Your RoleThe Medical Management team ensures that Blue Shield is on the cutting edge of medical, medication, and payment policy to accelerate the emergence of a value-based health care system in California. The Medical Director, Utilization Management will report to the Vice President, Medical Management. In this role you will deliver and collaborate on clinical review activities, which includes management of the physician processes in support of utilization management and transactional functions for the membership. These functions include performance of pre-service, concurrent and retrospective utilization review, Appeals and Grievances, and provider claims dispute reviews. The Medical Director, Utilization Management facilitates performance management and goals in alignment with organizational goals for the membership. Moreover, the Medical Director, Operations leads or meaningfully contributes to the Blue Shield priorities and transformative initiatives that continue to improve the health and wellbeing of Blue Shield of California members. You will also provide direction and leadership in compliance with regulatory requirements and key operational metrics and work collaboratively with the Director, Utilization Management to achieve these goals.Your Work In this role, you will: Complete assigned clinical reviews (preservice requests, Concurrent Review, Provider Claims Disputes, pharmacy, or others) within compliance standards while supporting clinical staff in maintaining high quality clinical reviews and work products and process improvement and optimization efforts for the membership as well as other lines of business, including MedicarePartner closely with the Sr. Medical Director, Utilization Management to develop improved utilization of effective and appropriate services and support operational implementation of transformation initiatives for the membershipSupport Sr. Medical Director, Concurrent Review in coordinating the care of membership, to provide access to high-quality health care to these membersSupport Sr. Medical Director, Concurrent Review in strategic initiatives whether by proposing clinical initiatives, providing expert input, shaping the strategy, and/or serving as the initiative driverCollaborate with teams in the implementation and operation of assigned initiativesUnderstands and abides by all departmental policies and procedures as well as the organization’s Standards of Conduct and Corporate Compliance ProgramAttends mandatory Corporate Compliance Program education sessions, as required for this position, including the annual mandatory Standards of Conduct classParticipates actively in assigned CommitteesAbides by all applicable laws and regulations as mandated by state and federal lawsAny other assigned dutiesYour Knowledge and Experience Medical degree (M.D./D.O.)Completed residency preferably in adult based primary care specialty (e.g. internal medicine, family practice)Maintain active, unrestricted California State Medical License required; Maintain active, unrestricted Medical License in all additional assigned states requiredMaintain Board Certification in one of ABMS or AOA categories required (preferably Internal Medicine or Family Practice)Minimum 5 years direct patient care experience post residencyDemonstrated proficiency in at least 3 of the following: Medicare/Medicare STARS, Dual Special Needs Plan (D-SNP), Medi-Cal, NCQA/URAC/Quality Programs, Policies/Procedures 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 ImprovementKnowledge of Medicare, California statutes and regulations including DMHC. Understanding of NCQA accreditation standards preferredKnowledge and skilled application of National evidence-based medical necessity criteria references (MCG or InterQual)An ability to work independently to achieve objectives and resolve issues in ambiguous circumstancesClear, compelling communication skills with demonstrated ability to motivate, guide, influence, and lead others, including the ability to translate detailed analytic analysis and complex materials into compelling communicationsStrong collaboration skills to effectively work within a team that may consist of diverse individuals who bring a variety of different skills ranging from medical to project management and moreExcellent written and verbal communication skillsExcellent analytical, time management and organizational skillsProficient with computer programs such as Microsoft Excel, Outlook, Word, and PowerPoint

Application Deadline:07/30/2025Address:460 Brunswick Rd.Job Family Group:Retail Banking Sales & ServiceThis is a licensed position requiring the SIE, Series 6, 63, Life and HealthThe mission of Premier Services is to help mass affluent clientele make real financial progress by understanding and planning for what comes next.A BMO Senior Premier Relationship Manager is charged with managing and growingan assigned portfolio of mass affluent clients. Each RM partners with multiple branch locations and a team of financial advisors to identify new opportunities and deliver a differentiated experience.Our customer-centric approach prioritizes client goals through financial planning, delivering solutions that are tailor made for the individual. Premier Relationship Managers play the role of our banking product experts and process all banking solutions, including checking, savings, and lending needs.As aLicensed Senior Premier Relationship Manager at BMO, you will:Serve as the customers’ relationship managerproviding personalized attention to uncover their specific financial needs and goals, backed by BMO’s expertise, technology and resources.Acts as the primary client contact to uncover financial needs and provide meaningful solutions in compliance with regulatory and compliance policies. Works collaboratively within the market, BMO partners, and the community to build relationships and deliver the desired customer experience.Enjoya tremendous, values-based culture that focuses on providing you with all the tools and support necessary for your success.Work with your internal partnerships toleverage their expertise to provide comprehensive strategies and solutions for our affluent customers’ financial needs.Enjoy a competitive base salary, quarterlyincentives and annual bonus opportunities, as well as comprehensive benefits with a company that celebrates big ideas, supports your personal and professional growth, and makes a real impact in local communities.BMO IS ON AN EXCITING JOURNEYWe have built a digitally-enabled, future-ready bank with leading efficiency,profitability and loyalty – all powered by a Winning Culture and driven by our Purpose to Boldly Grow the Good,in business and life. We’ve been recognized as a great place to work, for our focus on diversity & inclusion and for always putting the customer first.You belong here!This is a licensed position requiring the SIE, Series 6, 63, Life and HealthProactively builds and manages an assigned portfolio of mass affluent clients across multiple branch locations.Acts as the primary client contact to uncover financial needs and provide meaningful solutions in compliance with regulatory and compliance policies.Works collaboratively within the market, BMO partners, and the community to build relationships and deliver the desired customer experience.Uses a consultative sales process to develop strong customer relationships; acts as client’s trusted advisor and primary point of contact.Proactively works with assigned customer portfolio to uncover needs, provide solutions, and identify additional sales opportunities.Makes key recommendations on products, pricing, and services; links customer to business partner experts based on key financial decisions.Achieves results and meets sales targets by acquiring new assets from existing client portfolio and new client acquisition.Proactively works with branch business partners to identify existing customers that meet the target profile and create a calling plan.Review credit applications to ensure sound credit granting principles; recommends remedies to maintain acceptable asset and credit quality.Executes quality customer review meetings for retention and relationship expansion purposes.Actively participates in the community to identify prospects through relationship building efforts and identify centres of influence (e.g. law and accounting firms) and two-way referral relationships.Provides individual and group training in order to mentor and coach branch personnel to enhance their knowledge and skills around the mass affluent client.Educates clients about available digital options for conducting banking transactions and provides guidance in the use of digital and self-serve technologies.Liaises between clients and various departments across the organization to provide product support as well as diagnose and solve problems within given rules.Follows security and safeguarding procedures and applies due diligence in accordance with Bank’s policies and ethical standards for the prevention of loss due to fraud, robbery, counterfeiting, money laundering, or defalcation.Maintains the confidentiality of customer and Bank information in compliance with Bank policies and procedures.Identifies risks and takes appropriate actions, including all documentation and other regulatory requirements to maintain operational integrity.Monitors individual exception reports and takes action to remove exceptions.Supports the execution of strategic initiatives in collaboration with internal and external stakeholders.Executes work to deliver timely, accurate, and efficient service.Focus is primarily on business/group within BMO; may have broader, enterprise-wide focus.Exercises judgment to identify, diagnose, and solve problems within given rules.Works independently on a range of complex tasks, which may include unique situations.Broader work or accountabilities may be assigned as needed.Qualifications:Typically between 4 - 6 years of relevant experience; post-secondary degree in related field of study preferred, not required.7+ years of experience in a financial services organization with knowledge of banking products, services, pricing, and profitability.Required: SIE Exam, Series 6, Series 63, Life & Health licenses (if licenses not currently held, required within six months of role start date).Advanced understanding of deposit, loan (including mortgage) and banking products and practices, cash flow analysis, lending process and directives, credit risk policies and standards, supporting processes, applicable legal and regulatory requirements, and Bank policies.Excellent understanding of brokerage and insurance products.Excellent knowledge of business services, including retirement plans, business banking solutions, insurance, and succession planning – required.Excellent understanding of personal trust and investment management – required.In-depth knowledge of client portfolio management.Technical proficiency gained through education and/or business experience.Verbal & written communication skills - In-depth.Collaboration & team skills - In-depth.Analytical and problem solving skills - In-depth.Influence skills - In-depth.Data driven decision making - In-depth.U.S. Only: This position will act as an originator of consumer loans as defined by Regulation Z, Regulation G, and the Secure and Fair Enforcement for Mortgage Licensing Act (the S.A.F.E. Act). This position will require a Federal registration with the Nationwide Mortgage Licensing System and Registry. The Bank will instruct you on the registration requirements needed to comply with this requirement. A criminal background review and credit history evaluation will be required for this position as well as restrictions on performing in a real estate agent capacity.Salary:$56,000.00 - $104,000.00Pay Type: SalariedThe above represents BMO Financial Group’s pay range and type.Salaries will vary based on factors such as location, skills, experience, education, and qualifications for the role, and may include a commission structure. Salaries for part-time roles will be pro-rated based on number of hours regularly worked. For commission roles, the salary listed above represents BMO Financial Group’s expected target for the first year in this position.BMO Financial Group’s total compensation package will vary based on the pay type of the position and may include performance-based incentives, discretionary bonuses, as well as other perks and rewards. BMO also offers health insurance, tuition reimbursement, accident and life insurance, and retirement savings plans. To view more details of our benefits, please visit:https://jobs.bmo.com/global/en/Total-RewardsAbout UsAt BMO we are driven by a shared Purpose: Boldly Grow the Good in business and life. It calls on us to create lasting, positive change for our customers, our communities and our people. By working together, innovating and pushing boundaries, we transform lives and businesses, and power economic growth around the world.As a member of the BMO team you are valued, respected and heard, and you have more ways to grow and make an impact. We strive to help you make an impact from day one – for yourself and our customers. We’ll support you with the tools and resources you need to reach new milestones, as you help our customers reach theirs. From in-depth training and coaching, to manager support and network-building opportunities, we’ll help you gain valuable experience, and broaden your skillset.To find out more visit us at http://jobs.bmo.com/us/enBMO is proud to be an equal employment opportunity employer. We evaluate applicants without regard to race, religion, color, national origin, sex (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity, gender expression, transgender status, sexual stereotypes, age, status as a protected veteran, status as an individual with a disability, or any other legally protected characteristics. We also consider applicants with criminal histories, consistent with applicable federal, state and local law.BMO is committed to working with and providing reasonable accommodations to individuals with disabilities. If you need a reasonable accommodation because of a disability for any part of the employment process, please send an e-mail to and let us know the nature of your request and your contact information.Note to Recruiters: BMO does not accept unsolicited resumes from any source other than directly from a candidate. Any unsolicited resumes sent to BMO, directly or indirectly, will be considered BMO property. BMO will not pay a fee for any placement resulting from the receipt of an unsolicited resume. A recruiting agency must first have a valid, written and fully executed agency agreement contract for service to submit resumes.

$68,640/yr + Company Vehicle (Gas, Insurance, Maintenance Included)Are you driven by a passion for customer satisfaction Do you thrive in a fastpaced, high-pressure environment Join us as an Operations Manager Trainee and embark on a dynamic learning journey. Through our structured, hands-on program, you’ll immerse yourself in operations, mastering the skills to enhance financial profitability, operational efficiency, and improve customer satisfaction while leading the teams. With rotation through key operational areas such areas including Sales, Logistics, and Customer ServiceAfter completing the eight-week training, you will transition into a supervisory role, overseeing one or more of the daily operations and sales functions to ensure maximization of fleet, revenue, customer satisfaction and employee management. You'll receive mentorship to develop skills and advance from Operations Manager to Area Vice President in our Fortune 500 company.Benefits you’ll receive:Annual Compensation Min $50,000/yr - Max $50,000/yrCompany vehicle provided with gas, insurance, and maintenancePaid time off401K retirement plan with company-matched contributionsAccess to Medical, Dental, Vision, Life and Disability insuranceEligible to elect other voluntary benefits including Group Legal, Identity Theft, Insurance, FSA, additional life insurance coveragesContribute up to $260 as a tax-free benefit for public transportation or parking expensesEmployee discounts, including discounted prices on purchase of Avis / Budget carsAccess to an Employee Assistance Program for services including counseling, financial and legal consultation, referrals for care service, and moreWhat we’re looking for:Recent graduate with bachelor's degree OR associate's degree plus at least two years’ supervisory experienceAbility to demonstrate strong leadership capabilities, work well in a team environment with a positive attitude, and make independent decisionsValid driver’s licenseFlexibility to work days, evenings, overnights, weekends, and holidaysWillingness to work outdoors in weather conditions with moderate noise levelThis position requires regular, on-site presence and cannot be performed remotelyExtra points for this:One year of experience providing high quality customer serviceWho We Are:Here at Avis Budget Group, you will be joining a team of 25,000 driven people, performing with purpose. Together, we’re moving the future of transportation forward with our innovative, customer-focused solutions. Our culture is performance driven, where we encourage and support each other to be at our best through leadership, training, tools, and rewards. We are proud to make a positive difference to the lives of our colleagues, customers, and communities where we operate.Avis Budget Group is an Equal Opportunity Employer – Qualified applicants will receive consideration for employment without regard to their race, color, religion, sex, sexual orientation, gender identity, national origin, disability, status as a protected veteran or any other category protected by applicable law. This advertisement does not constitute a promise or guarantee of employment.This advertisement describes the general nature and level of this position only. Essential functions and responsibilities may change as business needs require. The compensation and benefits information is accurate as of the date of this posting. The Company reserves the right to modify this information at any time, with or without notice, subject to applicable law. This position may be with any affiliate of Avis Budget Group.*Use of company vehicle subject to company policy. This position may be with any affiliate of Avis Budget Group.*#POSTSacramentoCaliforniaUnited States of America

Join us and inspire with every cup! At Starbucks, it’s all about connection. People are at the heart of who we are, especially the people that are a part of our store team. We connect with each other, our customers and our communities to make a positive impact every day. We believe in working together to make a difference and in celebrating our shared success, which is why we call ourselves Starbucks “partners.” Starbucks is a place of warmth and belonging, where everyone is welcome, and we value the unique experiences that each partner brings to our team! As a Starbucks shift supervisor, you’ll be a role model of the store operations standards that define our Starbucks Experience. You’ll lead each shift, working alongside a team of baristas to deliver quality customer service and expertly-crafted products. You’ll be in an energetic store environment where you’ll have the ability to positively influence and guide others, maintain an encouraging team environment, and grow your leadership skills. We believe our shift supervisors are leaders in creating an uplifting experience for our customers and partners alike. You’d make a great shift supervisor if you: Take initiative and act as a role model to others. Enjoy working as a team and motivating others.Understand how to create a great customer service experience.Have a focus on quality and take pride in your work.Are confident in leading, deploying, and guiding others.Are open to learning new things (especially the latest beverage recipe!)Are experienced with responsibilities like cash-handling and store safety. Can keep cool and calm in a fast-paced, energetic work environment.Have excellent communications skills. From free coffee to competitive pay, Starbucks is proud to offer a comprehensive compensation and benefits package to our eligible part-time and full-time partners. Benefits include 100% tuition coverage through our Starbucks College Achievement Plan, health coverage with a variety of plans to choose from, and stock & savings programs like our equity reward program, Bean Stock. What’s more, Starbucks offers flexible scheduling and opportunities for paid time off. Visit starbucksbenefits.com for details. Benefit Information Summary of Experience Customer service experience in a retail or restaurant environment - 1 year Basic Qualifications Maintain regular and consistent attendance and punctuality, with or without reasonable accommodationAvailable to work flexible hours that may include early mornings, evenings, weekends, nights and/or holidaysMeet store operating policies and standards, including providing quality beverages and food products, cash handling and store safety and security, with or without reasonable accommodationsSix (6) months of experience in a position that required constant interacting with and fulfilling the requests of customersPrepare and coach the preparation of food and beverages to standard recipes or customized for customers, including recipe changes such as temperature, quantity of ingredients or substituted ingredientsAt least six (6) months of experience delegating tasks to other employees and/or coordinating the tasks of two (2) or more employees Knowledge, Skills and Abilities Ability to direct the work of othersAbility to learn quicklyEffective oral communication skillsKnowledge of the retail environmentStrong interpersonal skillsAbility to work as part of a teamAbility to build relationships As a Starbuckspartner, you (and your family) will have access to medical, dental, vision,basic and supplemental life insurance, and other voluntary insurance benefits.Partners have access to short-term and long-term disability, paid parental leave, family expansion reimbursement, paid vacationthat accrues starting at .01961 hours based on a 40 hour week up to 40 hours annually (64 hours in California) after an introductory period, sick time (accrued at1 hour for every 25 or 30 hours worked, depending on work location),and additional pay if working on one of eightobserved holidays. Starbucks also offers eligible partners participation in a 401(k)-retirement plan with employer match, a discounted company stock program (S.I.P.), Starbucks equity program (Bean Stock), incentivized emergency savings, and financial well-being tools. Additionally, Starbucks offers 100% upfront tuition coverage for a first-time bachelor’s degree through Arizona State University’s online program viathe Starbucks College Achievement Plan, student loan management resources, and access to other educational opportunities.You will also have access to backup careand DACA reimbursement. Starbucks will comply with any applicable state and local laws regarding employee leave benefits, including, but not limited to providing time off pursuant to the Colorado Healthy Families and Workplaces Act, in accordance with its plans and policies. This list is subject to change depending on collective bargaining in locations where partners have a certified bargaining representative. For additional information regarding partner perks and more detailed information regarding benefits, go to starbucksbenefits.com. At Starbucks, it is typical for new partners to be hired at the entry point of the range for their role, which is based upon geographic location. Individual compensation decisions are dependent upon the facts and circumstances of each position and candidate. Starbucks Coffee Company is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, age, national origin, disability, or protected veteran status, or any other characteristic protected by law. Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances. Starbucks Coffee Company is committed to offering reasonable accommodations to job applicants with disabilities. If you need assistance or an accommodation due to a disability, please contact us at or 1.

Overview: Are you an experienced health and safety leader passionate about creating a safe and healthy workplace As the Health and Safety Manager, youwill oversee occupational health and safety programs, analyze trends and ensure compliance with regulations to safeguard one or more project sites within the same District.Your role involves providing technical expertise, conducting safety orientationsand reviewing safety procedures. Collaborate with industry experts and committed teams to promote a safe working environment. This role will be supporting our Orinda Water project.Apply now and transform your career with us. What you will be doing: Oversees safety program and procedures for one or more project sites within the same District.Performs project site trend analysis and ensures accurate tracking of accidents, injuries, fire, property damage and other safety related incidents are recorded.Develops and conducts all safety orientations, trainings and oversees project site toolbox talks for all project staff within designated timeframe.Ensures all required project permits and certifications are active, documented and tracked for all required construction activities to avoid delays in construction schedule.Provides technical expertise to training, equipment needs and inspection requirements to support construction schedule and promote project cost savings.Oversees equipment maintenance and procurement for project needs to ensure onsite crews have all necessary safety items before construction activity begins.Provides project status and trend analysis to manager and project team, as needed.Oversees injury reporting and resolution for entire project site. Reviews investigation documentation and corrective action plans to ensure appropriate mitigation strategies are implemented on the job site.Reviews and approves Daily Hazard Analysis (DHA) from direct reports and personal daily documentation to ensure accurate and timely tracking of safety procedures. Participates in Jobsite Hazard Analysis (JHA) discussions and documentation for the entire project plan.Creates, reviews or approves the worksite safety and evacuation plan for the project site. Supports emergency response and vehicle access planning with Project Manager. What we are looking for: Bachelor’s Degree in Health & Safety or a related field preferred.8+ years’ experience in construction or safety required.Experience managing construction or safety teams required.Developed skills identifying and mentoring direct report safety professionals. Assigning tasks and training to build a strong and well balanced internal team.Able to provide training and learning opportunities for construction teams based on expert safety knowledge and standard safety principles.Proven skill to identify onsite project safety risks and develop innovative and compliant mitigation strategies within safety program and agency requirement standards.Expert knowledge of construction site equipment, methods and processes.Strong verbal, written and presentation skills with all levels of the organization. Why work for us: Some of the benefits you may be eligible for as an employee are:Comprehensive compensation package and paid time off programIndustry leading 401(k)/RRSPMedical/Extended Health Care, Dental, Vison and/or Provincial MedicalWellness benefits & Employee Assistance ProgramTuition Reimbursement ProgramWe are an EEO/AA/ADA/Veterans employer. Salary Min: USD $130,000.00/Yr. Salary Max: USD $145,000.00/Yr. Vehicle Program: Personal Vehicle Allowance Tier I: $750 USD/month

SierraAt 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:We’re looking for an Assistant Store Manager who is passionate about fostering an inclusive and supportive environment. In this role, you’ll empower your team to deliver unforgettable “magical moments” for our customers. Every day will bring exciting new challenges and opportunities, keeping your work dynamic and rewarding. If you thrive in a fast-paced, ever-evolving environment, this could be the perfect opportunity for you!Why Work With Us We value integrity, respect, and teamwork, encouraging a unique and inclusive culture.Our comprehensive training and development programs provide you with the tools and resources to expand your skills.Enjoy Associate discounts at our stores, available to you and eligible family members.We have a range of global well-being programs focused on physical, financial, and emotional wellness.Exciting career paths with growth opportunitiesWhat You’ll Do:Drive store performance by supporting sales results, managing expenses, and overseeing key operations including merchandising, backroom, frontline, cash office, customer service, markdowns, scheduling, shipping, and receiving, with a strong focus on minimizing shrink and damages.Attract, recruit, and cultivate top talent by providing comprehensive training and ongoing development for Associates. Serve as a mentor and role model, fostering a supportive environment that ensures a positive and engaging experience for both Associates and customers.Communicate and implement action plans for projects, targets, company initiatives, and store changes. Provide input on succession planning to meet future needs.Implement strategies to meet sales, expense, and customer service targets. Coordinate loss prevention and operational programs and improve store layout and efficiency.About You:Minimum of 2 years of retail leadership experience as an Assistant or Store Manager.Demonstrated ability to lead, develop, and empower a large team.Excellent organizational and communication skills with ability to influence and provide effective feedback and mentorship to others.Proficient in store operations, customer service, merchandising, people management, health and safety, and loss prevention, with strong follow-through skills to successfully implement tasks and initiatives.If you’re ready to bring your energy and passion, we’d love to hear from you. Join us and be part of a place where every day is a chance to make a difference.Benefits include Associate discount; 401(k) match; medical/dental/vision; HSA; health care FSA; life insurance; short/long-term disability; paid holidays/vacation /sick/bereavement/parental leave; EAP; incentive programs; auto/home insurance discounts; scholarship program; adoption/surrogacy assistance; smoking cessation; child care/cell phone discounts; pet/legal insurance; credit union; referral bonuses. All benefits are subject to applicable plan or program terms (including eligibility terms) 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:8670 Sierra College BlvdLocation:USA Sierra Store 0222 Roseville CAThis is a bonus and overtime eligible position with a starting pay range of $22.05 to $30.30 per hour, which equates to approximately $54,956.54 - $75,518.51 annually. Actual starting pay is determined by a number of factors, including relevant skills, qualifications, and experience.

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 Career.Leads the frontline to promote a “Highly-Satisfied” customer experience while driving customer loyalty. Helps develop high-performing teams through training and mentoring of Associates on frontline execution of all register transactions. Acts with integrity to adhere to company policy and procedures. Promotes a culture where everyone feels welcomed, valued, and engaged. Has a strong desire to achieve team and individual results. Available and willing to work in multiple areas of the store as neededPromotes a “Highly Satisfied” customer experienceDrives customer loyalty through programs and initiativesAddresses customer concerns and issues promptlyUpdates Associates on current customer experience feedback, goals, and company initiativesTrains and mentors all Associates on Policies and ProceduresProvides recognition and constructive feedback on cashier performanceMaintains and monitors cash controls including change fundAdheres to all labor laws and meal and break period policiesAssigns registers and coordinates breaks to ensure optimized coverage at frontline and sales floorAudits and approves paperworkMaintains cleanliness, recovery, and organizational standards throughout the frontlineMonitors all frontline equipment, communicating issues to managementExecutes and adheres to Company directivesMaintains and upholds merchandising standards within the queue-lineAdheres to all operational, merchandise, and loss prevention policies and procedures (i.e. merchandise ticketing, EAS tagging - if applicable, and coding standards)Ensures proper and timely handling of damages and Mark out of StockPromotes a safe environment, reporting any type of safety hazard in the storeOther duties as assignedWho We’re Looking For: You.High School graduate or equivalent degree preferredAvailable to work flexible schedule including evenings and weekendsAble to work as a team memberExcellent interpersonal skillsExceptional customer service skillsAble to lift heavy merchandise with/without reasonable accommodationsAble to train and provide direction to othersAble to run a register/handle moneyMust be able to handle confidential information with discretionExperience as a coordinator or previous retail/supervisory experience preferredBenefits 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:1010 E Bidwell StreetLocation:USA HomeGoods Store 0522 Folsom 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.

About the RoleIn this role, you will be the expert in store operational processes, supervising store operations while working alongside and leading associates to deliver excellent customer service and operational efficiency. You will teach, coach, develop and supervise associates while completing all operational processes focused on consistent execution and operational efficiency.What You’ll DoExecute sound operational processes including freight unload, receiving, processing product, stockroom management and omni channel fulfillmentSupport inventory accuracy by timely and accurate completion of all required merchandise disposition practicesMaintain appropriate levels of product on the sales floor by processing incoming freight, managing an accurate stockroom and directing floor replenishment as necessary based on sell through and seasonal changesSupport the training processes for new hires on the operations team, ensuring associates are skilled on process best practices, proper inventory procedures, productivity standards and how to leverage Kohl’s tools and resourcesSupport and partner with the merchandising team in store on merchandising incoming product, ensuring partnership on product placement and brand standardsAll Supervisor roles at Kohl’s are responsible for:Leading with integrity, honesty and fostering teamwork in an engaged and inclusive cultureExercising good judgment; taking appropriate partners as neededModeling, guiding and providing direction to associatesDemonstrating and coaching a customer service mindset, including customer service philosophies, anticipating customer needs and satisfactorily resolving issuesSupporting strong operational standards, shortage mitigation, and merchandising presentation to include accurate pricing and proper signingPreventing loss by educating associates, monitoring daily store activity and product protection standards, and partnering with Loss PreventionMonitoring and adjusting resources as the business dictates to support customer needs and workload demands when assigned by a store executive as leader on dutyUse key performance indicators (KPIs) to make informed business decisions that drive overall store resultsAccomplishing multiple tasks within established timeframesTraining, monitoring and reinforcing company policies, procedures, standards and guidelinesMaintaining adherence to company safety policies for the safety of all associates and customersKey holder responsibilities include opening and closing store processes, and providing direction to associatesOther responsibilities as assignedWhat Skills You HaveRequiredMust be at least 18 years of age or olderExperience supervising teams or associates to include the responsibility for coaching to achieve daily goalsStrong verbal/written communication and interpersonal skillsFlexible availability, including days, nights, weekends, and holidaysPreferred2 years experience in retail or similar industryPay Range: $22.25 - $34.50Kohl’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).

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 Nurse Consultant will report to the Manager of Care Management for the Population Health Management Medi-Cal Team. In this role, you will ensure that services are 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 WorkIn 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 applicable assessments and 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.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.Assumes supervisor day to day responsibilities in manager’s absence and under the direction of the managerAnalyze productivity and internal reports to ensure compliance.Collaborates with department leadership to identify program development opportunities.Mentors case managers with complex cases to promote quality of care, cost effective health care services based on medical necessity and complies with contract for each appropriate plan typePerforms precepting for new hires or those who are not meeting expectation.Participates in special projects as neededYour Knowledge and ExperienceCurrent CA RN License.Bachelors of Science in Nursing or advanced degree preferred.Certified Case Manager (CCM) Certification or is in process of completing certification when eligible based on CCM application requirementsRequires at least 7 years of prior experience in nursing, healthcare or related fieldA minimum of 3+ year experience in inpatient, outpatient or managed care environment requiredHealth insurance/managed care experience desired.Transitions of care experience desiredExcellent communications skills

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.

TJ MaxxAt 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 promoting an excellent customer experience. Oversees a team of Associates at front of store ensuring prompt, courteous customer service and promotion of loyalty programs. Leads by example by engaging and interacting with all customers, and maintaining a clean and organized store. Role models outstanding customer service.Creates a positive internal and external customer experiencePromotes a culture of honesty and integrity; maintains confidentialityTakes an active role in training and mentoring Associates on front end principlesTrains and coaches Associates on personalizing the customer experience while promoting loyalty programsAssigns registers, supports and responds to POS coverage needs, and coordinates breaks for all AssociatesAddresses customer concerns and issues promptly, ensuring a positive customer experienceEnsures Associates execute tasks and activities according to store plan; prioritizes as neededCommunicates 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.Available to work flexible schedule, including nights and weekendsStrong understanding of merchandising techniquesCapable of multi-taskingStrong communication and organizational skills with attention to detailAble to respond appropriately to changes in direction or unexpected situationsTeam player, working effectively with peers and supervisorsAble 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:8874 Madison AveLocation:USA TJ Maxx Store 0166 Fair Oaks 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.

Your Role The Utilization Management team reviews the inpatient stays for our members and correctly applies the guidelines for nationally recognized levels of care. The Utilization Management Nurse will report to the Utilization Management Nurse Manager. In this role you will be assigned a list of inpatient facilities and then review clinical information provided by the facilities to determine medical necessity when our members admit. You will also be involved with discharge planning and transfers as needed for higher levels of care or out of network admissions.Your WorkIn this role, you will:Perform prospective, concurrent and 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 complianceEnsuredischarge (DC) planning at levels of care appropriate for the members needs and acuityand determine post-acute needs of member including levels of care, durable medical equipment, and post service needs to ensure quality and cost-appropriate DC planningPrepare 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 standardsand identifypotential quality of care issues, service or treatment delays and intervenes or as clinically appropriateRefer to Case Management when there are acute inpatient needs affecting dischargeAttend staff meetings, clinical rounds and weekly huddlesMaintain quality and productivity metrics for all caseworkBuddy or support new employeesMaintaining HIPAA compliant workspace for telework environmentYour Knowledge and ExperienceBachelors of Science in Nursing or advanced degree preferred.Requires a current California RN LicenseRequires at least 5 years of prior relevant experienceRequires strong communication and computer navigation skillsDesires strong teamwork and collaboration skillsRequires independent motivation and strong work ethicRequires strong critical thinking skills2 years of transplant experience required

TJ MaxxAt 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:9154 West Stockton BlvdLocation:USA TJ Maxx Store 0836 Elk Grove 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.

Your Role The Case Management team performs and case management (CM) activities demonstrating clinical judgment and independent analysis, collaborating with members and those involved with members care including clinical nurses and treating MDs.. The Case Management Nurse, Seniorwill report to the Manager, Care Management. In this role you will determine, develop and implement the plan of care based on accurate assessment of the member and current or proposed treatment plan in cases of member inquiry, triage hub, chronic conditions, poly-pharmacy, and voluntary member health assessment, in addition to indication of multiple monthly ER visits. The RN in this role will be assisting members of the Catholic Diocese. The Care Management Nurse-Senior empowers members to take an active role in their healthcare by educating them on the benefits of their health plan, sharing resources, and providing high-quality options for care. Our nurses primarily work from home but travel expectations for in person meetings with clergy members up to a few trips per month that may be outside of California.Your WorkIn 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 withcontract for each appropriate plan typeProvide Referrals to QualityManagement (QM), Disease Management (DM) and Appeals and Grievance department (AGD)Recognize 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 teamDesign an 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 settingsConducts member care review with medical groups or individual providers for continuity of care, out of area/out of network and investigational/experimental cases.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 promote continuous improvement. Anticipates potential barriers while establishing realistic goals to ensure success for the member, providers and BSC.Planning: Designs an appropriate and fiscally responsible care plan with targeted interventions that enhance quality, access and cost-effective outcomes. Adjust 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.Upholds professional, caring, and compassionate communication to both clients and vendorsResponds to client questions or concerns within 2 business days.Thorough documentation of interactions with vendors and clientsYour Knowledge and ExperienceRequires a current unrestricted CA RN License.Other assigned states are Oregon, Nevada, and Idaho. Must maintain active, unrestricted licensing in those states or the ability to obtain required licensure within 90 days of hire.Requires a valid California Driver’s License with Proof of InsuranceBachelor of Science in Nursing or advanced degree preferred.Certified 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 fieldAt least 3 years of managed care experience preferredDemonstrated ability to independently assess, evaluate, and interpret clinical information and care planning.Extensive knowledge of evidence based clinical practice guidelines particularly for chronic conditions.Incorporates professional judgment and critical thinking when determining medical necessity that promotes quality, cost-effective care.Knowledge of Coordination of Care, Medicare regulations, prior authorization, level of care and length of stay criteria sets preferred, Care GapsAble to operate PC-based software programs including proficiency in Microsoft Office 365 applications including Word, Excel, Outlook, PowerPoint and Teams.

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