Drive-up (DU) and maintain a compliance culture while executing those duties, such as compliance with federal, state, and local adult beverage laws. Model creating a welcoming experience by greeting guests as you & your team are completing your daily tasks. Demonstrate how to engage with guests when assistance is needed, engage with guests in a welcoming way, and help solve their specific needs.Lead by thanking guests and let them know we’re happy they chose to shop at Target.All other duties based on business needsWHAT WE ARE LOOKING FORThis may be the right job for you if:You enjoy interacting and helping others - including guests that shop our store and fellow team members you work with. You thrive in a fast-moving, highly active and physically demanding role, where teamwork, flexibility, and creative problem solving are key to success. You are open to working a flexible work schedule with varying hours, days or shifts (including nights, weekends, holidays and other peak shopping times).The good news is that we have some amazing training that will help teach you everything you need to know to be a Specialty Sales Team Leader. But, there are a few skills you should have from the get-go:High school diploma or equivalentMust be at least 18 years of age or olderPrevious retail experience preferred, but not requiredLead and hold others accountableAbility to communicate on multiple frequency devices and operate handheld scanners, and other technology equipment as directed.Work independently and as part of a teamManage workload and prioritize tasks independentlyWelcoming and helpful attitudetoward all guests and other team membersEffective communication skills Capability to remain focused and composed in a fast-paced environment and accomplish multiple tasks within established timeframesWe are an awesome place to work and care about our teams, so we want to make sure we are clear on a few more basics that we expect:Access all areas of the building to respond to guest or team member issuesInterpret instructions, reports and informationAccurately handle cash register operations as neededClimb up and down ladders as needed Scan, handle and move merchandise efficiently and safely, including frequently lifting or moving merchandise up to 15 pounds and occasionally lifting or moving merchandise up to 44 pounds without additional assistance from othersFlexible work schedule (e.g., nights, weekends and holidays) and reliable and prompt attendance necessaryCapable of working in and exposure to varying temperatures, humidity, and other elements while performing certain job duties including but not limited to Drive-Up, carryout, etc. as neededAbility to remain mobile for the duration of a scheduled shift (shift length may vary).Target will consider for employment qualified applicants with criminal histories in a manner consistent with the San Francisco and City of Los Angeles Fair Chance Ordinances.Benefits EligibilityPlease paste this url into your preferred browser to learn about benefits eligibility for this role: https://tgt.biz/BenefitsForYou_C | Pegue esta URL en su navegador preferido para obtener información sobre la elegibilidad de este puesto para recibir beneficios: https://tgt.biz/BenefitsForYou_CAmericans with Disabilities Act (ADA)Target will provide reasonable accommodations with the application process upon your request as required to comply with applicable laws. If you have a disability and require assistance in this application process, please visit your nearest Target store or reach out to Guest Services at 1-800-440-0680 for additional information.
Full Time
6/10/2025
El Dorado Hills, CA 95762
(18.0 miles)
Your Role The Behavioral Health Utilization Management team performs prospective & concurrent utilization reviews and first level determinations for members using BSC evidenced based guidelines, policies, and nationally recognized clinal criteria across multiple lines of business. The Behavioral Health Utilization Management Clinician, Experienced, will report to the Manager of Behavioral Health Utilization Management (BH UM). In this role you will conduct clinical review of mental health and substance use authorization requests at various levels of care for medical necessity, coding accuracy, medical policy compliance and contract compliance.Your WorkIn this role, you will:Perform prospective & concurrent utilization reviews and first level determination approvals for members admitted to facilities using BSC evidenced based guidelines, policies and nationally recognized clinal criteria across lines of business or for a specific line of business such as Medicare as neededGather clinical information and apply the appropriate clinical criteria/guideline, policy, procedure and clinical judgment to render coverage determination/recommendation along the continuum of care facilitates including effective discharge planning at levels of care appropriate for the members needs and acuity; prepare and present cases to Medical Director (MD) for medical director oversight and necessity determinationProvide information to facilities and providers regarding community treatment resources, mental health care management programs, company policies and procedures, and medical necessity criteriaWork with multidisciplinary teams to support members using an integrated team-based approach including Interdisciplinary Team Meetings and case consultations with Medical Director and/or Licensed ManagerRecognize the members right to self-determination as it relates to the ethical principle of autonomy, including the members/family's right to make informed choices that may not promote the best outcomes, as determined by the healthcare teamSupport 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 three (3) years of prior experience in healthcare related fieldOne (1) year conducting Behavioral Health Utilization Management for a health insurance plan or managed care environment preferredStrong understanding of Behavioral Health Utilization Management including ability to apply and interpret admission and continued stay criteria of multiple standardized clinical criteria sets including but not limited to MCG guidelines, nonprofit association guidelines, and various Medicare 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
6/1/2025
Sacramento, CA 95834
(5.8 miles)
Description & Requirements Description Compensation:$26 - $32 Per Hour- Full time, based upon experiencePromotion opportunity to Program Supervisor (salaried) based upon experienceBenefits of Working at Intercare:Monthly Bonuses!Flexible work schedule with a focus on work/life balance; Manage your own scheduleMileage reimbursement, a company computer and cell phoneEducation tuition reimbursement program (Masters & BCBA)!Leadership training and CEUs - we will teach how to become a better leader!Medical, Dental, and Vision insuranceGenerous time off policy (vacation, sick time, and holidays)Company 401k PlanOutstanding mentorship and supportive environment for continual learningRequired Credentials/Experience:Completed Bachelor’s degree and either of the following:12 semester units of ABA course work with one (1) year experience implementing and/or designing ABA programmingTwo (2) years of experience designing or implementing ABA programsStrong ABA and clinical skillsExcellent written and spoken communication, time management skills, and interpersonal skillsAbility to give and receive constructive feedback with a team player attitudeBilingual skills valuedJob DescriptionIntercare Therapy provides evidence-based behavioral therapies that help children overcome challenges related to autism spectrum disorders. Our mission is to optimize the independence and quality of life of our clients and their families. We love what we do, and we are seeking team members who share our passion for improving the lives of children and families affected by autism.AProgram Managerserves in the field as the onsite case supervisor and leader, mastering daily case management skills, including developing and overseeing clinical programs, supervising BIs and providing education and training for client caregivers. You must be willing to drive 30 to 60 miles a day, andable to supervise client sessions anytime between 8AM and 6PM on weekdays, and occasionally on weekends.We are proud to be the highest rated established ABA organization on Glassdoor! Check out our rankings and reviews on Glassdoor!Learn more about us on You Tube!This position may require the candidate be fully vaccinated for COVID-19 in accordance with all vaccination requirements set forth by Intercare funding sources and pursuant to any guidelines from the California Department of Health.Closing:If you have experience in any of the following fields, we encourage you to apply:Behavior Analyst, Autism, Social Learning, Social Skills, Developmental Condition, Psychology, Sociology, Social Services, Children, ABA, Applied behavior analysis, BCBAIntercare Therapy will consider for employment qualified applicants with criminal histories in a manner consistent with the requirements of the Los Angeles Fair Chance Initiative for Hiring (Ban the Box) Ordinance.Intercare Therapy supports a diverse workforce and is an Equal Opportunity Employer.
Full Time
6/1/2025
Vacaville, CA 95687
(37.1 miles)
We want you to help us shape the future of shopping experiences and deliver on our purpose of connecting people with the products and experiences that enrich their lives. Joining Advantage Solutions means joining a network of 65,000 teammates serving 4,000+ brands and retail customers across 40+ countries. All the while, being provided the opportunities, support, and enrichment you need to grow your career.In this position, you'll drive sales by engaging customers and bringing brands to life by providing live events and sampling to consumers where they live and shop. Additionally, you will provide support to management as needed.What we offer:Competitive wages; $18.72 per hourGrowth opportunities abound – We promote from withinNo prior experience is required as we provide training and team support to help you succeedAdditional hours may be available upon requestWe offer benefits that can be customized to meet your family’s needs, including medical, dental, vision, life insurance, supplemental voluntary plans, wellness programs, and access to discounts through Associate PerksNow, about you:Are comfortable interacting with customers and management in a friendly, enthusiastic, and outgoing mannerAre 18 years or olderAvailable to work 2-3 shifts per week, including weekendsCan lift up to 50 lbs. on a regular basis and stand for up to 6 hoursAre comfortable preparing, cooking, and cleaning work area and equipmentHave reliable transportation to and from work locationDemonstrate excellent customer service and interpersonal skills with our clients, customers and team membersAre a motivated self-starter with a strong bias for action and resultsWork independently, but also possess successful team building skillsHave the ability to perform job duties with a safety-first mentality in a retail environmentIf this sounds like you, we can’t wait to learn more about you. Apply Now!
Full Time
6/10/2025
El Dorado Hills, CA 95762
(18.0 miles)
Your Role Reporting to the Manager, Care Management- Behavioral Health, the Behavioral Health Care Management Clinician, Consultant (Lead) is a team lead for a team of Behavioral Health Care Managers.The Behavioral Health Care Management Team helps members with behavioral health needs navigate the health care system for linkages to behavioral health providers, treatment, and programs. The Behavioral Health Care Managers offer support in assessing members’ emotional and psychological well-being and providing resource coordination, crisis intervention, substance abuse, and with any behavioral or mental health referrals. The Behavioral Health Care Managers will be available to physicians and nurse care managers as consultants for patients with complex psychosocial needs. The position requires an intensive focus on crisis intervention and counseling, problem-solving and conflict resolution, patient and family management, interdisciplinary collaboration, psychosocial assessments, education, advocacy, and community resource linkages.Your Work In this role, you will: Act in a leadership role as a lead Care Manager - addresses line staff questions and issues and escalate 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 care 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 partnersProvide consultation and guidance on escalated or high complexity member concerns.Identify 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 care 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 memberSupport team through consistent and successful caseload management and workload to achieve team goals, regulatory timelines, and accreditation standardsYour Knowledge and Experience Current 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 relevant experience including 3 years of experience in behavioral health.Certified Case Manager preferredPrevious experience in a lead or leadership role or demonstrated mastery of case management principles through hands on experience with successful outcomes.Possess excellent interpersonal, organizational, and communication skills, positive attitude, and high level of initiativeAbility to identify problems and work towards problem resolution independently, seeking guidance as neededExperience conducting thorough psychosocial assessments, developing care plans and providing necessary interventions identified during assessment with complex client populations that may have, among other things, inadequate coping skills, severe emotional disorders, developmental disabilities, mental illnesses, and/or unstable housingConsiderable knowledge of a wide range of psychosocial challenges and familiarity with behavioral health diagnoses and treatmentProficient with computer programs such as Microsoft Excel, Outlook, Word, and PowerPoint
Full Time
6/1/2025
Sacramento, CA 95834
(5.8 miles)
Description & Requirements Description Compensation:$26 - $32 Per Hour- Full time, based upon experiencePromotion opportunity to Program Supervisor (salaried) based upon experienceBenefits of Working at Intercare:Monthly Bonuses!Flexible work schedule with a focus on work/life balance; Manage your own scheduleMileage reimbursement, a company computer and cell phoneEducation tuition reimbursement program (Masters & BCBA)!Leadership training and CEUs - we will teach how to become a better leader!Medical, Dental, and Vision insuranceGenerous time off policy (vacation, sick time, and holidays)Company 401k PlanOutstanding mentorship and supportive environment for continual learningRequired Credentials/Experience:Completed Bachelor’s degree and either of the following:12 semester units of ABA course work with one (1) year experience implementing and/or designing ABA programmingTwo (2) years of experience designing or implementing ABA programsStrong ABA and clinical skillsExcellent written and spoken communication, time management skills, and interpersonal skillsAbility to give and receive constructive feedback with a team player attitudeBilingual skills valuedJob DescriptionIntercare Therapy provides evidence-based behavioral therapies that help children overcome challenges related to autism spectrum disorders. Our mission is to optimize the independence and quality of life of our clients and their families. We love what we do, and we are seeking team members who share our passion for improving the lives of children and families affected by autism.AProgram Managerserves in the field as the onsite case supervisor and leader, mastering daily case management skills, including developing and overseeing clinical programs, supervising BIs and providing education and training for client caregivers. You must be willing to drive 30 to 60 miles a day, andable to supervise client sessions anytime between 8AM and 6PM on weekdays, and occasionally on weekends.We are proud to be the highest rated established ABA organization on Glassdoor! Check out our rankings and reviews on Glassdoor!Learn more about us on You Tube!This position may require the candidate be fully vaccinated for COVID-19 in accordance with all vaccination requirements set forth by Intercare funding sources and pursuant to any guidelines from the California Department of Health.Closing:If you have experience in any of the following fields, we encourage you to apply:Behavior Analyst, Autism, Social Learning, Social Skills, Developmental Condition, Psychology, Sociology, Social Services, Children, ABA, Applied behavior analysis, BCBAIntercare Therapy will consider for employment qualified applicants with criminal histories in a manner consistent with the requirements of the Los Angeles Fair Chance Initiative for Hiring (Ban the Box) Ordinance.Intercare Therapy supports a diverse workforce and is an Equal Opportunity Employer.
Full Time
6/1/2025
Vacaville, CA 95687
(37.1 miles)
We want you to help us shape the future of shopping experiences and deliver on our purpose of connecting people with the products and experiences that enrich their lives. Joining Advantage Solutions means joining a network of 65,000 teammates serving 4,000+ brands and retail customers across 40+ countries. All the while, being provided the opportunities, support, and enrichment you need to grow your career.In this position, you'll drive sales by engaging customers and bringing brands to life by providing live events and sampling to consumers where they live and shop. Additionally, you will provide support to management as needed.What we offer:Competitive wages; $18.72 per hourGrowth opportunities abound – We promote from withinNo prior experience is required as we provide training and team support to help you succeedAdditional hours may be available upon requestWe offer benefits that can be customized to meet your family’s needs, including medical, dental, vision, life insurance, supplemental voluntary plans, wellness programs, and access to discounts through Associate PerksNow, about you:Are comfortable interacting with customers and management in a friendly, enthusiastic, and outgoing mannerAre 18 years or olderAvailable to work 2-3 shifts per week, including weekendsCan lift up to 50 lbs. on a regular basis and stand for up to 6 hoursAre comfortable preparing, cooking, and cleaning work area and equipmentHave reliable transportation to and from work locationDemonstrate excellent customer service and interpersonal skills with our clients, customers and team membersAre a motivated self-starter with a strong bias for action and resultsWork independently, but also possess successful team building skillsHave the ability to perform job duties with a safety-first mentality in a retail environmentIf this sounds like you, we can’t wait to learn more about you. Apply Now!
Full Time
6/10/2025
El Dorado Hills, CA 95762
(18.0 miles)
Your Role The Care Managementteam 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 Senior Care Manager will report to the Manager of Care Management. In this role you will ensure that services are provided based on standardized procedures including coordination of care with specialists, community resources. Care Managers perform a blended function of utilization management (UM) and care management (CM) activities demonstrating clinical judgement and independent analysis, collaborating with members and those involved with members’ care including clinical nurses and treating physicians.Your Work In this role, you will: Research and design treatment /care plans to promote quality of care, cost effective health care services based on medical necessity complying with contract for each appropriate plan type.Initiation of timely individualized care plans (ICP) based on health risk assessment (HRA) completion, participation in and documentation of interdisciplinary meetings (ICT), assisting in transitions of care across all ages.Determines appropriateness of referral for CM services, mental health, and social services.Provides Referrals to Quality Management (QM), Disease Management (DM) and Appeals and Grievance department (AGD).Conducts member care review with medical groups or individual providers for continuity of care, out of area/out of network and investigational/experimental cases.Manages member treatment in order to meet recommended length of stay. Ensures DC planning at levels of care appropriate for the members needs and acuity.Assessment: Assesses members health behaviors, cultural influences and clients belief/value system. Evaluates all information related to current/proposed treatment plan and in accordance with clinical practice guidelines to identify potential barriers.Research opportunities for improvement in assessment methodology and actively promotes continuous improvement. Anticipates potential barriers while establishing realistic goals to ensure success for the member, providers and BSC.Determines realistic goals and objectives and provides appropriate alternatives. Actively solicits client’s involvement.Planning: Designs appropriate and fiscally responsible plan of care with targeted interventions that enhance quality, access, and cost-effective outcomes. Adjusts plans or creates contingency plans as necessary.Assesses and re-evaluates health and progress due to the dynamic nature of the plan of care required on an ongoing basis. Initiates and implements appropriate modifications in plan of care to adapt to changes occurring over time and through various settings.Develops appropriate and fiscally responsible plan of care with targeted interventions that enhance quality, access, and cost-effective outcomes.Recognizes need for contingency plans throughout the healthcare process.Develops and implements the plan of care based on accurate assessment of the member and current of proposed treatment. Your Knowledge and Experience Requires a current CA LVN LicenseCertified Case Manager (CCM) Certification or is in process of completing certification when eligible based on CCM application requirementsRequires at least 5 years of prior experience in nursing, healthcare or related fieldA minimum of 3 years’ experience in inpatient, outpatient, and/or managed care environment requiredHealth insurance/managed care experience is preferredExcellent communications skillsExcellent communication and interpersonal skills, with the ability to engage and build rapport with diverse populationsDemonstrated ability to independently assess, evaluate, and interpret clinical informationMaternity experience highly preferred
Full Time
6/1/2025
Sacramento, CA 95834
(5.8 miles)
Description & Requirements Description Compensation:$26 - $32 Per Hour- Full time, based upon experiencePromotion opportunity to Program Supervisor (salaried) based upon experienceBenefits of Working at Intercare:Monthly Bonuses!Flexible work schedule with a focus on work/life balance; Manage your own scheduleMileage reimbursement, a company computer and cell phoneEducation tuition reimbursement program (Masters & BCBA)!Leadership training and CEUs - we will teach how to become a better leader!Medical, Dental, and Vision insuranceGenerous time off policy (vacation, sick time, and holidays)Company 401k PlanOutstanding mentorship and supportive environment for continual learningRequired Credentials/Experience:Completed Bachelor’s degree and either of the following:12 semester units of ABA course work with one (1) year experience implementing and/or designing ABA programmingTwo (2) years of experience designing or implementing ABA programsStrong ABA and clinical skillsExcellent written and spoken communication, time management skills, and interpersonal skillsAbility to give and receive constructive feedback with a team player attitudeBilingual skills valuedJob DescriptionIntercare Therapy provides evidence-based behavioral therapies that help children overcome challenges related to autism spectrum disorders. Our mission is to optimize the independence and quality of life of our clients and their families. We love what we do, and we are seeking team members who share our passion for improving the lives of children and families affected by autism.AProgram Managerserves in the field as the onsite case supervisor and leader, mastering daily case management skills, including developing and overseeing clinical programs, supervising BIs and providing education and training for client caregivers. You must be willing to drive 30 to 60 miles a day, andable to supervise client sessions anytime between 8AM and 6PM on weekdays, and occasionally on weekends.We are proud to be the highest rated established ABA organization on Glassdoor! Check out our rankings and reviews on Glassdoor!Learn more about us on You Tube!This position may require the candidate be fully vaccinated for COVID-19 in accordance with all vaccination requirements set forth by Intercare funding sources and pursuant to any guidelines from the California Department of Health.Closing:If you have experience in any of the following fields, we encourage you to apply:Behavior Analyst, Autism, Social Learning, Social Skills, Developmental Condition, Psychology, Sociology, Social Services, Children, ABA, Applied behavior analysis, BCBAIntercare Therapy will consider for employment qualified applicants with criminal histories in a manner consistent with the requirements of the Los Angeles Fair Chance Initiative for Hiring (Ban the Box) Ordinance.Intercare Therapy supports a diverse workforce and is an Equal Opportunity Employer.
Full Time
6/1/2025
Vacaville, CA 95687
(37.1 miles)
We want you to help us shape the future of shopping experiences and deliver on our purpose of connecting people with the products and experiences that enrich their lives. Joining Advantage Solutions means joining a network of 65,000 teammates serving 4,000+ brands and retail customers across 40+ countries. All the while, being provided the opportunities, support, and enrichment you need to grow your career.In this position, you'll drive sales by engaging customers and bringing brands to life by providing live events and sampling to consumers where they live and shop. Additionally, you will provide support to management as needed.What we offer:Competitive wages; $18.72 per hourGrowth opportunities abound – We promote from withinNo prior experience is required as we provide training and team support to help you succeedAdditional hours may be available upon requestWe offer benefits that can be customized to meet your family’s needs, including medical, dental, vision, life insurance, supplemental voluntary plans, wellness programs, and access to discounts through Associate PerksNow, about you:Are comfortable interacting with customers and management in a friendly, enthusiastic, and outgoing mannerAre 18 years or olderAvailable to work 2-3 shifts per week, including weekendsCan lift up to 50 lbs. on a regular basis and stand for up to 6 hoursAre comfortable preparing, cooking, and cleaning work area and equipmentHave reliable transportation to and from work locationDemonstrate excellent customer service and interpersonal skills with our clients, customers and team membersAre a motivated self-starter with a strong bias for action and resultsWork independently, but also possess successful team building skillsHave the ability to perform job duties with a safety-first mentality in a retail environmentIf this sounds like you, we can’t wait to learn more about you. Apply Now!
Full Time
6/10/2025
El Dorado Hills, CA 95762
(18.0 miles)
Your Role The Promise Health Plan Medical Director provides clinical leadership within the Blue Shield Promise Office of the CMO. The Medical Director’s duties include oversight and management of the clinical processes in support of member health initiatives, utilization management, care and case management, and clinically related functions. These functions include performance of pre-service, concurrent and retrospective utilization review, and retrospective provider claims dispute reviews. The Medical Director also provides physician oversight and support for various aspects including, but not limited to, Appeals and Grievances, provider dispute resolution, and peer review.Moreover, the Promise Chief Medical Officer will assign or delegate the Medical Director to lead or meaningfully contribute to Promise Health Plan priorities and transformative initiatives that continue to improve the health and wellbeing of Promise Health Plan members. The Medical Director serves as a role model for other clinical staff and is a knowledgeable resource in Medi-Cal and Medicare regulatory requirements,NCQA guidelines, measurement of health care quality (HEDIS and CAHPS) and California Department of Health Care Services’ population health strategies to reduce health care inequities in vulnerable populations and communities of color.The Blue Shield Promise Medical Director works collaboratively with Blue Shield’s Medical Care Services (MCS)and other appropriate departments across product lines to identify and address opportunities to improve service, reduce administrative cost and support department and organizational business goals. Finally, at the direction of the Promise Chief Medical Officer or VP, Medical Director, Medical Management, the Medical Director will be responsible for engaging in organization-wide quality improvement efforts and promoting a culture of continuous improvement throughout the organization and contracted provider partners in each regional market.Your Work In this role, you will: Complete clinical reviews (pre-service authorizations, concurrent review, provider claims disputes or others) within standards of care, regulatory, and compliance standards.Provide clinical review and resolution of appeals and grievances cases within compliance standards.Support process improvement and optimization efforts.Participate and lead discussions in cross-functional forums such as long-length of stay rounds, interdisciplinary care rounds, and assisting case management and other departments as needed.Serve as a clinical, regulatory, and quality improvement resource and clinical thought leader within the organization and externally with provider groups and community partners.Support Chief Medical Officer, VP Medical Director, Medical Management, and Senior Medical Director in strategic initiatives by proposing clinical initiatives, providing expert input, shaping the strategy, and/or serving as the initiative driver.Understand and abide by all departmental policies and procedures as well as the organization’s Standards of Conduct and Corporate Compliance Program.Attend mandatory Corporate Compliance Program education sessions, as required for this position, including the annual mandatory Standards of Conduct class.Participate in medical director on-call schedule including weekends, holidays and evenings.Any other duties assigned by CMO and/or VP Medical Director, Medical Management and/or Senior Medical Director.Your Knowledge and Experience Medical degree (M.D./D.O.)Maintain active, unrestricted California State Medical License required; Maintain active, unrestricted Medical License in all additional assigned states requiredCompleted residency preferably in adult based primary care specialty (e.g., Internal medicine, Family practice)Minimum 5 years direct patient care experience post residencyMaintain Board Certification in one of ABMS or AOA recognized specialty required (preferably Internal Medicine or Family Practice)Demonstrated proficiency in at least three of the following: (MEDICARE/MEDICARE STARS, Dual Special Needs Plan (D-SNP), MEDI-CAL, NCQA/URAC/Quality Programs, Policies/Procedure development, Clinical Subject Matter Expert for Litigation, SIU/Waste/Fraud/Abuse, Appeals/Grievances, Case Management/Population Health, Federal Employee Program (FEP), Education/Training (DELIVERS CME, CEU), Quality Improvement and/or Requirements for Behavioral HealthExperience with working in and/or with a Health Plan setting is preferred.Knowledge of Medi-Cal regulatory requirements, benefits and available resources is preferred.Knowledge of the wide ranges of psychosocial challenges, social determinants and health care inequities in diverse communities.Comfortable with written and verbal communication skills, analytical, time management and organizational skills. Proficient with computer programs such as Microsoft Excel, Outlook, Teams, Word, and PowerPoint.
Full Time
6/1/2025
Sacramento, CA 95834
(5.8 miles)
Description & Requirements Description Compensation:$26 - $32 Per Hour- Full time, based upon experiencePromotion opportunity to Program Supervisor (salaried) based upon experienceBenefits of Working at Intercare:Monthly Bonuses!Flexible work schedule with a focus on work/life balance; Manage your own scheduleMileage reimbursement, a company computer and cell phoneEducation tuition reimbursement program (Masters & BCBA)!Leadership training and CEUs - we will teach how to become a better leader!Medical, Dental, and Vision insuranceGenerous time off policy (vacation, sick time, and holidays)Company 401k PlanOutstanding mentorship and supportive environment for continual learningRequired Credentials/Experience:Completed Bachelor’s degree and either of the following:12 semester units of ABA course work with one (1) year experience implementing and/or designing ABA programmingTwo (2) years of experience designing or implementing ABA programsStrong ABA and clinical skillsExcellent written and spoken communication, time management skills, and interpersonal skillsAbility to give and receive constructive feedback with a team player attitudeBilingual skills valuedJob DescriptionIntercare Therapy provides evidence-based behavioral therapies that help children overcome challenges related to autism spectrum disorders. Our mission is to optimize the independence and quality of life of our clients and their families. We love what we do, and we are seeking team members who share our passion for improving the lives of children and families affected by autism.AProgram Managerserves in the field as the onsite case supervisor and leader, mastering daily case management skills, including developing and overseeing clinical programs, supervising BIs and providing education and training for client caregivers. You must be willing to drive 30 to 60 miles a day, andable to supervise client sessions anytime between 8AM and 6PM on weekdays, and occasionally on weekends.We are proud to be the highest rated established ABA organization on Glassdoor! Check out our rankings and reviews on Glassdoor!Learn more about us on You Tube!This position may require the candidate be fully vaccinated for COVID-19 in accordance with all vaccination requirements set forth by Intercare funding sources and pursuant to any guidelines from the California Department of Health.Closing:If you have experience in any of the following fields, we encourage you to apply:Behavior Analyst, Autism, Social Learning, Social Skills, Developmental Condition, Psychology, Sociology, Social Services, Children, ABA, Applied behavior analysis, BCBAIntercare Therapy will consider for employment qualified applicants with criminal histories in a manner consistent with the requirements of the Los Angeles Fair Chance Initiative for Hiring (Ban the Box) Ordinance.Intercare Therapy supports a diverse workforce and is an Equal Opportunity Employer.
Full Time
6/10/2025
El Dorado Hills, CA 95762
(18.0 miles)
Your Role The Facility Compliance Review (FCR) team reviews post service prepayment facility claims for contract compliance, industry billing standards, medical necessity and hospital acquired conditions/never events . The Manager, Utilization Management Nurse Management will report to the Senior Manager, Facility Compliance Review . In this role you will be responsible for several direct reports, be a resource for problem solving issues, training and updating documentation as needed. You will work to enhance the department’s operations with efficiency and attention to detail/quality.Your Work In this role, you will: Establish operational objectives for department or functional area and participate with other managers to establish group objectivesBe responsible for team, department or functional area results in terms of planning, cost in collaboration with Sr ManagerDevelop and maintain FCR workflows, protocols, and policies to ensure efficient and effective care coordinationEnsure workflow procedures and guidelines are clearly documented and communicatedInterpret or initiate changes in guidelines/policies/proceduresMonitor and evaluate the performance of the FCR team and implement improvement strategies as neededKeeps team focused on specific and measurable performance goals and monitors performance against clear standards.Works collaboratively among business units to align and partner with others to achieve performance goals and/or outcomesProvide Ensure the delivery of high-quality, patient-centered care through the management of chronic disease, complex case management, and discharge planningOther duties as assigned by Sr ManagerYour Knowledge and Experience Requires a current CA RN LicenseBachelors of Science in Nursing or advanced degree preferred.Requires at least 7 years of prior relevant experience including 3 years of management experience gained as a team leader, supervisor, or project/program managerA minimum of 3+ year experience in inpatient or managed care environment preferredExcellent communication, interpersonal, and negotiation skillsHas functional expertise within the area of responsibility.Knowledge of NCQA requirements preferredAbility to analyze data and create reports to guide decision-making and process improvements
Full Time
6/1/2025
Sacramento, CA 95834
(5.8 miles)
Description & Requirements Description Compensation:$26 - $32 Per Hour- Full time, based upon experiencePromotion opportunity to Program Supervisor (salaried) based upon experienceBenefits of Working at Intercare:Monthly Bonuses!Flexible work schedule with a focus on work/life balance; Manage your own scheduleMileage reimbursement, a company computer and cell phoneEducation tuition reimbursement program (Masters & BCBA)!Leadership training and CEUs - we will teach how to become a better leader!Medical, Dental, and Vision insuranceGenerous time off policy (vacation, sick time, and holidays)Company 401k PlanOutstanding mentorship and supportive environment for continual learningRequired Credentials/Experience:Completed Bachelor’s degree and either of the following:12 semester units of ABA course work with one (1) year experience implementing and/or designing ABA programmingTwo (2) years of experience designing or implementing ABA programsStrong ABA and clinical skillsExcellent written and spoken communication, time management skills, and interpersonal skillsAbility to give and receive constructive feedback with a team player attitudeBilingual skills valuedJob DescriptionIntercare Therapy provides evidence-based behavioral therapies that help children overcome challenges related to autism spectrum disorders. Our mission is to optimize the independence and quality of life of our clients and their families. We love what we do, and we are seeking team members who share our passion for improving the lives of children and families affected by autism.AProgram Managerserves in the field as the onsite case supervisor and leader, mastering daily case management skills, including developing and overseeing clinical programs, supervising BIs and providing education and training for client caregivers. You must be willing to drive 30 to 60 miles a day, andable to supervise client sessions anytime between 8AM and 6PM on weekdays, and occasionally on weekends.We are proud to be the highest rated established ABA organization on Glassdoor! Check out our rankings and reviews on Glassdoor!Learn more about us on You Tube!This position may require the candidate be fully vaccinated for COVID-19 in accordance with all vaccination requirements set forth by Intercare funding sources and pursuant to any guidelines from the California Department of Health.Closing:If you have experience in any of the following fields, we encourage you to apply:Behavior Analyst, Autism, Social Learning, Social Skills, Developmental Condition, Psychology, Sociology, Social Services, Children, ABA, Applied behavior analysis, BCBAIntercare Therapy will consider for employment qualified applicants with criminal histories in a manner consistent with the requirements of the Los Angeles Fair Chance Initiative for Hiring (Ban the Box) Ordinance.Intercare Therapy supports a diverse workforce and is an Equal Opportunity Employer.
Full Time
6/10/2025
El Dorado Hills, CA 95762
(18.0 miles)
Your Role The Behavioral Health Utilization Management team performs prospective & concurrent utilization reviews and first level determinations for members using BSC evidenced based guidelines, policies, and nationally recognized clinal criteria across multiple lines of business. The Behavioral Health Utilization Management Clinician, Senior, will report to the Manager of Behavioral Health Utilization Management (BH UM). In this role you will conduct clinical review of mental health and substance use authorization requests at various levels of care for medical necessity, coding accuracy, medical policy compliance and contract compliance.Your Work In this role, you will: Perform prospective & concurrent utilization reviews and first level determination approvals for members admitted to facilities using BSC evidenced based guidelines, policies and nationally recognized clinal criteria across lines of business or for a specific line of business such as Medicare as neededGather clinical information and apply the appropriate clinical criteria/guideline, policy, procedure and clinical judgment to render coverage determination/recommendation along the continuum of care facilitates including effective discharge planning at levels of care appropriate for the members needs and acuity; prepare and present cases to Medical Director (MD) for medical director oversight and necessity determinationProvide information to facilities and providers regarding community treatment resources, mental health care management programs, company policies and procedures, and medical necessity criteriaWork with multidisciplinary teams to support members using an integrated team-based approach including Interdisciplinary Team Meetings and case consultations with Medical Director and/or Licensed ManagerRecognize the members right to self-determination as it relates to the ethical principle of autonomy, including the members/family's right to make informed choices that may not promote the best outcomes, as determined by the healthcare teamSupport team through consistent and successful caseload management and workload to achieve team goals, regulatory timelines, and accreditation standardsYour Knowledge and Experience Current unrestricted CA license (LCSW, LMFT, LPCC, PhD/PsyD or RN with Behavioral Health experience) requiredAdvanced degree commensurate with field is preferredRequires at least five (5) years of prior experience in healthcare related fieldThree (3) years conducting Behavioral Health Utilization Management for a health insurance plan or managed care environment requiredStrong understanding of Behavioral Health Utilization Management including ability to apply and interpret admission and continued stay criteria of multiple standardized clinical criteria sets including but not limited to MCG guidelines, nonprofit association guidelines, and various Medicare 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
6/1/2025
Sacramento, CA 95834
(5.8 miles)
Description & Requirements Description Compensation:$26 - $32 Per Hour- Full time, based upon experiencePromotion opportunity to Program Supervisor (salaried) based upon experienceBenefits of Working at Intercare:Monthly Bonuses!Flexible work schedule with a focus on work/life balance; Manage your own scheduleMileage reimbursement, a company computer and cell phoneEducation tuition reimbursement program (Masters & BCBA)!Leadership training and CEUs - we will teach how to become a better leader!Medical, Dental, and Vision insuranceGenerous time off policy (vacation, sick time, and holidays)Company 401k PlanOutstanding mentorship and supportive environment for continual learningRequired Credentials/Experience:Completed Bachelor’s degree and either of the following:12 semester units of ABA course work with one (1) year experience implementing and/or designing ABA programmingTwo (2) years of experience designing or implementing ABA programsStrong ABA and clinical skillsExcellent written and spoken communication, time management skills, and interpersonal skillsAbility to give and receive constructive feedback with a team player attitudeBilingual skills valuedJob DescriptionIntercare Therapy provides evidence-based behavioral therapies that help children overcome challenges related to autism spectrum disorders. Our mission is to optimize the independence and quality of life of our clients and their families. We love what we do, and we are seeking team members who share our passion for improving the lives of children and families affected by autism.AProgram Managerserves in the field as the onsite case supervisor and leader, mastering daily case management skills, including developing and overseeing clinical programs, supervising BIs and providing education and training for client caregivers. You must be willing to drive 30 to 60 miles a day, andable to supervise client sessions anytime between 8AM and 6PM on weekdays, and occasionally on weekends.We are proud to be the highest rated established ABA organization on Glassdoor! Check out our rankings and reviews on Glassdoor!Learn more about us on You Tube!This position may require the candidate be fully vaccinated for COVID-19 in accordance with all vaccination requirements set forth by Intercare funding sources and pursuant to any guidelines from the California Department of Health.Closing:If you have experience in any of the following fields, we encourage you to apply:Behavior Analyst, Autism, Social Learning, Social Skills, Developmental Condition, Psychology, Sociology, Social Services, Children, ABA, Applied behavior analysis, BCBAIntercare Therapy will consider for employment qualified applicants with criminal histories in a manner consistent with the requirements of the Los Angeles Fair Chance Initiative for Hiring (Ban the Box) Ordinance.Intercare Therapy supports a diverse workforce and is an Equal Opportunity Employer.
Full Time
6/10/2025
El Dorado Hills, CA 95762
(18.0 miles)
Your Role Reporting to the Sr. Director, Utilization Management, the role of the Director, Commercial Utilization Management is critical to the success of Blue Shield of California (BSC) and the Utilization Management (UM) department in realizing its goals and objectives. This individual will play a key role as part of UM team in delivering and collaborating on all aspects of utilization management and care coordination for Commercial membership. The Director, Commercial Utilization Management role will also provide direction and leadership in compliance to regulatory requirements and key operational metrics. This role requires weekly travel to an approved BSC office, and monthly travel to the Rancho Cordova BSC office. Ad hoc travel as needed.Your WorkIn this role, you will:Manage and monitor prior authorization and concurrent review to ensure that the patient is getting the right care in a timely and cost-effective wayLead development of UM strategy by leveraging the use of data/analytics to inform and technology solutions to streamline operational efficiencies while also building a cost-benefit methodology to rationalize decisions on UM reviews to be performed based upon staffing costs, productivity, and projected medical cost savingsProvide analysis and reports of significant utilization trends, patterns, and resource allocation. Partner with physicians and others to develop improved utilization of effective and appropriate servicesEstablish and measure productivity metrics in order to support workforce planning methodology and rationalization of services required to perform UM reviewsReview and report out on Utilization Review (UR) trending for Commercial membershipEnsure alignment of the authorization strategy with clinical policy, payment integrity, and network development strategies to optimize quality and cost of careManage strategic projects and support operations initiativesLead operational implementation of transformation changes (organizational management, process implementation, technology adoption)Lead operational teams' performance, resource management, continuous improvement, and trainingLead operational audit readiness, ensure adequate processes and internal audit measures are in place and maintained quarterlyEnsure all operational processes are meeting regulatory and accreditation requirementsFoster a culture of process excellence, BSC leadership principles, and a great place to work environmentYour Knowledge and ExperienceRequires current CA RN LicenseBachelors of Science in Nursing or advanced degree preferredMaster’s degree or equivalent experience preferredMinimum of 10 years prior relevant experience, including 6 years of management experienceMinimum of 5 years of progressive leadership in Utilization Management operations, preferredHealth plan or similar health care organization structure experience requiredSuccessful track record in driving organizational change managementExcellent relationship and consensus-building skills required#LI-JS3
Full Time
6/10/2025
El Dorado Hills, CA 95762
(18.0 miles)
Your Role Work schedule is Mon-Fri 10am- 7pm 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 Regional Registered Nurse Case Manager will report to the FEP Care Management Department Manager. In this role you will determine, develop, and implement a plan of care based on accurate and comprehensive assessment of the member’s needsYour WorkIn this role, you will:Coordinate care for lower level of care such Skilled Nursing Facility, Home Health, Home Infusion, Acute Rehab, Long-term Acute Care Hospital, Hospice, and other community program as appropriatePerform effective discharge planning and collaborate with member’s support system and health care professionals involved in the continuum of careProvides disease management education on core chronic conditions (Diabetes, Heart Failure, COPD, Asthma and Coronary Artery Disease). Outreach to members with HEDIS Care Gaps to assist with closureApply detailed knowledge of FEP PPO and Blue Shield of California's established medical/departmental policies, clinical practice guidelines, community resources, contracting and community care standards to each caseResearch and design treatment/care plans to promote quality of care, cost effective health care services based on medical necessity complying withcontract for each appropriate plan typeProvide Referrals to QualityManagement (QM), Disease Management (DM) and Appeals and Grievance department (AGD)Recognize the clients right to self-determination as it relates to the ethical principle of autonomy, including the client/family's right to make informed choices that may not promote the best outcomes, as determined by the healthcare teamDesign appropriate and fiscally responsible plan of care with targeted interventions that enhance quality, access and cost-effective outcomesInitiate and implement appropriate modifications in plan of care to adapt to changes occurring over time and through various settingsMust be able to sit for extended periods of time and read information on one computer screen and apply that information on a second computer screen to complete documentationYour Knowledge and ExperienceRequires a current CA RN License.Bachelor of Science in Nursing or advanced degree preferredCertified Case Manager (CCM) Certification or is in process of completing certification when eligible based on CCM application requirementsRequires at least 5 years of prior experience in nursing, healthcare or related field3+ years managed care experience preferred.Comprehensive knowledge of case management, discharge planning, utilization management, disease management and community resources preferredBehavioral health, oncology, or OB/NICU/pediatrics experience preferredStrong electronic clinical documentation skills, independent problem identification and resolution skillsKnowledge of coordination of care, prior authorization, level of care and length of stay criteria sets desirableCompetent understanding of NCQA and federal regulatory requirementsDemonstrate leadership, project management and program evaluation skills and ability to interact with all levels including senior management and influence decision-makingDemonstrates professional judgment, and critical thinking, to promote the delivery of quality, cost-effective care. This judgment is based on medical necessity including intensity of service and severity of illness within contracted benefits and appropriate level of care
Full Time
6/10/2025
El Dorado Hills, CA 95762
(18.0 miles)
Your Role The Care Managementteam 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 Case Management – Nurse, Senior will report to the Manager of Care Management. In this role you will play a pivotal role in assessing member needs, providing clinical education, as well as care coordinationwith providers, medical groups, and community resources. You will be responsible for managing and coordinating patient care, ensuring that our members receive the highest quality of care and services. Care Managers perform care management (CM) activities demonstrating clinical judgement and independent analysis, collaborating with members and those involved with members’ care including clinical nurses and treating physicians.Your Work In this role, you will: Determine appropriateness of referral for CM services, mental health, and social servicesAssess members health behaviors, cultural influences and clients belief/value system. Evaluate all information related to current/proposed treatment plan and in accordance with clinical practice guidelines to identify potential barriersResearch and design treatment/care plans to promote quality of care, cost effective health care services based on medical necessity complying with contract for each appropriate plan type. Adjust plans or create contingency plans as necessaryIdentify appropriate programs and services that align with member needs and preferencesInitiate timely Individualized Care Plans (ICP) based on Health Risk Assessment (HRA) completion, participation in and documentation of Interdisciplinary meetings (ICT), assisting in transitions of care across all agesProvide Referrals to Quality Management (QM), Disease Management (DM) and Appeals and Grievance department (AGD)Conduct member care review with medical groups or individual providers for continuity of care, out of area/out of network and investigational/experimental casesResearch opportunities for improvement in assessment methodology and actively promote continuous improvement. Anticipate potential barriers while establishing realistic goals to ensure success for the member, providers, and BSCDetermine realistic goals and objectives and provide appropriate alternatives. Actively soliciting client’s involvementRecognize need for contingency plans throughout the healthcare processProvide education and support to members and their families regarding health conditions, treatment options, and community resourcesFollow up with members as appropriate to ensure they have successfully connected with recommended programs and servicesYour Knowledge and Experience Requires a current and valid CA RN License or valid RN license(s) from other state(s). Preferred licensure from a compact state. If assigned to another state, must maintain an active, unrestricted RN license in assigned state(s) or the ability to obtain required RN license (in addition to primary state license) within 90 days of hireBachelor of Science in Nursing or advanced degree preferredCertified Case Manager (CCM) Certification or is in process of completing certification when eligible based on CCM application requirementsRequires 5 years experience in nursing, healthcare, or related field A minimum of 3 years managed care experience in inpatient, outpatient, or managed care environment preferredHealth insurance/managed care experience preferredTransitions of care experience preferredStrong knowledge of healthcare delivery systems, managed care principles, and care coordinationExcellent communication skills
Full Time
5/30/2025
El Dorado Hills, CA 95762
(18.0 miles)
Your Role Reporting to the Sr. Director, Utilization Management, the role of the Director, Medicare & Medi-Cal Utilization Management is critical to the success of Blue Shield of California and the Utilization Management department in realizing its goals and objectives.This individual will play a key role as part of the Utilization Management team in delivering and collaborating on all aspects of utilization management and care coordination for our Medicare and Medi-Cal membership. The Director, Medicare & Medi-Cal Utilization Management role will also provide direction and leadership in compliance to regulatory requirements and key operational metrics.Your Work In this role, you will: Manages and monitors prior authorization and concurrent review to ensure that the patient is getting the right care in a timely and cost-effective way.Leading development of UM strategy by leveraging the use of data/analytics to inform and technology solutions to streamline operational efficiencies while also building a cost-benefit methodology to rationalize decisions on UM reviews to be performed based upon staffing costs, productivity, and projected medical cost savings.Provides analysis and reports of significant utilization trends, patterns, and resource allocation.Partners with physicians and others to develop improved utilization of effective and appropriate services.Establishing and measuring productivity metrics to support workforce planning methodology and rationalization of services required to perform UM reviews.Reviewing and reporting out on Utilization Review (UR) trending for Medicare and Medi-Cal membership.Ensuring alignment of the authorization strategy with clinical policy, payment integrity, and network development strategies to optimize quality and cost of care.Responsible for managing strategic projects and supporting operations initiatives.Leading operational implementation of transformation changes (organizational management, process implementation, technology adoption).Responsible for operational teams' performance, resource management, continuous improvement, and training.Responsible for operational audit readiness, ensuring adequate processes and internal audit measures in place and maintained quarterly.Ensuring all operational processes are meeting regulatory and accreditation requirements.Fosters a culture of process excellence, BSC leadership principles, and a great place to work environment.Occasional business travel required.Your Knowledge and Experience Requires current CA RN LicenseBachelor’s of Science in Nursing or advanced degree preferredMaster’s degree or equivalent experience preferredMinimum of 10 years of Utilization Management or relevant experience, including 6 years of management experienceMinimum of 5 years of progressive leadership in Utilization Management operationsHealth plan or similar health care organization structure experience requiredSuccessful track record in driving organizational change managementExcellent relationship and consensus-building skills required
Full Time
5/24/2025
El Dorado Hills, CA 95762
(18.0 miles)
Your Role The Care management team is looking for a leader with Medi-Cal experience who can help design and lead our Medi-Cal line of business. The Senior Manager of Care Management, Medi-Cal will report to the Director of Care Management in the Population Health Department.. In this role you will be will serve as the professional leader of registered nurses within Blue Shield care management who is a good collaborator, experienced in people leadership, and will serve as a mentor and advisor to senior leadership. The selected candidate will also function as the subject matter expert on professional nursing/ care management for Medi-Cal regulations- who will represent care management in initiatives, client presentations, act as a liaison between other business units within Blue Shield to bolster care management knowledge on community resources, best practices, and promote holistic and integrated approach to medical care management..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,buildingand sustaining high-performing teams, getting results the right way, and fostering continuous learning.Your WorkYour WorkIn this role, you will:Establish operational objectives for department or functional area andparticipatesand leads other managers to establish group objectivesBe responsible for team, department or functional area results in terms of planning, cost and methods in collaboration with DirectorParticipate in the development and implementation of the annual budget under the direction of DirectorEnsure workflow procedures and guidelines are clearly documented and communicatedInterpret or initiate changes in guidelines/policies/proceduresProvides leadership to ensure best utilization of resources in obtaining organizational goals, regulatory compliance, adhering to corporate policies through oversight of daily operations, assessment of adequacy of staffing, and adherence to standard of social workersEnhancement or creation of care management processes in compliance with regulatory requirementsMaintenance and operationalizing of the Model of Care (MOC) for Medi-Cal SPD members, Cal-AIM, and other contracts with DHCS and CMS in close collaboration with and guidance from Director of Care ManagementResponsible for ensuring that the care management department readiness for internal and external regulatory and accreditation auditsPrimary involvement with committees, projects, initiatives, professional associations, and other service providers to promote appropriate and cost-effective care delivery for the populationFocused on services and programs to increase quality of life and health of all membersMacro level collaboration and involvement with committees, projects, initiatives, community leaders, county social service personnel, professional associations, and other service providers to promote appropriate and cost-effective care delivery for the populationDemonstrates a passion for leading positive change by enhancement and sustainment of an innovative care management program that advocates for patient safety by keeping informed of mandates, regulations, and best practice innovationsEnhancement and development of client health education, Advance Healthcare Planning and End of Life counseling and support and promotes participation in staff, patient, and community educationPromotion of best practice in impacting social determinants of health and homelessnessRepresent Blue Shield care management in Blue Shield sponsored community events and fairsRegular collaboration with other Blue Shield managers in care management and other business unitsMaintain daily measurement standards and outcomes for staffAn active participant in practice transformationYour Knowledge and ExperienceRequires a bachelor's degree or equivalent experienceRequires a current CA RN LicenseCertified Case Manager (CCM) Certification or is in process of completing certification when eligible based on CCM application requirementsRequires at least 10 years of prior relevant experience including 4 years of management experience gained as a team leader, supervisor, or project/program managerRequires health insurance/managed care experience (Commercial, Medicare, and Medi-Cal).Requires excellent communication, presentation, and procedure-writing skillsLean methodology desiredAdvanced degree preferred
Full Time
5/23/2025
El Dorado Hills, CA 95762
(18.0 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
5/21/2025
El Dorado Hills, CA 95762
(18.0 miles)
Your Role Reporting to the Manager, Care Management- Behavioral Health, the Behavioral Health Care Management Clinician, Seniorhelps members with behavioral health needs navigate the health care system for linkages to behavioral health providers, treatment, and programs. The Behavioral Health Care Manager will offer support in assessing members’ emotional and psychological well-being and providing resource coordination, crisis intervention, substance abuse, and with any behavioral or mental health referrals. The Behavioral Health Care Management Clinician, Senior will be available to physicians and nurse care managers as a consultant for patients with complex psychosocial needs. The position requires an intensive focus on crisis intervention and counseling, problem-solving and conflict resolution, patient and family management, interdisciplinary collaboration, psychosocial assessments, education, advocacy, and community resource linkages.Your Work In this role, you will: Collaborate with case managers and other team members tocomplete member assessments related to social and resource needs tosupportmemberaccess to servicesCollaborate with service coordination staff and act as liaison to ensure a timely and accurate response to member needsCollaborate with providers to support members’ treatment plan and care needsRecognize the client’s right to self-determination as it relates to the ethical principle of autonomy, including the client/family's right to make informed choices that may not promote the best outcomes, as determined by the healthcare teamAssessmembers health behaviors, cultural influences and clients belief/value systemand evaluates all information related to current/proposed treatment plan and in accordance with clinical practice guidelines to identify potential barriersEfficiently manages and maintains a caseload of members for behavioral health care coordination and or BH case management for persons experiencing severe and persistent mental illness.Maintains an active workload in accordance with National Care Manager performance standards.Provides information to members and providers regarding mental health and substance abuse benefits, community treatment resources, mental health managed care programs, and company policies and procedures, and criteria.Interacts with Utilization department and Physician Advisors to discuss clinical questions and concerns regarding specific cases.Coordinates services with state and community programs on behalf of the member, particularly when the member is unable to effectively do so independentlyAs a mandated reporter, files and follows-up on reports made to the appropriate government agency (e.g., Adult Protective Services, Child Protective Services, etc.)Actively participates in Interdisciplinary Team Meetings and case consultations with Licensed Manager.)Your Knowledge and Experience Current unrestricted CA License (LCSW, LMFT, LPCC, Registered Nurse (RN), or PsyD by the Board of Behavioral Health Sciences requiredAdvanced degree commensurate with field is preferredRequires at least five (5) years of prior relevant experience, including three (3) years of experience in behavioral health.Certified Case Manager preferredExperience conducting thorough psychosocial assessments, developing care plans and providing necessary interventions identified during assessment with complex client populations that may have, among other things, inadequate coping skills, severe emotional disorders, developmental disabilities, mental illnesses, and/or unstable housingConsiderable knowledge of a wide range of psychosocial challenges and familiarity with behavioral health diagnoses and treatmentProficient with computer programs such as Microsoft Excel, Outlook, Word, and PowerPoint
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