• Complex Case Manager

    Highmark Health (Sacramento, CA)
    …the appropriate clinical interventions and referrals, the incumbent will manage an active case load of members in his/her panel that are enrolled in case ... management. The incumbent conducts outreach to members enrolled in case management including but is not limited to: developing...in addressing targeted populations **LICENSES AND CERTIFICATIONS** **Required** + RN license in PA or WV or DE or… more
    Highmark Health (03/13/25)
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  • Care Manager , Registered

    Sutter Health (Roseville, CA)
    …school of nursing + Bachelor's in Nursing preferred. **CERTIFICATION & LICENSURE:** + RN - Registered Nurse of California Upon Hire **TYPICAL EXPERIENCE:** + ... This position works in collaboration with the Physician, Utilization Manager , Medical Social Worker and bedside RN ...Emergency Department, the Care Management process is to address complex clinical and social situations efficiently in order to… more
    Sutter Health (03/14/25)
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  • Manager , Utilization Management…

    Humana (Sacramento, CA)
    …**Use your skills to make an impact** **Required Qualifications** + Active Licensed Registered Nurse ( RN ) in Virginia or enhanced compact license, ... part of our caring community and help us put health first** The Manager , Utilization Management Nursing utilizes clinical nursing skills to support the coordination,… more
    Humana (03/12/25)
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  • Care Manager , Registered

    Sharecare (Sacramento, CA)
    …of their members to ensure successful completion of member goals, while providing Complex Case Management and/or care management support through the duration of ... within a matrix organizational design. **Qualifications:** + Current multi-state compact Registered Nurse licensure in state of residence is required,… more
    Sharecare (02/17/25)
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  • Hospice Oversight Case Manager

    Molina Healthcare (Sacramento, CA)
    **HOSPICE OVERSIGHT CASE MANAGER ( REGISTERED NURSE )** **JOB DESCRIPTION** **Job Summary** Molina Healthcare Services (HCS) works with members, providers ... to address concerns. + RNs provide consultation, recommendations and education as appropriate to non- RN case managers. + RNs are assigned cases with members who… more
    Molina Healthcare (02/24/25)
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  • Case Manager , RN

    CAI (Sacramento, CA)
    …Type** Full time **Worksite Flexibility** Remote **Job Summary** We are looking for a motivated Case Manager , RN ready to take us to the next level! ... apply now. **Job Description** We are looking for a Case Manager , RN to provide...duties as assigned/requested **What You'll Need** Required: + Current Registered Nurse , licensed in the state of… more
    CAI (02/01/25)
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  • ( RN ) Case Manager : Care…

    Molina Healthcare (Sacramento, CA)
    REGISTERED NURSE , qualified candidate must live and be willing to travel in California.** **JOB DESCRIPTION** **Job Summary** Molina Healthcare Services (HCS) ... ICT collaboration. + RNs provide consultation, recommendations, and education as appropriate to non- RN case managers. + RNs are assigned cases with members who… more
    Molina Healthcare (02/01/25)
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  • Director, Care Management, RN SW

    Sutter Health (Sacramento, CA)
    …Work candidates must have Masters in Social Work) **CERTIFICATION & LICENSURE:** + RN - Registered Nurse of California Upon Hire OR LCSW-Licensed Clinical ... Social Worker Upon Hire + CCM-Certified Case Manager Upon Hire **TYPICAL EXPERIENCE:** +...facilitation skills. + Demonstrated ability to develop and manage complex projects. + Working knowledge of InterQual criteria preferred.… more
    Sutter Health (01/11/25)
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  • Patient Logistics RN

    CommonSpirit Health (Rancho Cordova, CA)
    …out in the community. **Responsibilities** **Position Summary:** The Patient Logistics RN supervises the transfer center activities for Dignity Health Facilities. ... to carry out the patient logistics program responsibilities. The Patient Logistics RN collaborates with customers and staff to ensure efficient and effective… more
    CommonSpirit Health (02/20/25)
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  • Supervising Public Health Nurse

    Sacramento County (Sacramento, CA)
    …of Supervising Public Health Nurse : + Must possess and maintain a current Registered Nurse License and Public Health Nurse Certificate issued by the ... under general administrative supervision of a higher-level health program manager , and receive medical direction as needed from a...to this class must possess and maintain a current Registered Nurse license and Public Health … more
    Sacramento County (01/21/25)
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  • Manager , Utilization Management Behavioral…

    Humana (Sacramento, CA)
    …**Required Qualifications:** **Must meet** **one** **of the following:** + Active unrestricted registered nurse license in the state of Virginia or reside ... coaching, performance review, up to termination. + Certified or certified-eligible case manager required. **Additional Information:** **Workstyle:** Remote work… more
    Humana (03/12/25)
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  • UM Clinical Denial Manager

    Sutter Health (Sacramento, CA)
    …* Graduate of an accredited school of nursing **CERTIFICATION & LICENSURE:** * RN - Registered Nurse of California Upon Hire **TYPICAL EXPERIENCE:** * ... state regulations and guidelines. Has frequent contact with hospital leadership, Nurse Executives and Directors, Risk Management & Ethics staff, Ancillary Services,… more
    Sutter Health (03/08/25)
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  • Excess Risk Managed Care Clinician

    Highmark Health (Sacramento, CA)
    …Bachelor's degree in Nursing **LICENSES or CERTIFICATIONS** **Required** + Registered Nurse **Preferred** + Certified Case Manager (CCM) **Language ... data to assess potential stop loss and managed care claim liability, utilizing Case Management oversight techniques to ensure front line case management and… more
    Highmark Health (02/24/25)
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