Job ID: 267700Location Name: CA-FSC SF Off (0174)Address: 350 Mission St, 20th Floor, San Francisco, CA 94105, United States (US)Job Type: Full TimePosition Type: RegularJob Function: FinanceRemote Eligible:Hybrid Schedule, 2 days onsiteCompany 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:As our Accounting Senior Manager, reporting to the Director of Accounting, you will be working closely with numerous business partners and key stakeholders and be responsible for Retail, FSC and Canada area of the business, manage the P&L and revenue recognition of business. You will also be performing analytical reviews and variance investigations as needed throughout the year, month-end reconciliations, maintaining accounting policies and procedures, and continuing the optimization of accounting and operational processes.Manage FSC, Sephora Canada, Occupancy, Credit Card and Beauty Insider in accordance with US GAAP/IFRS – This includes but is not limited to month end close activities and other day to day activities.Identify and implement key controls and mitigate risks. Monitor, maintain, and improve ongoing processes, accounting policies, and procedures across the business. Identify ways to automate processes and improve efficiency. Lead cross-functional projects to improve the level of internal control and risk management.Collaborate with cross functional teams. Work closely with numerous business partners and key stakeholders (both internally and externally) to implement process improvements, understand variances to budget, and present findings to executive management for decision making.Liaise with external auditors on audit schedules (including OAR flux analysis) and provide requested supporting documentation to ensure a smooth audit.Assist on S4HANA implementationResponsible for ad hoc projectsWe’d love to hear from you if you have …9+ years of related business experience Retail industry preferred but not a mustAdvanced skills with Excel applications (PIVOTs, SUMIFs, VLOOKUPs, macros)Experience with SAPMust demonstrate strong strategic, analytical, interpersonal, organizational, and communication skillsFamiliarity with IFRS accounting principles and financial statementsDriven, able to balance multiple priorities. Good interpersonal skills with the ability to build relationships across all levels of the organizationTech-savvySelf-motivated and resourceful#LI-MMGThe annual base salary range for this position is $151,810.00 - $169,670.00 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. This job will be posted for a minimum of 5 days.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.

Starting Hourly Rate / Salario por Hora Inicial: $19.50 USD per hourALL ABOUT TARGETWorking at Target means helping all families discover the joy of everyday life. We bring that vision to life through our values and culture. ALL ABOUT HUMAN RESOURCESYou are a team that champions change, proactively removes roadblocks and builds diverse and inclusive talent strategies to deliver on our guest centric mission. You are part ofa Human Resource (HR)team who are committed to supporting teams and leaders to build a sales force that is passionate about exceeding guests’expectations and a place where teams love to work. At Target, we believe in our team members having meaningful experiences that help them build and develop skills for a career. The role of a Human Resources Expert can provide you with the: Knowledge of federal,state and local employment lawsExperience using basic Microsoft Office Suite computer and workforce management programsAbility to effectively use scheduling software As a Human Resources Expert, no two days are ever the same, but a typical day will most likely include the following responsibilities: Work with your HR leader to anticipate and address specific talent and staffing needs for each area of the business; this includes understanding guests’ needs and ensuring the right mix of experience, and enthusiasm to deliver on the in-store and digital shopping experiences.Lead focused recruiting efforts to help store leaders find and hire candidates with the right skills and experiences to best serve their guest.Support team member and leader training needs and be an advocate for continuous learning.Be an expert resource for scheduling systems and pay practices.Be approachable and available by listening to team members and collaborating with appropriate leaders to take action as needed.Deliver on all Human Resources processes and programs to maximize team member engagement and minimize business disruption.Support your leader in following company compliancepolicies that mitigate risk to the team member experience.Create a welcoming experience by greeting guests as you are completing your daily tasks.When a guest needs assistance, engage with guests in a welcoming way, to help solve their specific needs.Thank guests and let them know we’re happy they chose to shop at Target.Demonstrate a culture of ethical conduct, safety and compliance.Work in a safe manner at all times;comply with all safety policies,best practices, and training; report hazards and correct where possible.All other duties based on business needsWHAT WE ARE LOOKING FORThis may be the right job for you if:You enjoy interacting and helping others - including guests that shop our store and fellow team members you work with. You thrive in a fast-moving, highly active and physically demanding role, where teamwork, flexibility, and creative problem solving are key to success. You are open to working a flexible work schedule with varying hours, days or shifts (including nights, weekends, holidays and other peak shopping times).The good news is that we have some amazing training that will help teach you everything you need to know to be a Human Resources Expert. But there are a few skills you should have from the get-go:Welcoming and helpful attitude toward all guests and other team membersAbility to communicate on multiple frequency devices and operate handheld scanners, and other technology equipment as directed.Effective communication skillsWork both independently and with a teamResolve guest questions quickly on the spotAttention to detail and follow a multi-step processesCapability to remain focused and composed in a fast-paced environment and accomplish multiple tasks within established timeframesWe are an awesome place to work and care about our teams, so we want to make sure we are clear on a few more basics that we expect:Accurately handle cash register operations as needed.Lift product up to 10 pounds regularly without additional assistance from others.Capable of working in and exposure to varying temperatures, humidity, and other elements while performing certain job duties including but not limited to Drive-Up, carryout, etc.Ability to remain mobile for the duration of a scheduled shift (shift length may vary).Flexible work schedule (e.g., nights, weekends and holidays); reliable and prompt attendance necessaryFind competitive benefits from financial and education to well-being and beyond at .Target will consider for employment qualified applicants with criminal histories in a manner consistent with the San Francisco and City of Los Angeles Fair Chance Ordinances.Benefits EligibilityPlease paste this url into your preferred browser to learn about benefits eligibility for this role: https://tgt.biz/BenefitsForYou_A | Pegue esta URL en su navegador preferido para obtener información sobre la elegibilidad de este puesto para recibir beneficios: https://tgt.biz/BenefitsForYou_AAmericans with Disabilities Act (ADA)Target will provide reasonable accommodations with the application process upon your request as required to comply with applicable laws. If you have a disability and require assistance in this application process, please visit your nearest Target store or reach out to Guest Services at 1-800-440-0680 for additional information.

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 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.Applicants with arrest or conviction records will be considered for employment.Address:5652 Cottle RoadLocation:USA Marshalls Store 1252 San Jose CAThis position has a starting pay range of $18.95 to $19.45 per hour. Actual starting pay is determined by a number of factors, including relevant skills, qualifications, and experience.

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

The pay range per hour is $28.00 - $47.60Pay is based on several factors which vary based on position. These include labor markets and in some instances may include education, work experience and certifications. In addition to your pay, Target cares about and invests in you as a team member, so that you can take care of yourself and your family. Target offers eligible team members and their dependents comprehensive health benefits and programs, which may include medical, vision, dental, life insurance and more, to help you and your family take care of your whole selves. Other benefits for eligible team members include 401(k), employee discount, short term disability, long term disability, paid sick leave, paid national holidays, and paid vacation. Find competitive benefits from financial and education to well-being and beyond at .ALL ABOUT TARGETWorking at Target means helping all families discover the joy of everyday life. We bring that vision to life through our values and culture. ALL ABOUT SERVICE & ENGAGEMENTAdvocates of guest experience who welcome, thank, and exceed guest service expectations by focusing on guest interaction and recovery. Advocates of both in-store and digital services and solutions who are knowledgeable about capabilities and features that drive adoption, usage and ultimately guest loyalty. Empowered to make shopping quick and easy for guests at the checklanes, guest services, gift registry, pick-up and drive up while ensuring exceptional quality.At Target, we believe in our leaders having meaningful experiences that help them build and develop skills for a career. The role of a Service and Engagement Team Leader can provide you with the skills and experience of: Guest service fundamentals,experience building a guest first team culture and driving loyalty programsGuest engagement; problem solving and resolution Retail business fundamentalsincluding: department sales trends, inventory management, guest shopping patterns, pricing and promotions strategiesPlanning department(s) daily/weekly workload to support business priorities and deliver service and sales goalsLeading a team of hourly team members; including skills in interviewing, developing, coaching, evaluating and retaining talentAs a Service and Engagement Team Leader, no two days are ever the same, but a typical day will most likely include the following responsibilities:Demonstrate inclusivity by valuing diverse voices and approaches, being authentic and respectful, and creating equitable experiences.Lead a team of passionate and knowledgeable Guest Advocates, Service Advocates and Front of Store Attendants who strive to exceed guest service expectations by focusing on decreasing wait time, friendly guest interactions, quality of service,resolution, driving loyalty and cleanliness standards.Lead and demonstrate a culture of executing all best practices as outlined with team onboarding and learning; help close skill gaps through development, coaching and team interactions.Understand sales goals, business reporting and guest insights to plan and execute daily/weekly workload,to deliver on store sales goals,guest engagement and troubleshoot opportunity areas as needed throughout the day.Support Target Loyalty Programs to ensure your team caneducate and promote the suite of benefits, features and offerings that reward our guest and/or enhance their shopping experience.Support your direct leaderbyfollowing-up on training completion, checking for understanding and supporting continuous education opportunities to drive proficiencies for all front of store experiences.Engage in consistent, meaningful development conversations throughout the critical touch points within the teams career path.Personalize recognition and appreciationof your team to reinforce critical guest service behaviors and promote a positive team and guest centric culture.With guidance from your direct leader, help lead a culture of accountability through clear expectations and performance management (listen, observe, recognize and coach) on critical Service and Engagement behaviors.Quickly respond to anyconcerns with aguests’ shopping experience by de-escalating the situation and ensuring your team understands and feels supported to resolve or address guest concerns and issues.Ensureyour teammembers stay up-to-date on upcoming major promotions, brand launches and events.Evaluate candidates for open positions and develop a guest-centric team.Work a schedule that aligns to guest and business needs (this includes early morning, evening, closing, overnight shifts,holidays and weekends).Support and enableteam membersto deliver pick up and drive uporders (including drive up returns and Starbucks) efficiently and accurately to digital guests, following all federal, state and local adult beverage laws. Support guest services as needed.Demonstrate a culture of ethical conductand compliance; lead team to work in the same way and hold others accountable to this commitment.Lead and demonstrate a safety culture through modeling and recognizing safe behaviors, identifying and correct hazards, holding team accountable to following safety expectations, assisting with incident response, and reporting/investigating injuries timely and accurately. Model creating a welcoming experience by greeting guests as you & your team are completing daily tasks.Demonstrate how to engage with guests when assistance is needed, engage with guests in a welcoming way, and help solve their specific needs.Lead by thanking guests and let them know we’re happy they chose to shop at Target.Model the execution of physical security processes in order to enhance the instore security culture.Support merchandise protection strategies across the total store; including ordering, storage and application as directed by best practicesIf applicable, as a key carrier, follow all safe and secure training and processes.Address all store emergency and compliance needs.All other duties based on business needsWHAT WE ARE LOOKING FORThis may be the right job for you if:You enjoy interacting and helping others - including guests that shop our store and fellow team members you work with. You thrive in a fast-moving, highly active and physically demanding role, where teamwork, flexibility, and creative problem solving are key to success. You are open to working a flexible work schedule with varying hours, days or shifts (including nights, weekends, holidays and other peak shopping times).The good news is that we have some amazing training that will help teach you everything you need to know to be a Service and Engagement Team Leader.But, there are a few skills you should have from the get-go:High school diploma or equivalentMust be at least 18 years of age or olderPrevious retail experience preferred, but not requiredLead and hold others accountableAbility to communicate on multiple frequency devices and operate handheld scanners, and other technology equipment as directed.Work independently and as part of a teamManage workload and prioritize tasks independently and with a teamWelcoming and helpful attitudeEffective communication skills Capability to remain focused and composed in a fast-paced environment and accomplish multiple tasks within established timeframesWe are an awesome place to work and care about our teams, so we want to make sure we are clear on a few more basics that we expect:Access all areas of the building to respond to guest or team member issuesInterpret instructions, reports and informationAccurately handle cash register operations, cash transactions, and oversee cash office processes as needed Scan, handle and move merchandise efficiently and safely, including frequently lifting or moving merchandise up to 10 pounds and occasionally lifting or moving merchandise up to 44 pounds without additional assistance from others Climb up and down ladders as needed Flexible work schedule (e.g., nights, weekends and holidays) and reliable and prompt attendance necessaryCapable of working in and exposure to varying temperatures, humidity, and other elements while performing certain job duties including but not limited to Drive-Up, carryout, etc. as neededAbility to remain mobile for the duration of a scheduled shift (shift length may vary).Target will consider for employment qualified applicants with criminal histories in a manner consistent with the San Francisco and City of Los Angeles Fair Chance Ordinances.Benefits EligibilityPlease paste this url into your preferred browser to learn about benefits eligibility for this role: https://tgt.biz/BenefitsForYou_C | Pegue esta URL en su navegador preferido para obtener información sobre la elegibilidad de este puesto para recibir beneficios: https://tgt.biz/BenefitsForYou_CAmericans with Disabilities Act (ADA)Target will provide reasonable accommodations with the application process upon your request as required to comply with applicable laws. If you have a disability and require assistance in this application process, please visit your nearest Target store or reach out to Guest Services at 1-800-440-0680 for additional information.

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:We’re looking for an Assistant Store Manager who is passionate about fostering an inclusive and supportive environment. In this role, you’ll empower your team to deliver unforgettable “magical moments” for our customers. Every day will bring exciting new challenges and opportunities, keeping your work dynamic and rewarding. If you thrive in a fast-paced, ever-evolving environment, this could be the perfect opportunity for you!Why Work With Us We value integrity, respect, and teamwork, encouraging a unique and inclusive culture.Our comprehensive training and development programs provide you with the tools and resources to expand your skills.Enjoy Associate discounts at our stores, available to you and eligible family members.We have a range of global well-being programs focused on physical, financial, and emotional wellness.Exciting career paths with growth opportunitiesWhat You’ll Do:Drive store performance by supporting sales results, managing expenses, and overseeing key operations including merchandising, backroom, frontline, cash office, customer service, markdowns, scheduling, shipping, and receiving, with a strong focus on minimizing shrink and damages.Attract, recruit, and cultivate top talent by providing comprehensive training and ongoing development for Associates. Serve as a mentor and role model, fostering a supportive environment that ensures a positive and engaging experience for both Associates and customers.Communicate and implement action plans for projects, targets, company initiatives, and store changes. Provide input on succession planning to meet future needs.Implement strategies to meet sales, expense, and customer service targets. Coordinate loss prevention and operational programs and improve store layout and efficiency.About You:Minimum of 2 years of retail leadership experience as an Assistant or Store Manager.Demonstrated ability to lead, develop, and empower a large team.Excellent organizational and communication skills with ability to influence and provide effective feedback and mentorship to others.Proficient in store operations, customer service, merchandising, people management, health and safety, and loss prevention, with strong follow-through skills to successfully implement tasks and initiatives.If you’re ready to bring your energy and passion, we’d love to hear from you. Join us and be part of a place where every day is a chance to make a difference.Benefits include Associate discount; 401(k) match; medical/dental/vision; HSA; health care FSA; life insurance; short/long-term disability; paid holidays/vacation /sick/bereavement/parental leave; EAP; incentive programs; auto/home insurance discounts; scholarship program; adoption/surrogacy assistance; smoking cessation; child care/cell phone discounts; pet/legal insurance; credit union; referral bonuses. All benefits are subject to applicable plan or program terms (including eligibility terms) and may change from time to time. Contact your TJX representative for more information.In addition to our open door policy and supportive work environment, we also strive to provide a competitive salary and benefits package. TJX considers all applicants for employment without regard to race, color, religion, gender, sexual orientation, national origin, age, disability, gender identity and expression, marital or military status, or based on any individual's status in any group or class protected by applicable federal, state, or local law. TJX also provides reasonable accommodations to qualified individuals with disabilities in accordance with the Americans with Disabilities Act and applicable state and local law.Applicants with arrest or conviction records will be considered for employment.Address:4840 Dublin Blvd.Location:USA TJ Maxx Store 0403 Dublin CAThis is a bonus and overtime eligible position with a starting pay range of $22.05 to $30.30 per hour, which equates to approximately $54,956.54 - $75,518.51 annually. Actual starting pay is determined by a number of factors, including relevant skills, qualifications, and experience.

Job ID: 267032Store Name/Number: CA-The Veranda (1134)Address: 2075 Diamond Boulevard Suite 125, Concord, CA 94520, 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: $28.00 - $34.30/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.

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

The pay range per hour is $28.00 - $47.60Pay is based on several factors which vary based on position. These include labor markets and in some instances may include education, work experience and certifications. In addition to your pay, Target cares about and invests in you as a team member, so that you can take care of yourself and your family. Target offers eligible team members and their dependents comprehensive health benefits and programs, which may include medical, vision, dental, life insurance and more, to help you and your family take care of your whole selves. Other benefits for eligible team members include 401(k), employee discount, short term disability, long term disability, paid sick leave, paid national holidays, and paid vacation. Find competitive benefits from financial and education to well-being and beyond at .ALL ABOUT TARGETWorking at Target means helping all families discover the joy of everyday life. We bring that vision to life through our values and culture. ALL ABOUT SPECIALTY SALES A team of specialized consultants who understand what it means to meet our guests where they are at and deliver for them through strong operations, incredible guest experience and compelling visual merchandising presentations that inspire guests and build the basket. Teams in Apparel and Accessories (A&A), Home, Baby, Beauty and Electronics prioritize guest experience while blending completion of tasks that ensure product is available and easy to shop – pulling, filling, pricing, setting, staging and maintaining the sales floor and the backroom.At Target, we believe in our leaders having meaningful experiences that help them build and develop skills for a career. The role of a Specialty Sales Team Leader can provide you with the skills and experience of:Guest service fundamentals and experience; building a guest first culture on your teamRetail business fundamentals retail including department sales trends, inventory management, guest shopping patterns, pricing and promotions strategiesPlanning department(s) daily/weekly workload to support business priorities and deliver sales goalsLead multiple businesses balancing team member expertise and effectively leading teams in each departmentLeading a team of hourly team members; including skills in interviewing, developing, coaching, evaluating and retaining talent.As a Specialty Sales Team Leader, no two days are ever the same, but a typical day will most likely include the following responsibilities:Demonstrate a service culture that prioritizes the guest service experience. Model, train and coach team member expectations to deliver onour GUEST service model culture.Demonstrate inclusivity by valuing diverse voices and approaches, being authentic and respectful, and creating equitable experiences.Plan daily/weekly workload at the direction of your direct leader,and execute the sameto deliver on department and store sales goals and guest engagement; including planning merchandising sets,make changes and updates to merchandisesets (planograms), sales plans, eventsand promotions.Lead and demonstrate a culture of executing all best practices as outlined with team onboarding and learning; help close skill gaps through development, coaching and team interactions.With direct leader guidance, develop, coach, and lead a team of consultants who are knowledgeable and passionate.Assign daily tasks to TMs based on planned workload and guest traffic patterns, ensuring alignment with weekly and monthly business priorities set by your direct leader.Encourage team to use tools available in their department (i.e. the fitting room, testers, displays) as an opportunity to welcome, inspire and influence guests by providing personalized recommendations to complete their purchase.With direct leader guidance, partner with third party vendors to ensure brand standards and merchandising are being met and areas are full and maintained.Support team's execution of changes and updates to merchandise sets, andvisual presentations for defined categories.Create inspiring visual moments by ensuring product is organized, signedcorrectly and merchandised to support seasonal trends.Support your direct leader in leading assigned departmentareabackroom processes, organization, layout and replenishment of the salesfloor to ensure product is available for guests.Participate in team hiring and onboarding processes.Leadyour team in prioritizing the guest experience by ensuring the fitting rooms are welcoming, clean and safe if applicable to your assigned areas of responsibility.Support your direct leader in establishing clear goals and expectations and hold team members accountable to expectations.Demonstrate a culture of ethical conduct, safety and compliance;lead and hold the team accountable to work in the same way.Lead and demonstrate a safety culture through modeling and recognizing safe behaviors,identifying and correcting hazards, holding team accountable to following safety expectations, assisting with incident response, and reporting/investigating injuries timely and accurately.Model the execution of physical security processes in order to enhance the instore security culture.Support merchandise protection strategies across the total store; including ordering, storage and application as directed by best practices.If applicable, as a key carrier, follow all safe and secure training and processes.Address all store emergency and compliance needs.Support guest services such as back-up cashier, order pick up (OPU) and Drive-up (DU) and maintain a compliance culture while executing those duties, such as compliance with federal, state, and local adult beverage laws. Model creating a welcoming experience by greeting guests as you & your team are completing your daily tasks. Demonstrate how to engage with guests when assistance is needed, engage with guests in a welcoming way, and help solve their specific needs.Lead by thanking guests and let them know we’re happy they chose to shop at Target.All other duties based on business needsWHAT WE ARE LOOKING FORThis may be the right job for you if:You enjoy interacting and helping others - including guests that shop our store and fellow team members you work with. You thrive in a fast-moving, highly active and physically demanding role, where teamwork, flexibility, and creative problem solving are key to success. You are open to working a flexible work schedule with varying hours, days or shifts (including nights, weekends, holidays and other peak shopping times).The good news is that we have some amazing training that will help teach you everything you need to know to be a Specialty Sales Team Leader. But, there are a few skills you should have from the get-go:High school diploma or equivalentMust be at least 18 years of age or olderPrevious retail experience preferred, but not requiredLead and hold others accountableAbility to communicate on multiple frequency devices and operate handheld scanners, and other technology equipment as directed.Work independently and as part of a teamManage workload and prioritize tasks independentlyWelcoming and helpful attitudetoward all guests and other team membersEffective communication skills Capability to remain focused and composed in a fast-paced environment and accomplish multiple tasks within established timeframesWe are an awesome place to work and care about our teams, so we want to make sure we are clear on a few more basics that we expect:Access all areas of the building to respond to guest or team member issuesInterpret instructions, reports and informationAccurately handle cash register operations as neededClimb up and down ladders as needed Scan, handle and move merchandise efficiently and safely, including frequently lifting or moving merchandise up to 15 pounds and occasionally lifting or moving merchandise up to 44 pounds without additional assistance from othersFlexible work schedule (e.g., nights, weekends and holidays) and reliable and prompt attendance necessaryCapable of working in and exposure to varying temperatures, humidity, and other elements while performing certain job duties including but not limited to Drive-Up, carryout, etc. as neededAbility to remain mobile for the duration of a scheduled shift (shift length may vary).Target will consider for employment qualified applicants with criminal histories in a manner consistent with the San Francisco and City of Los Angeles Fair Chance Ordinances.Benefits EligibilityPlease paste this url into your preferred browser to learn about benefits eligibility for this role: https://tgt.biz/BenefitsForYou_C | Pegue esta URL en su navegador preferido para obtener información sobre la elegibilidad de este puesto para recibir beneficios: https://tgt.biz/BenefitsForYou_CAmericans with Disabilities Act (ADA)Target will provide reasonable accommodations with the application process upon your request as required to comply with applicable laws. If you have a disability and require assistance in this application process, please visit your nearest Target store or reach out to Guest Services at 1-800-440-0680 for additional information.

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

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

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

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

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

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

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