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Management Jobs
Full Time
6/13/2025
Sacramento, CA 95834
(4.1 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, Program Management,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 Behavioral Program Managerswho share our passion for improving the lives of children and families affected by autism.A Behavioral Health or (ABA)Program 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
6/19/2025
Rancho Cordova, CA 95741
(14.5 miles)
Your Role The Utilization Management Prior Authorization team accurate and timely prior authorization of designated healthcare services, continuity or care, and access to care clinical review determinations. The Utilization Management Nurse, Senior will report to the Manager, Utilization and Medical Review. In this role you will be performing first level determination approvals for members using BSC evidenced based guidelines, policies, and nationally recognized clinical criteria across lines of business or for a specific line of business such as Medi-Cal and Medicare. Successful RN candidate reviews prior auth requests for medical necessity, coding accuracy and medical policy compliance. Clinical judgment and detailed knowledge of benefit plans used to complete review decisions is required.Your Work In this role, you will: Perform prospective 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 BSC Promise Medi-Cal and MedicareEnsuredischarge (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 appropriateTriages and prioritizes cases to meet required turn-around times and expedites access to appropriate care for members with urgent needsProvides referrals to Case Management, Disease Management, Appeals and Grievance and Quality Departments, as necessaryOther duties as assignedYour Knowledge and Experience Requires a bachelor's degree or equivalent experienceRequires a current California RN LicenseRequires at least 5 years of prior relevant experienceRequires practical knowledge of job area typically obtained through advanced education combined with experienceExperience working with or for a manage health care plan preferredExperience with Medi-Cal managed care including Medicare preferredEffective time management skills and ability to define and act on priorities efficiently preferredExcellent communication skills both orally and in writing with all levels of BSC Promise staff, members, contracted physicians, and participating provider groups preferred
Full Time
6/19/2025
Carmichael, CA 95609
(10.1 miles)
Job DescriptionNomad Health seeks an experienced Case Management registered nurse for a travel assignment in CA.Take the next step in your healthcare career and join Nomad Health as a Case Management travel nurse. As a traveler with Nomad, you get access to industry-leading pay, outstanding benefits, and our knowledgeable Nomad Navigator support team.QUALIFICATIONSMinimum one year of RN experienceOne yearCase Management experience within the last two years as an RNHave an active RN license or be willing to obtain a Registered Nurse license in CARN degree from an accredited registered nurse programBLS and all relevant Case Management/department-specific certifications requiredRegister for a Nomad Health account to view full job details and applyNOMAD BENEFITSMajor medical and dental plans available on your first day of work401(k) with employer matching availableReimbursement for travel to your assignmentHousing stipendWeekly deposits direct to your bank accountWe work with thousands of travel nurses all over the country, in a wide variety of specialties and disciplines. To apply as a travel RN with us, you must have an active Professional Registered Nursing License or be willing to obtain one in the state you’re applying to, evidence of a minimum of one year RN work experience, and evidence of at least one year of Case Management experience within the last two years. In addition, you must have a Bachelor’s or Associate degree in nursing from an accredited registered nursing program, as well as a Basic Life Support (BLS) and all other relevant specialty/department certifications.At Nomad, we want to give you the tools you need to succeed. Our Nomad Navigators are passionate about helping you get to the bedside as quickly and efficiently as possible. They can help you with your application, credentialing, and finding housing. Our Navigators have experience working with travel nurses and can even help with on-the-job concerns if any arise while on assignment, and can provide clinician-to-clinician support.In addition to real hands-on support, we have a benefits package that was explicitly built for traveling clinicians and includes a housing stipend, partial travel reimbursement, and major medical and dental plans available on your first day of work. We also have a 401(k) program with employer matching options, a user-friendly digital timekeeping process, and weekly direct deposits.With your Nomad Health account, you get access to our unique digital platform; a platform built to help you land your perfect assignment. Move your travel healthcare career forward and find your next job today.We are seeking experienced RNs in a number of specialties to fill critical roles across the country: Medical Surgical NurseEmergency Room NurseStep-Down NurseTelemetry NurseICU NurseOperating Room NurseLabor and Delivery NurseCath Lab NursePsychiatric NurseAnd more travel RN jobs!
Full Time
6/14/2025
Fair Oaks, CA 95628
(13.7 miles)
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.
Full Time
6/14/2025
Sacramento, CA 95815
(3.0 miles)
Job ID: 265055Store Name/Number: CA-Arden Fair (0050)Address: 1689 Arden Way Space 1084, Sacramento, CA 95815, United States (US)Hourly/Salaried: Hourly (Non-Exempt)Full Time/Part Time: Full TimePosition Type: RegularYour Role at Sephora: As a Sales and Service Leader, you'll be at the forefront of our mission to provide an exceptional shopping experience for every client. You'll support a dedicated team of Coordinators, Licensed Beauty Advisors, and Beauty Advisors, providing guidance to ensure they excel in their roles. If you have a passion for retail sales and services and love supporting a team, this is the perfect role for you.Key Responsibilities:Implementing Sales and Service Experiences: Ensure the implementation of sales and service experiences that meet Sephora's standards.Support and Coach Team: Support and coach team members in selling, service, and operations.Executing Client Service and Sales: Execute our client service model and sales strategies, driving customer engagement.Ensuring Compliance with Sephora Standards: Ensure compliance with store standards, maintaining a professional environment.Ensuring Client Loyalty and Engagement: Support client loyalty programs and services, monitoring key performance indicators (KPIs) to ensure success.Qualifications/Experience:Prior leadership experience, preferably in retail sales or services.Passion for client service and teamwork.Strong communication skills, ability to multitask.Resilience and adaptability to changing store priorities.Flexible availability to work during “peak” retail hours.Consistent and reliable attendance.Ability to lift and carry up to 50 pounds.While at Sephora, you’ll enjoy.Diversity, Inclusion & Belonging?We pledge to create a beauty community where everyone’s uniqueness is celebrated, respected, and honored.Meaningful Rewards?Sephora offers comprehensive healthcare and wellbeing benefits based on eligibility; Details about our company benefits can be found at the following link: $26.00 - $31.85/hr. The actual hourly pay offered depends on various factors, including qualifications for the position and relevant experience; and other legitimate, non-discriminatory business factors specific to the position or location. Sephora now offers a Flex (on demand) position for employees who can work anywhere from 0-19 hours a week. This flexibility allows you to balance your work schedule with other commitments. This could be a steppingstone into a more permanent position if you are looking for more in the future.Sephora is an equal opportunity employer; and values a diverse and inclusive workplace. All persons will receive consideration for employment without regard to sex, pregnancy, race, color, national origin, gender (including gender identity and gender expression), age, religion, sexual orientation, military/veteran status, disability, or any other legally protected status. Sephora is committed to providing reasonable accommodation in our recruiting processes to applicants with disabilities or other medical conditions.Sephora will consider for employment all qualified applicants, including those with a criminal history, in a manner consistent with the requirements of all applicable federal, state, and local laws, including the Los Angeles Fair Chance Initiative for Hiring Ordinance, the San Francisco Fair Chance Ordinance, and the New York City Fair Chance Act.*This job will be posted for a minimum of 5 business days.
Full Time
5/28/2025
Woodland, CA 95776
(13.6 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
5/23/2025
Sacramento, CA 95834
(4.2 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).
Full Time
6/1/2025
Sacramento, CA 95834
(4.1 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, Program Management,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 Behavioral Program Managerswho share our passion for improving the lives of children and families affected by autism.A Behavioral Health or (ABA)Program 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
6/19/2025
El Dorado Hills, CA 95762
(24.0 miles)
Your Role The Behavioral Health Registered Nurse Case Manager will report to the FEP 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 needs. 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. documentation.Your Work In this role, you will: Coordinates care for Lower Level of Care such as Residential Treatment, Partial Hospitalization Program, Intensive Outpatient Program, other outpatient services, and community programs as appropriate.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 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 settingsApplies detailed knowledge of FEP PPO and Blue Shield of California's (BSC) established medical/departmental policies, clinical practice guidelines, community resources, contracting and community care standards to each case.Performs effective discharge planning and collaborates with member support system and health care professionals involved in the continuum of care.Provides disease management education on core chronic conditions (Diabetes, Heart Failure, COPD, Asthma and Coronary Artery Disease).Determines, develops and implements a plan of care based on accurate and comprehensive assessment of the member's needs related to behavioral health.Must 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 documentation.Your Knowledge and Experience Requires 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 5 years of prior experience in nursing, healthcare or related fieldBachelor of Science in Nursing or advanced degree preferred.Requires relevant behavioral health experience.Comprehensive knowledge of case management, discharge planning, utilization management, disease management and community resources.Able to operate PC-based software programs including proficiency in Word and Excel.Strong clinical documentation skills, independent problem identification and resolution skills.Strong supervisory, communication, abstracting skills with strong verbal and written communication skills and negotiation skills.Competent understanding of NCQA and federal regulatory requirements.Knowledge of coordination of care, prior authorization, level of care and length of stay criteria sets desirable.Demonstrates 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.Demonstrate leadership, project management and program evaluation skills and ability to interact with all levels including senior management and influence decision-making.
Full Time
6/14/2025
Yuba City, CA 95993
(35.9 miles)
About the RoleAs an Operations Manager or Merchandising Manager you will provide oversight of store operations and/ or merchandising, delivering excellent customer service. You will teach, coach, and develop associates to execute operational, service and merchandising processes focused on consistent execution and efficiency. You will be accountable for the overall results and success of all key performance measures with a primary goal of driving sales and profitability.What You’ll DoEnsure sound operational processes, including receiving and processing product, stockroom management and omni channel fulfillment Drive accuracy through completion of all required business directives such as merchandise disposition practicesMaintain appropriate levels of product on the sales floor by planning and directing floor replenishment as necessary based on sell through and seasonal changesLead efforts at point of sale and customer service departments to deliver speed of service transactions while creating a compelling customer experienceEnsure that store merchandising standards follow visual merchandising direction, accomplishing product presentation; make decisions about and adaptations to merchandising direction based on the layout, adjacencies and needs of the store; ensure product is displayed in a manner which is clear and easy to understand and is compelling to the customerMaintain appropriate levels of product on the sales floor by planning and directing floor remerchandising and replenishment as necessary, based on sell through and seasonal changesDirect, teach and train associates to accurately execute all company merchandising direction to brand standards in a timely mannerLead execution of pricing activities in the store, ensure that price changes, sign changes and ticketing procedures are completed accurately and efficientlySupport prevention of loss by educating associates, monitoring daily store activity, maintaining product protection standards, ensuring company policies are followed and partnering with Loss PreventionManage the training processes for new hires, ensuring associates are skilled on process best practices, proper inventory procedures, productivity and merchandising standards, product knowledge and how to leverage Kohl’s tools and resources All manager roles at Kohl’s are responsible for:Managing with integrity, honesty and fostering teamwork in an engaged and inclusive cultureExercising good judgment and discernment when making decisions; taking appropriate partners as neededModeling, enforcing and providing direction and guidance to associatesDemonstrating, coaching and developing a customer service mindset, including customer service techniques, anticipating customer needs and satisfactorily resolving issuesEnsuring the store has strong operational standards, shortage mitigation, and merchandising presentation to include accurate pricing and proper signingMonitoring and adjusting resources as the business dictates to support customer needs and workload demandsAssessing key performance indicators (KPIs) to make informed business decisions that drive overall store resultsManaging talent, including hiring, training, developing, and supervisingAccomplishing multiple tasks within established timeframesTraining, monitoring and reinforcing company policies, procedures, standards and guidelinesMaintaining adherence to company safety policies and ensuring the safety of associates and customersOther responsibilities as assigned What Skills You HaveRequiredMust be 18 years of age or olderExperience supervising teams or associates, including the responsibility for coaching to achieve daily goals and performance managementGreat verbal/written communication and interpersonal skillsExcellent decision-making and problem-solving skills to make quick decisionsStrong people management skills and ability to develop talentFlexible availability, including days, nights, weekends and holidays PreferredExperience working in a retail environment, preferably in a managerial positionCollege degree OR equivalent combination of education and 2 years experience in retail or similar industryPay Range: $72,200.00 - $104,700.00Kohl’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).
Full Time
6/14/2025
Folsom, CA 95630
(19.9 miles)
Job ID: 266917Store Name/Number: CA-Folsom (1190)Address: 280 Palladio Parkway Space #901, Folsom, CA 95630, United States (US)Hourly/Salaried: Salaried (Exempt)Job Type: Full TimePosition Type: RegularJob Function: Stores - LeadershipCompany Overview:At Sephora we inspire our customers, empower our teams, and help them become the best versions of themselves. We create an environment where people are valued, and differences are celebrated. Every day, our teams across the world bring to life our purpose: to expand the way the world sees beauty by empowering the Extra Ordinary in each of us. We are united by a common goal - to reimagine the future of beauty.The Opportunity: At Sephora, our people are the driving force behind our success. We believe that the best way to bring top-notch beauty products, services, tools, and experiences to our clients is by finding, training, and engaging the absolute best talent in the industry. Our teams invest heavily in our talent, both at our corporate headquarters and in Sephora stores. We strongly believe (and our actions prove it!) that our people are our best asset, and we work every day to arm them with the knowledge and tools not just to get the job done, but to feel inspired and fearless while doing it.Your role at Sephora: As an Assistant Store Manager, you will be responsible for supporting the Store Manager in overseeing the entire store operations, ensuring a high level of client service, and driving sales. You will assist in leading a team of dedicated associates, fostering a positive work environment that encourages growth and development.Key Responsibilities:Supporting Store Operations and Sales:Assist the Store Manager in overseeing daily store operations, ensuring a smooth and efficient client experience.Help develop and implement strategies to drive store sales and increase profitability.Assist in coordinating and overseeing sales and profitability, performance, service, and operations.Team Leadership and Development:Assist in leading, coaching, and motivating a team of associates to meet or exceed sales targets.Conduct performance appraisals, manage employee development and provide ongoing feedback.Support the leadership team, ensuring effective collaboration and achievement of store goals.Client Satisfaction and Service:Ensure high levels of client satisfaction through excellent service.Handle client complaints and provide appropriate solutions.Support client loyalty programs and services to ensure client loyalty and engagement.Store Standards and Compliance:Maintain outstanding store condition and visual merchandising standards.Ensure compliance with company policies and procedures to maintain a safe and efficient work environment.Uphold Sephora brand excellence in-store, ensuring a consistent and high-quality client experience.Resource Management:Assist in managing inventory levels to ensure product availability.Support the Store Manager in allocating resources and handling staffing, ensuring optimal productivity and performance.Qualifications/Experience:Proven successful experience as a retail assistant manager.3-5 years of experience managing a high volume, complex retail, or hospitality setting.Strong leadership skills and business acumen.Client management skills.Strong organizational skills.Excellent communication and interpersonal skills.A knack for attracting, identifying, and inspiring employees.Flexible availability to work a retail schedule.Ability to lift and carry up to 50 pounds, bend/stretch to stock shelves, stand/walk the sales floor for entire shift and work in a fragrance filled environment & can handle and apply products to clients-with or without accommodation.Adherence to Sephora’s dress code and policies in the Sephora Employee HandbookThe annual base salary range for this position is $64,480.00 - $74,000.00 The actual base salary offered depends on a variety of factors, which may include, as applicable, the applicant’s qualifications for the position; years of relevant experience; specific and unique skills; level of education attained; certifications or other professional licenses held; other legitimate, non-discriminatory business factors specific to the position; and the geographic location in which the applicant lives and/or from which they will perform the job. Individuals employed in this position may also be eligible to earn bonuses. Sephora offers a generous benefits package to full-time employees, which includes comprehensive health, dental and vision plans; a superior 401(k) plan, various paid time off programs; employee discount/perks; life insurance; disability insurance; flexible spending accounts; and an employee referral bonus program.While at Sephora, you’ll enjoy… The people. You will be surrounded by some of the most talented leaders and teams – people you can be proud to work with. The learning. We invest in training and developing our teams, and you will continue evolving and building your skills through personalized career plans.The culture. As a leading beauty retailer within the LVMH family, our reach is broad, and our impact is global. It is in our DNA to innovate and, at Sephora, all 40,000 passionate team members across 35 markets and 3,000+ stores, are united by a common goal - to reimagine the future of beauty.You can unleash your creativity, because we’ve got disruptive spirit. You can learn and evolve, because we empower you to be your best. You can be yourself, because you are what sets us apart. This, is the future of beauty. Reimagine your future, at Sephora.Sephora is an equal opportunity employer and values diversity at our company. We do not discriminate on the basis of race, religion, color, national origin, ancestry, citizenship, gender, gender identity, sexual orientation, age, marital status, military/veteran status, or disability status. Sephora is committed to working with and providing reasonable accommodation to applicants with physical and mental disabilities.Sephora will consider for employment all qualified applicants with criminal histories in a manner consistent with applicable law.?
Full Time
5/28/2025
Yuba City, CA 95993
(35.9 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
6/1/2025
Sacramento, CA 95834
(4.1 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, Program Management,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 Behavioral Program Managerswho share our passion for improving the lives of children and families affected by autism.A Behavioral Health or (ABA)Program 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
6/15/2025
El Dorado Hills, CA 95762
(24.0 miles)
Your Role Reporting to the Manager, Care Management- Behavioral Health, the Licensed Clinician, Senior (ABA Case Manager) helps members with behavioral health needs navigate the health care system for linkages to behavioral health providers, treatment, and programs. This role is ideal for professionals with a background and experience in Applied Behavioral Analysis and passion for ensuring access to high quality behavioral health services. The ABA Case Manager will coordinate care and services for families, supporting members and families through their care. The ABA Case Manager will offer support in assessing members’ emotional and psychological well-being and providing resource coordination, crisis intervention, and with any general behavioral or mental health referrals. 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 WorkIn this role, you will:Collaborate with other Case Managers and Utilization Management 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 as well as members seeking and utilizing ABA services.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 ExperienceCurrent unrestricted CA License (LCSW, LMFT, LPCC, Registered Nurse (RN), or PsyD by the Board of Behavioral Health Sciences requiredRequires at least 5 years of prior relevant experience including 3 years of experience in behavioral health or ABA, case management.Advanced degree commensurate with field is preferredBCBA 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 treatmentPrevious health plan or insurance experience preferred.Proficient with computer programs such as Microsoft Excel, Outlook, Word, and PowerPoint
Full Time
6/1/2025
Sacramento, CA 95834
(4.1 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, Program Management,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 Behavioral Program Managerswho share our passion for improving the lives of children and families affected by autism.A Behavioral Health or (ABA)Program 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
(24.0 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
(4.1 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, Program Management,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 Behavioral Program Managerswho share our passion for improving the lives of children and families affected by autism.A Behavioral Health or (ABA)Program 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
(24.0 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
(4.1 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, Program Management,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 Behavioral Program Managerswho share our passion for improving the lives of children and families affected by autism.A Behavioral Health or (ABA)Program 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
(24.0 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
(4.1 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, Program Management,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 Behavioral Program Managerswho share our passion for improving the lives of children and families affected by autism.A Behavioral Health or (ABA)Program 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
(24.0 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
(4.1 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, Program Management,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 Behavioral Program Managerswho share our passion for improving the lives of children and families affected by autism.A Behavioral Health or (ABA)Program 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
(24.0 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
(24.0 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
(24.0 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
(24.0 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
(24.0 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
6/19/2025
El Dorado Hills, CA 95762
(24.0 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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