243 case manager ii jobs found

Job Summary and Responsibilities As our Utilization Review Nurse at the Utilization Management Hub, you will be a critical guardian of healthcare efficiency and quality, ensuring integrity in clinical decision-making, regulatory compliance, and responsible resource utilization.   Every day you will meticulously review medical records, authorize services, and prepare cases for physician review in partnership with UM teams. You'll monitor patient care for appropriateness, quality, and cost-effectiveness, aligning decisions with established criteria.    To be successful in this role, you will possess a strong clinical background, deep UM/regulatory knowledge, and exceptional analytical/organizational skills. Your ability to manage charts, apply criteria precisely, and communicate effectively with enthusiasm, efficiency, and empathy is paramount for optimal patient care and operational flow. Conducts admission and continued stay reviews per the Care...

Job Summary and Responsibilities As our Director of Care Coordination for St. Mary Medical Center, you will be responsible for the overall direction and management of care coordination and social services including planning, organizing and directing all activities, staffing, performance improvement in the delivery of clinical services (such as LOS reduction) and reporting needs within the Medical Center and Dignity Health, as well as government and regulatory reporting.   In this position, you will work closely with all departments at the Medical Center and the post-acute service providers to streamline the patient transition through the health care system and into the community post discharge, and consult/collaborate with other managers, physicians, administration, and community based healthcare workers regarding care management issues identified through corporate or facility initiatives and current literature.   To be successful in this role, you must...

Job Summary and Responsibilities As our RN Care Coordinator, you will be a central figure in patient care, seamlessly navigating the healthcare journey to achieve optimal outcomes and an exceptional patient experience. Every day, you will strategically assess, plan, and facilitate comprehensive care across the continuum, expertly advocating for patients while collaborating with physicians, nursing, departments, insurers, and post-acute providers to ensure timely, high-quality transitions. To be successful in this role, you will possess strong clinical acumen, exceptional communication and advocacy skills, and a strategic mindset, all driven by a passion for optimizing patient care across every touchpoint. Completes and documents a discharge planning assessment on those patients identified by the designated screening process, or upon request. Reassess the patient as appropriate and update the plan accordingly. Facilitates the development of a multidisciplinary...

Job Summary and Responsibilities As our Care Coordination Manager, you will provide operational leadership for the Care Coordination department in line with the CommonSpirit Health Care Coordination model, under the direction of the Director of Care Coordination. Every day you will oversee clinical resource management, progression of care, discharge planning, patient advocacy, clinical social work, and care coordination services. You will supervise staff, manage workflow, patient progression, resource utilization, regulatory compliance, and quality outcomes, and partner with physicians, nursing, Utilization Management, and interdisciplinary teams to meet department priorities. To be successful in this role, you will bring care coordination leadership experience, knowledge of regulatory requirements, and strong collaboration skills. Provides operational leadership for the Care Coordination department through staff supervision, team development, coaching, and performance...

ABOUT THE POSITION The County of Riverside- Riverside University Health System- Public Health is currently recruiting for a full-time Registered Nurse I-V for the California Children's Services (CCS) department located in Riverside. This program ensures that children with significant medical conditions receive treatment services, therapy, equipment, and care coordination necessary to improve their health, function and quality of life. Incumbents in this position provide case management services to children and youth with special health care needs. The incumbent evaluates medical eligibility, coordinates specialty medical care and community resources, authorizes medically necessary services, monitors utilization of services, and serves as a liaison among families, healthcare providers, community agencies, and multidisciplinary care teams. The Registered Nurse ensures compliance with California Children's Services regulations, Title 22 requirements, California Children's...

Work Location Requirement :  This position may be performed onsite or remotely; however, onsite work is preferred based on business needs.  Preference will be given to qualified candidates who are able to work onsite and are located within a reasonable commuting distance. Remote Work Eligibility :  This position is open to candidates located within the continental United States. Due to state-specific employment requirements and workers’ compensation regulations, we are unable to support remote work arrangements in the following locations: Washington, Ohio, Wyoming, North Dakota, Puerto Rico, and the U.S. Virgin Islands. At Northbay Health, the Professional Fee Coding Auditor / Claims Edit Specialist is responsible for auditing professional fee coding across all service lines (Ambulatory/Hospitalist, Surgery, and Emergency Medicine), resolving pre‑billing coding edits, and reviewing post‑billing coding‑related denials. This role ensures coding...

ABOUT ROCKET LAB Rocket Lab is the end-to-end space company building rockets, spacecraft, and critical subsystems that keep the world connected, protected, expand humanity’s reach to the Moon, Mars, and beyond. We move fast, build real hardware for meaningful missions, and make the impossible routine. Come shape the future with us. SPACE SYSTEMS   At Rocket Lab, we’re not just launching rockets — we're building the future of space. Our Space Systems team builds everything from complete spacecraft, precision payloads to the components and subsystems that allow them to thrive in space, like solar panels, flight software, star trackers, optical systems, separation systems, radios, and more. Our Space Systems team has enabled more than 1,700 missions, ranging from interplanetary exploration, in-space manufacturing to national security and defense initiatives. The team has built spacecraft, payloads, and components for missions to the Moon and Mars, working with partners...

ABOUT ROCKET LAB Rocket Lab is the end-to-end space company building rockets, spacecraft, and critical subsystems that keep the world connected, protected, expand humanity’s reach to the Moon, Mars, and beyond. We move fast, build real hardware for meaningful missions, and make the impossible routine. Come shape the future with us. SUPPLY CHAIN   Rocket Lab’s Supply Chain team is responsible for the flow of all materials, products, and components through the business. With many of our own products functioning as critical components to our own and our customers’ missions, the Supply Chain team has a direct impact on the success of our rocket and satellite programs. They set up the assembly kits that enables our technicians to put together our Electron rockets, manage inventory, look after shipping and receiving, manage direct and indirect procurement, and inspect and ensure that all of our materials and products are compliant and...

ABOUT ROCKET LAB Rocket Lab is the end-to-end space company building rockets, spacecraft, and critical subsystems that keep the world connected, protected, expand humanity’s reach to the Moon, Mars, and beyond. We move fast, build real hardware for meaningful missions, and make the impossible routine. Come shape the future with us. SUPPLY CHAIN  Rocket Lab’s Supply Chain team is responsible for the flow of all materials, products, and components through the business. With many of our own products functioning as critical components to our own and our customers’ missions, the Supply Chain team has a direct impact on the success of our rocket and satellite programs. They set up the assembly kits that enables our technicians to put together our Electron & Neutron rockets, manage inventory, look after shipping and receiving, manage direct and indirect procurement, and inspect and ensure that all of our materials and products are compliant and up to standard. They are the...

ABOUT ROCKET LAB Rocket Lab is the end-to-end space company building rockets, spacecraft, and critical subsystems that keep the world connected, protected, expand humanity’s reach to the Moon, Mars, and beyond. We move fast, build real hardware for meaningful missions, and make the impossible routine. Come shape the future with us. BUSINESS DEVELOPMENT Rocket Lab’s Business Development team is responsible for connecting customers across government and commercial sectors with our industry leading mission solutions spanning launch and space systems. They work closely with new and existing customers to understand their needs and develop tailored solutions to deliver their missions. Building and maintaining relationships with customers and internally with engineering and operations teams is at the core of our Business Development team. They have their fingers on the pulse of the space industry and are driven to deliver results for our customers and our business. SENIOR...

ABOUT ROCKET LAB Rocket Lab is the end-to-end space company building rockets, spacecraft, and critical subsystems that keep the world connected, protected, expand humanity’s reach to the Moon, Mars, and beyond. We move fast, build real hardware for meaningful missions, and make the impossible routine. Come shape the future with us. SPACE SYSTEMS At Rocket Lab, we’re not just launching rockets - we're building the future of space. Our Space Systems team builds everything from complete spacecraft and precision payloads to the components and subsystems that allow them to thrive in space, including solar panels, flight software, star trackers, optical systems, separation systems, radios, and more. Our Space Systems team has enabled more than 1,700 missions, ranging from interplanetary exploration and in-space manufacturing to national security and defense initiatives. The team has built spacecraft, payloads, and components for missions to the Moon and Mars, working with...

ABOUT ROCKET LAB Rocket Lab is the end-to-end space company building rockets, spacecraft, and critical subsystems that keep the world connected, protected, expand humanity’s reach to the Moon, Mars, and beyond. We move fast, build real hardware for meaningful missions, and make the impossible routine. Come shape the future with us. SPACE SYSTEMS   At Rocket Lab, we’re not just launching rockets — we’re building the future of space. Our Space Systems team builds everything from complete spacecraft, precision payloads to the components and subsystems that allow them to thrive in space, like solar panels, flight software, star trackers, optical systems, separation systems, radios, laser communication terminals, and more.  Our Space Systems team has enabled more than 1,700 missions, ranging from interplanetary exploration, in-space manufacturing to national security and defense initiatives. The team has built spacecraft, payloads, and components for missions to the...

ABOUT ROCKET LAB Rocket Lab is the end-to-end space company building rockets, spacecraft, and critical subsystems that keep the world connected, protected, expand humanity’s reach to the Moon, Mars, and beyond. We move fast, build real hardware for meaningful missions, and make the impossible routine. Come shape the future with us. SPACE SYSTEMS At Rocket Lab, we’re not just launching rockets - we're building the future of space. Our Space Systems team builds everything from complete spacecraft and precision payloads to the components and subsystems that allow them to thrive in space, including solar panels, flight software, star trackers, optical systems, separation systems, radios, and more. Our Space Systems team has enabled more than 1,700 missions, ranging from interplanetary exploration and in-space manufacturing to national security and defense initiatives. The team has built spacecraft, payloads, and components for missions to the Moon and Mars, working with...

ABOUT ROCKET LAB Rocket Lab is the end-to-end space company building rockets, spacecraft, and critical subsystems that keep the world connected, protected, expand humanity’s reach to the Moon, Mars, and beyond. We move fast, build real hardware for meaningful missions, and make the impossible routine. Come shape the future with us. SPACE SYSTEMS At Rocket Lab, we’re not just launching rockets - we're building the future of space. Our Space Systems team builds everything from complete spacecraft and precision payloads to the components and subsystems that allow them to thrive in space, including solar panels, flight software, star trackers, optical systems, separation systems, radios, and more. Our Space Systems team has enabled more than 1,700 missions, ranging from interplanetary exploration and in-space manufacturing to national security and defense initiatives. The team has built spacecraft, payloads, and components for missions to the Moon and Mars, working with...

At Northbay Health, we are seeking a Licensed Clinical Social Worker (LCSW) in Fairfield, CA to provide clinical social work services to hospital patients and their families. This role supports patients with complex psychosocial needs and collaborates with interdisciplinary teams to ensure effective care, improved outcomes, and safe transitions. Responsibilities: Provide direct clinical social work services, including counseling, discharge planning, and case management Primarily support inpatient hospital units, including reviewing daily census to identify patients needing clinical intervention and education to improve outcomes and reduce readmissions Conduct comprehensive biopsychosocial assessments addressing emotional, psychological, social, financial, and environmental needs Develop, implement, and monitor individualized care and discharge plans based on patient strengths and needs Manage psychosocially complex patients across the continuum of care, identifying and...

***This role will work On-Site in Fairfield, CA*** At Northbay Health, the Clinical Denials Specialist performs advanced clinical and revenue cycle functions related to payer denials, including medical necessity, prior authorization, referrals, notifications, non-coverage determinations, and other denial categories as assigned. Reviews and analyzes denied claims, prepares and submits comprehensive appeals, collaborates with physicians, Health Information Management (HIM), Case Management, Coding, Patient Financial Services, and other interdisciplinary teams to resolve denials, identify root causes and denial trends, and support denial prevention and revenue optimization initiatives. Executes the denial appeal process by receiving, reviewing, documenting, tracking, preparing, submitting, and resolving appeals with third-party payers in a timely manner for services provided to patients. Performs detailed clinical and coding reviews to support appeal development, ensures compliance...

NorthBay Integrative Primary Care (IPC) believes that lasting health is created through sustainable lifestyle change, meaningful patient partnerships, and whole-person care. The Integrative Primary Care RN serves as a trusted partner within the Integrative Primary Care Program, working in close collaboration with the Program MD’s and an on-site interdisciplinary team — including RNs, dietitians, and movement, stress management, and sleep specialists, and medical acupuncturists — to offer a highly personalized, relationship-based care experience built around a smaller patient panel. The Integrative Primary Care Program measures success not only by the clinical care delivered, but by patients’ ability to feel informed, supported, and engaged as active partners in their own health. While not a concierge medicine practice, the Integrative Primary Care participants do pay a program fee, not covered by insurance. At NorthBay Health, the Program RN provides complex care management and...

At NorthBay Health the Transfer Center Coordinator is a critical role in the NorthBay Health system facilitating both inbound and outbound transfers.  The Transfer Center Coordinator is responsible for facilitating and coordinating patient transfers both inbound/outbound, tertiary transfers both emergent and urgent, consults from NorthBay Health to tertiary acute care hospitals.  Sets up systems to enable both cost containment and quality patient care. This position requires excellent communication and organizational skills to ensure seamless coordination between various departments, healthcare facilities, and external agencies.  The Transfer Center Coordinator works collaboratively with all areas of NorthBay Health to facilitate timely and appropriate transfer of patients regardless of complaint or need. This position will require liaison with the case management/utilization review team as well as the Administrative Coordinator.  Areas of focus are...

This posting covers San Diego County. The location shown is the county; the work may be anywhere in it. Job Summary Exceptional Professional Planning Career Opportunity -  Be part of a Progressive and Recognized Land Use/Environmental Program SENIOR PLANNER  Interviews will take place on an ongoing basis.  The starting salary for this position will be based on the candidate’s qualifications at time of appointment. Future Salary Increases ** June 2027 – 3.30% increase to base pay (3% Across-the- Board +.30% Market Adjustment)  ***This hard to recruit position qualifies for the Employee Referral Reward Program. If a current County of San Diego employee referred you to apply for this position, please indicate the employee’s name on your job application in the space provided. ***  Are you passionate about urban and rural planning and looking for an exciting opportunity to join a dynamic team?  Look no further than the County...

Northbay Health is seeking a Medical Social Worker to join our team in Fairfield, CA, supporting our inpatient hospital units and broader care coordination efforts. This role is essential in improving patient outcomes through clinical intervention, education, and continuity of care across both inpatient and outpatient settings. This role plays a key part in identifying patients at risk for readmission and ensuring seamless transitions across the continuum of care. JOB SUMMARY Provides psychosocial assessment, case management, crisis intervention and care coordination services to patients receiving treatment for substance use disorders withing an addiction medicine clinic. This includes assessment and documentation of emotional, social, financial, environmental or follow-up referral needs under the guidance.  Works collaboratively with the interdisciplinary teams and Population health including physicians, pharmacy, counselors, and peer recovery specialists to support...