RN Case Manager, Home Health AccentCare, Inc.RN Case Manager, Home HealthCulver City, CaliforniaRemote$108,000–$120,000 / yearThe position combines direct and indirect patient care activities and directs staff nurses, LPNs, and CHHAs in delivering the individual patient’s plan of care, as well as identifying interdisciplinary needs and coordinating allied health clinicians. What You Need to Know: This RN Case Manager is responsible for managing patients' care plans from admission through discharge and for ensuring the delivery of quality patient care.
Care Review Clinician (RN) - reside in PST or MST Molina Healthcare IncCare Review Clinician (RN) - reside in PST or MSTCARemoteResponsible for verifying that services are medically necessary and align with established clinical guidelines, insurance policies, and regulations - ensuring members reach desired outcomes through integrated delivery of care across the continuum. At least 2 years experience, including experience in hospital acute care, inpatient review, prior authorization, managed care, or equivalent combination of relevant education and experience.
NewSenior Clinical Specialist, Deep Brain Stimulation (DBS) - Los Angeles, CA Medtronic PlcSenior Clinical Specialist, Deep Brain Stimulation (DBS) - Los Angeles, CALong Beach, CARemoteThe following benefits and additional compensation are available to those regular employees who work 20+ hours per week: Health, Dental and vision insurance, Health Savings Account, Healthcare Flexible Spending Account, Life insurance, Long-term disability leave, Dependent daycare spending account, Tuition assistance/reimbursement, and Simple Steps (global well-being program). If you are applying to perform work for Medtronic, Inc. ("Medtronic") in any position which will involve performing at least two (2) hours of work on average each week within the unincorporated areas of Los Angeles County, you can find here a list of all material job duties of the specific job position which Medtronic reasonably believes that criminal history may have a direct, adverse and negative relationship potentially resulting in the withdrawal of a conditional offer of employment.
Manager, Care Management SCAN Health PlanManager, Care ManagementLong Beach, CaliforniaRemoteManages the daily operations and continuous quality improvement of care management programs at SCAN to ensure the delivery of high quality, evidence-based care with a focus on addressing the medical, behavioral health, and social needs of members. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor’s legal duty to furnish information.
Market Manager Monogram Health IncMarket ManagerCalifornia, CARemote$102,000–$169,000 / yearReporting to the Market Physician Executive and matrixed to the General Manager, the Market Manager will be charged with achieving company Organizational Key Results, Key Performance Indicators, and Financial Health of the Market. The Market Manager will work closely with Regional/Market and Centralized clinical and operations Leaders to deliver quality patient care and overall patient and staff experience.
Care Manager - RN COPE HEALTH SOLUTIONSCare Manager - RNCARemote$80,000–$110,000 / yearOur comprehensive NCQA certified population health management platform and highly experienced team brings deep expertise, experience, proven tools, and processes to improve financial performance and quality outcomes for all types of payers and providers. Position Description: The Care Manager (CM) RN will lead a multidisciplinary healthcare team in a primary care / telephonic setting, focusing on coaching and coordination of care for patients needing navigation, addressing nursing care needs and follow up after clinical events.
Nurse Practitioner or Physician Assistant (Riverside) SHPCA SCAN Health PlanNurse Practitioner or Physician Assistant (Riverside)Riverside, CaliforniaRemote$125,400–$215,975 / yearHowever, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor’s legal duty to furnish information. Our work spans Medicare Advantage, fully integrated care models, primary care, care for the most medically and socially complex populations, and next-generation care delivery models.
Nurse Practitioner or Physician Assistant (Riverside) SCAN Health PlanNurse Practitioner or Physician Assistant (Riverside)Riverside, CaliforniaRemoteHowever, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor’s legal duty to furnish information. Our work spans Medicare Advantage, fully integrated care models, primary care, care for the most medically and socially complex populations, and next-generation care delivery models.
RN Clinical Consultant Titanium Healthcare IncRN Clinical ConsultantCARemoteAssociate's degree in nursing Minimum 1+ years of experience as an RN working in a healthcare setting, such as a medical clinic or acute care hospital A current and unrestricted CA state RN license Experience using an EHR Distraction-free home workspace with a secure internet connection. POSITION SUMMARY The RN Clinical Consultant is a key member of Titanium Healthcare's Enhanced Care Management (ECM) program, providing clinical oversight and guidance to support high-quality, coordinated care for complex member populations.
Bilingual (Spanish/English) Transitions of Care Advanced Practice Provider Devoted Health IncBilingual (Spanish/English) Transitions of Care Advanced Practice ProviderCARemoteThat's why we're gathering smart, diverse, and big-hearted people to create a new kind of all-in-one healthcare company - one that combines compassion, health insurance, clinical care, service, and technology - to deliver a complete and integrated healthcare solution that delivers high quality care that everyone would want for someone they love. Proficiency with complex medication reconciliation and guideline-directed medical therapy, especially for heart failure, COPD, diabetes, atrial fibrillation/anticoagulation, and hypertension - including recognizing duplicate, inappropriate, or contraindicated medications and adjusting regimens safely.
Transitions of Care Advanced Practice Provider Devoted Health IncTransitions of Care Advanced Practice ProviderCARemoteThat's why we're gathering smart, diverse, and big-hearted people to create a new kind of all-in-one healthcare company - one that combines compassion, health insurance, clinical care, service, and technology - to deliver a complete and integrated healthcare solution that delivers high quality care that everyone would want for someone they love. Proficiency with complex medication reconciliation and guideline-directed medical therapy, especially for heart failure, COPD, diabetes, atrial fibrillation/anticoagulation, and hypertension - including recognizing duplicate, inappropriate, or contraindicated medications and adjusting regimens safely.
NewRegional Operations Manager (IKC) DaVita IncRegional Operations Manager (IKC)El Segundo, CARemote$104,000–$150,000 / yearThe following duties and responsibilities generally reflect the expectations of this position but are not intended to be all inclusive: Lead operational execution of new models of care for chronic kidney disease (CKD) Medicare Advantage (MA) patients for the RN role, including overseeing the achievement of critical quality and performance measures, including STARs metrics such as hypertension and diabetes control, medication adherence, nephrologist visits, and optimal starts. The ideal candidate will be responsible for leading a team of IKC RNs who case manage dialysis and CKD patients; Candidate will also manage two supervisors and support the non-clinical IKC care coordinators, whom they manage; responsible for team performance, productivity, and creating a special place to come to work.
CA Based Licensed Nurse Care Manager, Adult Included HealthCA Based Licensed Nurse Care Manager, AdultCorona, CARemote$35.43–$50 / hourbehavioral health, urgent care, etc.) and health care navigation products and services offered at no cost for employees and dependents Generous Paid Time Off ("PTO") and Discretionary Time Off ("DTO") 12 weeks of 100% Paid Parental leave Family Building Benefit with fertility coverage and up to $25,000 for Surrogacy & Adoption financial assistance Compassionate Leave (paid leave for employees who experience a failed pregnancy, surrogacy, adoption or fertility treatment) 11 Holidays Paid with one Floating Paid Holiday Work-From-Home reimbursement to support team collaboration and effective home office work 24 hours of Paid Volunteer Time Off ("VTO") Per Year to Volunteer with Charitable Organizations . As a telephonic Nurse Care Manager you will report to the Manager, Care and Case Management and will guide members through complex medical and behavioral Health situations, partnering with a diverse clinical team that includes a variety of healthcare professionals, care coordinators, and records specialists, to deliver integrated remote care in a creative way.
Clinical Retention Specialist (West Region - AZ, CO, HI, ID, KS, MT, NE, NV, OR, UT, WA) Insulet CorpClinical Retention Specialist (West Region - AZ, CO, HI, ID, KS, MT, NE, NV, OR, UT, WA)CARemote$87,200–$130,850 / yearInsulet's flagship innovation, the Omnipod 5 Automated Insulin Delivery System, integrates with a continuous glucose monitor to manage blood sugar with no multiple daily injections, zero fingersticks, and can be controlled by a compatible personal smartphone in the U.S. or by the Omnipod 5 Controller. Identify early indicators of disengagement or churn through data assessment and analytics in partnership with the data science teams and collaborate with Customer Success teams to deploy targeted, regionally informed save strategies.
Oncology Account Executive BillionToOneOncology Account ExecutiveRiverside, CARemote$168,346–$184,186 / yearAt BillionToOne, we've built a category-defining, publicly traded company on Nasdaq where transparency fuels trust, collaboration drives breakthroughs, and every contribution moves the needle on our mission to make life-changing diagnostics accessible to all. Unity Confirm enables non-invasive confirmation for high-risk screening results through the capture of intact circulating fetal cells using BillionToOne’s Fetal Cell Capture Technology.
Bilingual Spanish Community Health Worker (Orange County) SHPCA SCAN Health PlanBilingual Spanish Community Health Worker (Orange County)Santa Ana, CaliforniaRemote$21.78–$31.52 / hourPerform Enhanced Care Management (ECM) activities related to specific Populations of Focus (POF): Individuals Experiencing Homelessness, Individuals At Risk for Avoidable Hospital Or ED Utilization, Adults Living In the Community At Risk of LTC Institutionalization, Adult Nursing Facility Residents Transitioning Back to the Community. Perform assessments for Medi-Cal/Medicare dual-eligible members referred to Complex Care Management for Long-Term Services and Supports (LTSS) and assist the Registered Nurse in determining Nursing Facility Level of Care.
Bilingual Spanish Community Health Worker (Orange County) SCAN Health PlanBilingual Spanish Community Health Worker (Orange County)Santa Ana, CaliforniaRemotePerform Enhanced Care Management (ECM) activities related to specific Populations of Focus (POF): Individuals Experiencing Homelessness, Individuals At Risk for Avoidable Hospital Or ED Utilization, Adults Living In the Community At Risk of LTC Institutionalization, Adult Nursing Facility Residents Transitioning Back to the Community. Perform assessments for Medi-Cal/Medicare dual-eligible members referred to Complex Care Management for Long-Term Services and Supports (LTSS) and assist the Registered Nurse in determining Nursing Facility Level of Care.
NewGrievance and Appeals Nurse (State) Centene Corporation GroupGrievance and Appeals Nurse (State)CARemote$27.02–$48.55 / hourReview clinical data to determine claim payment based on company policies and National Committee for Quality Assurance (NCQA) guidelines, including overturning denied claims, upholding the denials and submitting cases to the Medical Director for review. Position Purpose: Facilitate medical necessity grievance, appeals and denials including disposition of denials notification letters, review of clinical information to determine if medical necessity criteria are met.
Senior Medical Science Liaison - Solid Tumor - Southern CA/AZ Takeda Pharmaceutical Co LtdSenior Medical Science Liaison - Solid Tumor - Southern CA/AZCARemote$169,400–$266,200 / yearResponsible for establishing relationships and engaging in peer-to-peer level scientific discussions around emerging data, treatment guidelines, molecular pathways, mechanism of action Takeda Oncology products including clinical outcomes and research opportunities. The actual base salary offered may depend on a variety of factors, including the qualifications of the individual applicant for the position, years of relevant experience, specific and unique skills, level of education attained, certifications or other professional licenses held, and the location in which the applicant lives and/or from which they will be performing the job.
Utilization Management Clinician Behavioral Health Night Shift - 4 Days CVS Health CorpUtilization Management Clinician Behavioral Health Night Shift - 4 DaysCARemote$54,095–$142,576 / yearAbility to manage crisis calls, apply clinical judgment to assess risk, determine support needs, and coordinate appropriate interventions, including escalation for suicide risk, self-harm concerns, and welfare checks when necessary. Join our Utilization Management team and help ensure members receive timely, appropriate behavioral health services while making a meaningful impact on outcomes.