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Manager Clinic Operations (Clinical Center Manager) CalOptima Join Us in this Amazing Opportunity The Team You'll Join We are a mission driven community-based organization that serves member health with excellence and dignity, respecting the value and needs of each person. If you are ready to advance your career while making a difference, we encourage you to review and apply today and help us build healthier communities for all. More About the Opportunity We are hoping you will join us as a Manager Clinic Operations (Clinical Center Manager) and help shape the future of healthcare where you'll be an integral part of our PACE- Clinic team, helping to strive for excellence while we serve our member health with dignity, respecting the value and needs of each of our members through collaboration with our providers, community partners and local stakeholders. You will be responsible for overseeing clinical programs and services for our Program of All Inclusive Care for the Elderly (PACE) participants. You will oversee the social work department, behavioral health services, home care department, Interdisciplinary Team (IDT) meetings, clinical discussions and facilitation. You will also provide leadership to the IDT meetings and functions within PACE to ensure compliance with regulatory standards and care plan oversight. In addition, you will collaborate with IDT members to achieve clinical and quality organizational goals. You will oversee specific clinical PACE departments and oversee execution of the participants' care plan services. Lastly, you will serve as the liaison between direct care staff and leadership. Together, we are building a stronger, more equitable health system. Your Contributions To the Team: 
<ul>
<li>50% - Leadership Functions
<ul>
<li>Cultivates and promotes a mission-driven culture of high-quality performance, with a member focus on customer service, consistency, dignity and accountability. </li>
<li>Directs and assists the team in carrying out department responsibilities and collaborates with the leadership team and staff to support short- and long-term goals/priorities for the department. </li>
<li>Hires, manages, trains, reviews and sets goals for the team. </li>
<li>Provides guidance to the team regarding Utilization Management and guidelines.</li>
<li>Facilitates and leads the IDT meetings. </li>
<li>Delegates responsibilities and functions to appropriate staff.</li>
<li>Provides direction, mentoring, guidance and support to staff to ensure quality clinical service delivery; maintains high employee morale. </li>
<li>Encourages professional and personal development and uses regular ongoing training sessions to improve quality, ensure productivity and minimize employee turnover. </li>
<li>Evaluates operational systems and updates/creates new procedures, bringing an analytical orientation to daily operations. </li>
<li>Implements a best practice approach and ensures staff are trained to provide services effectively and efficiently.</li>
<li>Establishes, updates and standardizes clinical policies and procedures for PACE operations. </li>
<li>Consults and educates internal and external staff to improve overall compliance with regulations and standards related to PACE clinical operations.</li>
<li>Provides input in the development and ongoing improvement of the PACE electronic health record (EHR) system. </li>
<li>Collaborates with CalOptima Health directors and managers to provide oversight, development and monitoring of staff's performance within their discipline and on the team; ensures staff competencies and training goals are met.</li>
<li>Works with other members of the PACE department and related CalOptima Health departments to coordinate process improvement initiatives.</li>
<li>Participates in the preparation of annual budgets for PACE; effectively manages PACE resources.</li>
<li>Works with other managers and administrative staff to promote positive relationships. </li>
</ul>
</li>
</ul>
<ul>
<li>45% - Program Oversight
<ul>
<li>Coordinates all care planning and implementation of services authorized, preparation for interdisciplinary conferences and daily meetings, family conferences and initial and periodic assessments.</li>
<li>Participates in recurring scheduled intake and assessment meetings to review participant cases on a regular basis.</li>
<li>Oversees the quality of care and safety of PACE participants as outlined and approved by the IDT.</li>
<li>Serves as a liaison between discipline, leadership and direct staff.</li>
<li>Works closely with the primary care physician staff as part of the IDT to develop and implement the participant's individualized care plans.</li>
<li>Supports and guides clinical decisions for patient care that follow PACE center policies and procedures. </li>
<li>Engages proactively with PACE administration to further program development, including participation in working committees and project development/implementation.</li>
<li>Oversees the social work department, behavioral health services, home care department, IDT meetings, clinical discussions and facilitation.</li>
<li>Oversees the transportation contractors to ensure quality and regulations are being met for the safety of our participants. </li>
<li>Supports the Manager PACE Center (Operations) as needed with coverage. </li>
</ul>
</li>
</ul>
<ul>
<li>5% - Other
<ul>
<li>Completes other projects and duties as assigned. </li>
</ul>
</li>
</ul>
 Do You Have What the Role Requires? 
<ul>
<li>Master's degree in health care administration, social work, business administration or related field PLUS 5 years of experience in a supervisory/managerial capacity in a health care setting required, preferably in a PACE environment; an equivalent combination of education and experience sufficient to successfully perform the essential duties of the position such as those listed above may also be qualifying. </li>
<li>3 years of experience working with older adult populations required. </li>
<li>CPR and First-Aid Certification required or must be obtained within six (6) months of date of hire.</li>
</ul>
 You'll Stand Out More If You Possess the Following: 
<ul>
<li>Possess a clinical license such as an LCSW. </li>
<li>Experience overseeing clinical departments.</li>
</ul>
 What the Regulatory Agencies Need You to Possess? 
<ul>
<li>n/a</li>
</ul>
 Your Knowledge &amp; Abilities to Bring to this Role: 
<ul>
<li>Develop rapport and establish and maintain effective working relationships with CalOptima Health's leadership and staff and external contacts at all levels and with diverse backgrounds. </li>
<li>Work independently and exercise sound judgment.</li>
<li>Communicate clearly and concisely, both orally and in writing.</li>
<li>Work a flexible schedule; available to participate in evening and weekend events.</li>
<li>Organize, be analytical, problem-solve and possess project management skills.</li>
<li>Work in a fast-paced environment and in an efficient manner.</li>
<li>Manage multiple projects and identify opportunities for internal and external collaboration.</li>
<li>Motivate and lead multi-program teams and external committees/coalitions.</li>
<li>Utilize computer and appropriate software (e.g., Microsoft Office: Word, Outlook, Excel, PowerPoint) and job specific applications/systems to produce correspondence, charts, spreadsheets, and/or other information applicable to the position assignment.</li>
</ul>
 Your Physical Requirements (With or Without Accommodations): 
<ul>
<li>Ability to visually read information from computer screens, forms and other printed materials and information.</li>
<li>Ability to speak (enunciate) clearly in conversation and general communication.</li>
<li>Hearing ability for verbal communication/conversation/responses via telephone, telephone systems, and face-to-face interactions.</li>
<li>Manual dexterity for typing, writing, standing and reaching, flexibility, body movement for bending, crouching, walking, kneeling and prolonged sitting.</li>
<li>Lifting and moving objects, patients and/or equipment more than 50 pounds</li>
</ul>
 Ways We Are Here For You 
<ul>
<li>You'll enjoy competitive compensation for this role.
<ul>
<li>Our current hiring range is: Pay Grade: 316 - $120,881 - $193,410 ($58.12 - $92.9856). 
<ul>
<li>The final salary offered will be based on education, job-related knowledge and experience, skills relevant to the role and internal equity among other factors. </li>
</ul>
</li>
</ul>
</li>
<li>This position is approved for Full Office (**If the position is Telework, it is eligible in California only**) </li>
<li>A <a href="https://apptrkr.com/get_redirect.php?id=6702952&amp;targetURL=https://www.caloptima.org/en/careers#benefits" target="_blank">comprehensive benefits package</a> </li>
<li>CalPERS pension program and additional retirement packages. </li>
<li>Additional benefits and perks including:
<ul>
<li>A generous PTO program</li>
<li>A quality work life balance</li>
<li>Various wellness programs</li>
<li>Tuition Reimbursement</li>
<li>Professional development opportunities</li>
<li>Career development opportunities</li>
<li>Flexible scheduling</li>
<li>And the satisfaction of knowing your work directly impacts and improves healthcare access for thousands of individuals and families.</li>
</ul>
</li>
</ul>
 Our Work Environment: If located at the 500, 505 Building or a remote work location: 
<ul>
<li>Work is typically indoors and sedentary and is subject to schedule changes and/or variable work hours, with travel as needed.</li>
<li>There are no harmful environmental conditions present for this job.</li>
<li>The noise level in this work environment is usually moderate.</li>
</ul>
 If located at PACE: 
<ul>
<li>Work is typically indoors in a clinical setting serving the frail and elderly.</li>
<li>There may be harmful or hazardous environmental conditions present for this job.</li>
<li>The noise level in this work environment is usually moderate to loud.</li>
</ul>
 If located in the Community: 
<ul>
<li>Work is typically indoors and sedentary and is subject to schedule changes and/or variable work hours, with travel as needed. </li>
<li>Employee will occasionally work outdoors in varied temperatures.</li>
<li>There may be harmful or hazardous environmental conditions present for this job.</li>
<li>The noise level in this work environment is usually moderate to loud.</li>
</ul>
 Why Join Us? We believe that diverse perspectives drive innovation. Each employee brings a unique perspective to the overall team and we value everyone's input and we are committed to creating an inclusive environment where you and every team member can thrive while making a meaningful impacts on our community members. Our team reflects and represents the communities we serve, and we welcome candidates from all backgrounds who share our commitment to accessible, quality healthcare. What's Your Next Step? All Applications will be accepted on a continuous basis until a sufficient number of qualified applications have been received. Do NOT miss out. If you want to join our team, the deadline for the first review of applications is November 19, 2025 at 9:00 PM (PST). We are encouraging you to apply early. If you apply after the first review date, your application is not guaranteed to be considered for this recruitment. This recruitment may close at any time without notice after the first review date. Our Commitment to You Your application and resume will be reviewed by a dedicated recruiter to this position. If your experience matches what we need, we will reach out to you to discuss the next steps. The selection process may include, but is not limited to, a skills assessment, phone screen and interview. If you make it through the steps above and are selected for this exciting role, you will be required to undergo a reference and a background check (to include a conviction record) and if applicable also pass a drug screening and/or a post-offer pre-employment medical examination (for specific positions) If you are an Internal CalOptima Health applicant, please apply through the internal portal on InfoNet. We will make sure to keep you updated through each step of the process on your candidate portal. Please make sure to watch for updates on your candidate portal and you emails which will be sent to the email address you listed on your application. Please check your email, including your SPAM folder, regularly throughout the recruitment process. CalOptima Health is committed to attracting, hiring, and retaining a diverse staff, where we will honor your unique experiences, identity, and perspectives. Our organization strives to create and maintain a workplace environment that is inclusive, equitable and welcoming so we can truly be Better Together. CalOptima Health is an equal opportunity employer and makes all employment decisions on the basis of merit. CalOptima Health wants to have qualified employees in every job position. CalOptima Health prohibits unlawful discrimination against any employee, or applicant for employment, based on race, religion/religious creed, color, national origin, ancestry, mental or physical disability, medical condition, genetic information, marital status, sex, sex stereotype, gender, gender identity, gender expression, transitioning status, age, sexual orientation, immigration status, military status as a disabled veteran, or veteran of the Vietnam era, or any other consideration made unlawful by federal, state, or local laws. CalOptima Health also prohibits unlawful discrimination based on the perception that anyone has any of those characteristics or is associated with a person who has, or is perceived as having, any of those characteristics. If you are a qualified individual with a disability or a disabled veteran, you may request a reasonable accommodation at (714) 246-8400 if you are unable or limited in your ability to access job openings or apply for a job on this site as a result of your disability. To apply, please visit: <a href="https://apptrkr.com/6702952" target="_blank">https://jobs.caloptima.org/jobs/manager-clinic-operations-clinical-center-manager-pace-garden-grove-california-united-states</a> Copyright 2025 Jobelephant.com Inc. All rights reserved. <a href="https://www.jobelephant.com/" target="_blank">Posted by the FREE value-added recruitment advertising agency</a> jeid-f464ba5a4b7e2241b2e808834872d41b

Manager Clinic Operations (Clinical Center Manager)

Clinical Registered Nurse (RN (PACE)) CalOptima Join Us in this Amazing Opportunity The Team You'll Join We are a mission driven community-based organization that serves member health with excellence and dignity, respecting the value and needs of each person. If you are ready to advance your career while making a difference, we encourage you to review and apply today and help us build healthier communities for all. More About the Opportunity We are hoping you will join us as a Clinic Registered Nurse (RN (PACE)) and help shape the future of healthcare where you'll be an integral part of our PACE- Clinic team, helping to strive for excellence while we serve our member health with dignity, respecting the value and needs of each of our members through collaboration with our providers, community partners and local stakeholders. You will provide high-quality, participant-centered care in a dynamic, interdisciplinary Program for All-Inclusive Care for the Elderly (PACE) environment. Also, you will support direct care and case management functions, ensuring safe, timely and effective care delivery. Lastly, you will coordinate care across clinic, home and facility-based care settings. Together, we are building a stronger, more equitable health system. Your Contributions To the Team: 
<ul>
<li>95% - Clinical Practice and Care Delivery
<ul>
<li>Participates in a mission-driven culture of high-quality performance, with a member focus on customer service, consistency, dignity and accountability.</li>
<li>Assists the team in carrying out department responsibilities and collaborates with others to support short- and long-term goals/priorities for the department.</li>
<li>Conducts comprehensive assessments, triage and skilled nursing tasks, including wound care, IV insertion/removal and medication administration.</li>
<li>Develops and implements individualized care plans in collaboration with the interdisciplinary team and participant/family. </li>
<li>Provides education to participants and caregivers and responds to urgent/emergent clinical needs.</li>
<li>Performs case management duties, including facility visits, discharge planning and placement coordination.</li>
<li>Participates in initial and periodic assessments (at least every 6 months) and communicates changes in participant condition to the team.</li>
<li>Ensures accurate and timely documentation in the electronic health record (EHR). Care Coordination and Vendor Collaboration</li>
<li>Coordinates services with Home Health, Palliative and Hospice vendors to ensure seamless transitions of care.</li>
<li>Facilitates referrals and authorizations and follow-ups in accordance with organizational protocols. Team Support and Flexibility </li>
<li>Provides coverage for other RNs and adjusts staffing demands based on participant acuity.</li>
<li>Participates in interdisciplinary team meetings, case conferences and quality improvement initiatives. Leadership and Compliance</li>
<li>Oversees and mentors Licensed Vocational Nurses (LVNs) and Medical Assistants (MAs); provides clinical training and guidance.</li>
<li>Participates in clinic operations, including triage protocol development, supply tracking and safety compliance.</li>
<li>Supports program development, including input on medical equipment, EHR improvements and regulatory readiness. </li>
<li>Demonstrates accountability in quality, safety and cost-effective care delivery. </li>
</ul>
</li>
</ul>
<ul>
<li>5% - Other
<ul>
<li>Completes other projects and duties as assigned. </li>
</ul>
</li>
</ul>
 Do You Have What the Role Requires? 
<ul>
<li>Associate degree in nursing (ADN) or related field PLUS 3 years of clinical Registered Nursing experience working with the frail or elderly population required with relevant experience within the last 3 years; an equivalent combination of education and experience sufficient to successfully perform the essential duties of the position such as those listed above may also be qualifying. </li>
<li>CPR or Basic Life Support (BLS) certification required or must be obtained within six (6) months of date of hire. </li>
<li>Have access to means of transportation for work away from the primary office approximately 10% of the time required.</li>
</ul>
 You'll Stand Out More If You Possess the Following: 
<ul>
<li>Bachelor of Science in Nursing (BSN). </li>
<li>Bilingual in English and in one of CalOptima Health's defined threshold languages (Arabic, Chinese, Farsi, Korean, Russian, Spanish, Vietnamese).</li>
</ul>
 What the Regulatory Agencies Need You to Possess? 
<ul>
<li>Current, unrestricted Registered Nurse (RN) license to practice in the state of California.</li>
</ul>
 Your Knowledge &amp; Abilities to Bring to this Role: 
<ul>
<li>Develop rapport and establish and maintain effective working relationships with CalOptima Health's leadership and staff and external contacts at all levels and with diverse backgrounds. </li>
<li>Work independently and exercise sound judgment.</li>
<li>Communicate clearly and concisely, both orally and in writing.</li>
<li>Work a flexible schedule; available to participate in evening and weekend events.</li>
<li>Organize, be analytical, problem-solve and possess project management skills.</li>
<li>Work in a fast-paced environment and in an efficient manner.</li>
<li>Manage multiple projects and identify opportunities for internal and external collaboration.</li>
<li>Motivate and lead multi-program teams and external committees/coalitions.</li>
<li>Utilize computer and appropriate software (e.g., Microsoft Office: Word, Outlook, Excel, PowerPoint) and job specific applications/systems to produce correspondence, charts, spreadsheets, and/or other information applicable to the position assignment.</li>
</ul>
 Your Physical Requirements (With or Without Accommodations): 
<ul>
<li>Ability to visually read information from computer screens, forms and other printed materials and information.</li>
<li>Ability to speak (enunciate) clearly in conversation and general communication.</li>
<li>Hearing ability for verbal communication/conversation/responses via telephone, telephone systems, and face-to-face interactions.</li>
<li>Manual dexterity for typing, writing, standing and reaching, flexibility, body movement for bending, crouching, walking, kneeling and prolonged sitting.</li>
<li>Lifting and moving objects, patients and/or equipment more than 50 pounds</li>
</ul>
 Ways We Are Here For You 
<ul>
<li>You'll enjoy competitive compensation for this role.
<ul>
<li>Our current hiring range is: Pay Grade: 313 - $90,820 - $145,312 ($43.66 - $69.8615). 
<ul>
<li>The final salary offered will be based on education, job-related knowledge and experience, skills relevant to the role and internal equity among other factors. </li>
</ul>
</li>
</ul>
</li>
<li>This position is approved for Full Office (**If the position is Telework, it is eligible in California only**) </li>
<li>A <a href="https://apptrkr.com/get_redirect.php?id=6687121&amp;targetURL=https://www.caloptima.org/en/careers#benefits" target="_blank">comprehensive benefits package</a> </li>
<li>CalPERS pension program and additional retirement packages. </li>
<li>Additional benefits and perks including:
<ul>
<li>A generous PTO program</li>
<li>A quality work life balance</li>
<li>Various wellness programs</li>
<li>Tuition Reimbursement</li>
<li>Professional development opportunities</li>
<li>Career development opportunities</li>
<li>Flexible scheduling</li>
<li>And the satisfaction of knowing your work directly impacts and improves healthcare access for thousands of individuals and families.</li>
</ul>
</li>
</ul>
 Our Work Environment: If located at the 500, 505 Building or a remote work location: 
<ul>
<li>Work is typically indoors and sedentary and is subject to schedule changes and/or variable work hours, with travel as needed.</li>
<li>There are no harmful environmental conditions present for this job.</li>
<li>The noise level in this work environment is usually moderate.</li>
</ul>
 If located at PACE: 
<ul>
<li>Work is typically indoors in a clinical setting serving the frail and elderly.</li>
<li>There may be harmful or hazardous environmental conditions present for this job.</li>
<li>The noise level in this work environment is usually moderate to loud.</li>
</ul>
 If located in the Community: 
<ul>
<li>Work is typically indoors and sedentary and is subject to schedule changes and/or variable work hours, with travel as needed. </li>
<li>Employee will occasionally work outdoors in varied temperatures.</li>
<li>There may be harmful or hazardous environmental conditions present for this job.</li>
<li>The noise level in this work environment is usually moderate to loud.</li>
</ul>
 Why Join Us? We believe that diverse perspectives drive innovation. Each employee brings a unique perspective to the overall team and we value everyone's input and we are committed to creating an inclusive environment where you and every team member can thrive while making a meaningful impacts on our community members. Our team reflects and represents the communities we serve, and we welcome candidates from all backgrounds who share our commitment to accessible, quality healthcare. What's Your Next Step? All Applications will be accepted on a continuous basis until a sufficient number of qualified applications have been received. Do NOT miss out. If you want to join our team, the deadline for the first review of applications is November 12, 2025 at 9:00 PM (PST). We are encouraging you to apply early. If you apply after the first review date, your application is not guaranteed to be considered for this recruitment. This recruitment may close at any time without notice after the first review date. Our Commitment to You Your application and resume will be reviewed by a dedicated recruiter to this position. If your experience matches what we need, we will reach out to you to discuss the next steps. The selection process may include, but is not limited to, a skills assessment, phone screen and interview. If you make it through the steps above and are selected for this exciting role, you will be required to undergo a reference and a background check (to include a conviction record) and if applicable also pass a drug screening and/or a post-offer pre-employment medical examination (for specific positions) If you are an Internal CalOptima Health applicant, please apply through the internal portal on InfoNet. We will make sure to keep you updated through each step of the process on your candidate portal. Please make sure to watch for updates on your candidate portal and you emails which will be sent to the email address you listed on your application. Please check your email, including your SPAM folder, regularly throughout the recruitment process. CalOptima Health is committed to attracting, hiring, and retaining a diverse staff, where we will honor your unique experiences, identity, and perspectives. Our organization strives to create and maintain a workplace environment that is inclusive, equitable and welcoming so we can truly be Better Together. CalOptima Health is an equal opportunity employer and makes all employment decisions on the basis of merit. CalOptima Health wants to have qualified employees in every job position. CalOptima Health prohibits unlawful discrimination against any employee, or applicant for employment, based on race, religion/religious creed, color, national origin, ancestry, mental or physical disability, medical condition, genetic information, marital status, sex, sex stereotype, gender, gender identity, gender expression, transitioning status, age, sexual orientation, immigration status, military status as a disabled veteran, or veteran of the Vietnam era, or any other consideration made unlawful by federal, state, or local laws. CalOptima Health also prohibits unlawful discrimination based on the perception that anyone has any of those characteristics or is associated with a person who has, or is perceived as having, any of those characteristics. If you are a qualified individual with a disability or a disabled veteran, you may request a reasonable accommodation at (714) 246-8400 if you are unable or limited in your ability to access job openings or apply for a job on this site as a result of your disability. To apply, please visit: <a href="https://apptrkr.com/6687121" target="_blank">https://jobs.caloptima.org/jobs/clinical-registered-nurse-rn-pace-505-city-parkway-west-california-united-states</a> Copyright 2025 Jobelephant.com Inc. All rights reserved. <a href="https://www.jobelephant.com/" target="_blank">Posted by the FREE value-added recruitment advertising agency</a> jeid-a8ec5122f613b84b9d53d215eccf04f7

Clinical Registered Nurse (RN (PACE))

Supervisor Utilization Management (Prior Authorization) CalOptima Join Us in this Amazing Opportunity The Team You'll Join We are a mission driven community-based organization that serves member health with excellence and dignity, respecting the value and needs of each person. If you are ready to advance your career while making a difference, we encourage you to review and apply today and help us build healthier communities for all. More About the Opportunity We are hoping you will join us as a Supervisor Utilization Management (Prior Authorization) and help shape the future of healthcare where you'll be an integral part of our UM - Prior Authorization team, helping to strive for excellence while we serve our member health with dignity, respecting the value and needs of each of our members through collaboration with our providers, community partners and local stakeholders. You will monitor and supervise the department operations to ensure service standards are met. You will make recommendations regarding assignments based on assessment of workload serve as a resource to the Prior Authorization staff regarding CalOptima Health's policies and procedures and regulatory requirements governing authorization processing. Lastly, you will provide ongoing monitoring and development of staff. Together, we are building a stronger, more equitable health system. Your Contributions To the Team: 
<ul>
<li>50% - Supervisory Functions
<ul>
<li>Participates in a mission-driven culture of high-quality performance, with a member focus on customer service, consistency, dignity and accountability.</li>
<li>Assists the team in carrying out department responsibilities and collaborates with others to support short- and long-term goals/priorities for the department.</li>
<li>Assists the manager as needed to ensure departmental and agency goals are met.</li>
<li>Identifies learning opportunities for staff and develops training materials (e.g., desktop procedures and/or Microsoft PowerPoint presentations) to provide education.</li>
<li>Interviews potential candidates and makes recommendations for second round interviews and/or hiring of a candidate.</li>
<li>Creates staffing assignments based on authorization priority, workload, current staffing and review of timeliness reports.</li>
<li>Trains, audits, supervises and coaches Prior Authorization staff.</li>
<li>Reviews staff monthly productivity metrics and identifies and conducts performance feedback and/or counseling/corrective action meetings with the assistance of Human Resources as necessary.</li>
<li>Reviews workflows, procedures and/or policies and recommends or implements changes as appropriate.</li>
<li>Reviews denials and modifications of member notifications prior to mailing and collaborates with staff to implement updates as necessary. </li>
</ul>
</li>
<li>45% - Program Support
<ul>
<li>Assists in the monitoring of appropriate benefit checks, application of guidelines to determine medical necessity, appropriate routing and timely completion of authorization requests.</li>
<li>Assists with the collection, monitoring and analysis of prior authorization indicators and activities.</li>
<li>Provides coverage and expertise for other teams within the Utilization Management department.</li>
<li>Conducts prior authorization presentations to internal or external customers.</li>
<li>Serves as a subject matter expert (SME) to departmental staff, internal departments and affiliated health networks regarding authorization rules and processes. </li>
</ul>
</li>
<li>5% - Other
<ul>
<li>Completes other projects and duties as assigned. </li>
</ul>
</li>
</ul>
 Do You Have What the Role Requires? 
<ul>
<li>Associate degree in Nursing (ADN) PLUS 3 years of clinical nursing experience required, preferably in a managed care environment; an equivalent combination of education and experience sufficient to successfully perform the essential duties of the position such as those listed above may also be qualifying. </li>
<li>2 years of progressive leadership experience, including direct supervision of staff in managed care and/or utilization management required. </li>
<li>1 year of utilization management/prior authorization review experience required.</li>
</ul>
 You'll Stand Out More If You Possess the Following: 
<ul>
<li>Bachelor of Science degree in Nursing (BSN).</li>
</ul>
 What the Regulatory Agencies Need You to Possess? 
<ul>
<li>Current and unrestricted California Board Licensed Vocational Nurse (LVN) or Registered Nurse (RN) license required.</li>
</ul>
 Your Knowledge &amp; Abilities to Bring to this Role: 
<ul>
<li>Develop rapport and establish and maintain effective working relationships with CalOptima Health's leadership and staff and external contacts at all levels and with diverse backgrounds. </li>
<li>Work independently and exercise sound judgment.</li>
<li>Communicate clearly and concisely, both orally and in writing.</li>
<li>Work a flexible schedule; available to participate in evening and weekend events.</li>
<li>Organize, be analytical, problem-solve and possess project management skills.</li>
<li>Work in a fast-paced environment and in an efficient manner.</li>
<li>Manage multiple projects and identify opportunities for internal and external collaboration.</li>
<li>Motivate and lead multi-program teams and external committees/coalitions.</li>
<li>Utilize computer and appropriate software (e.g., Microsoft Office: Word, Outlook, Excel, PowerPoint) and job specific applications/systems to produce correspondence, charts, spreadsheets, and/or other information applicable to the position assignment.</li>
</ul>
 Your Physical Requirements (With or Without Accommodations): 
<ul>
<li>Ability to visually read information from computer screens, forms and other printed materials and information.</li>
<li>Ability to speak (enunciate) clearly in conversation and general communication.</li>
<li>Hearing ability for verbal communication/conversation/responses via telephone, telephone systems, and face-to-face interactions.</li>
<li>Manual dexterity for typing, writing, standing and reaching, flexibility, body movement for bending, crouching, walking, kneeling and prolonged sitting.</li>
<li>Lifting and moving objects, patients and/or equipment 10 to 25 pounds</li>
</ul>
 Ways We Are Here For You 
<ul>
<li>You'll enjoy competitive compensation for this role.
<ul>
<li>Our current hiring range is: Pay Grade: 315 - $109,892 - $175,827 ($52.83 - $84.5322). 
<ul>
<li>The final salary offered will be based on education, job-related knowledge and experience, skills relevant to the role and internal equity among other factors. </li>
</ul>
</li>
</ul>
</li>
<li>This position is approved for Partial Telework (**If the position is Telework, it is eligible in California only**) </li>
<li>A <a href="https://apptrkr.com/get_redirect.php?id=6687180&amp;targetURL=https://www.caloptima.org/en/careers#benefits" target="_blank">comprehensive benefits package</a> </li>
<li>CalPERS pension program and additional retirement packages. </li>
<li>Additional benefits and perks including:
<ul>
<li>A generous PTO program</li>
<li>A quality work life balance</li>
<li>Various wellness programs</li>
<li>Tuition Reimbursement</li>
<li>Professional development opportunities</li>
<li>Career development opportunities</li>
<li>Flexible scheduling</li>
<li>And the satisfaction of knowing your work directly impacts and improves healthcare access for thousands of individuals and families.</li>
</ul>
</li>
</ul>
 Our Work Environment: If located at the 500, 505 Building or a remote work location: 
<ul>
<li>Work is typically indoors and sedentary and is subject to schedule changes and/or variable work hours, with travel as needed.</li>
<li>There are no harmful environmental conditions present for this job.</li>
<li>The noise level in this work environment is usually moderate.</li>
</ul>
 If located at PACE: 
<ul>
<li>Work is typically indoors in a clinical setting serving the frail and elderly.</li>
<li>There may be harmful or hazardous environmental conditions present for this job.</li>
<li>The noise level in this work environment is usually moderate to loud.</li>
</ul>
 If located in the Community: 
<ul>
<li>Work is typically indoors and sedentary and is subject to schedule changes and/or variable work hours, with travel as needed. </li>
<li>Employee will occasionally work outdoors in varied temperatures.</li>
<li>There may be harmful or hazardous environmental conditions present for this job.</li>
<li>The noise level in this work environment is usually moderate to loud.</li>
</ul>
 Why Join Us? We believe that diverse perspectives drive innovation. Each employee brings a unique perspective to the overall team and we value everyone's input and we are committed to creating an inclusive environment where you and every team member can thrive while making a meaningful impacts on our community members. Our team reflects and represents the communities we serve, and we welcome candidates from all backgrounds who share our commitment to accessible, quality healthcare. What's Your Next Step? All Applications will be accepted on a continuous basis until a sufficient number of qualified applications have been received. Do NOT miss out. If you want to join our team, the deadline for the first review of applications is November 11, 2025 at 9:00 PM (PST). We are encouraging you to apply early. If you apply after the first review date, your application is not guaranteed to be considered for this recruitment. This recruitment may close at any time without notice after the first review date. Our Commitment to You Your application and resume will be reviewed by a dedicated recruiter to this position. If your experience matches what we need, we will reach out to you to discuss the next steps. The selection process may include, but is not limited to, a skills assessment, phone screen and interview. If you make it through the steps above and are selected for this exciting role, you will be required to undergo a reference and a background check (to include a conviction record) and if applicable also pass a drug screening and/or a post-offer pre-employment medical examination (for specific positions) If you are an Internal CalOptima Health applicant, please apply through the internal portal on InfoNet. We will make sure to keep you updated through each step of the process on your candidate portal. Please make sure to watch for updates on your candidate portal and you emails which will be sent to the email address you listed on your application. Please check your email, including your SPAM folder, regularly throughout the recruitment process. CalOptima Health is committed to attracting, hiring, and retaining a diverse staff, where we will honor your unique experiences, identity, and perspectives. Our organization strives to create and maintain a workplace environment that is inclusive, equitable and welcoming so we can truly be Better Together. CalOptima Health is an equal opportunity employer and makes all employment decisions on the basis of merit. CalOptima Health wants to have qualified employees in every job position. CalOptima Health prohibits unlawful discrimination against any employee, or applicant for employment, based on race, religion/religious creed, color, national origin, ancestry, mental or physical disability, medical condition, genetic information, marital status, sex, sex stereotype, gender, gender identity, gender expression, transitioning status, age, sexual orientation, immigration status, military status as a disabled veteran, or veteran of the Vietnam era, or any other consideration made unlawful by federal, state, or local laws. CalOptima Health also prohibits unlawful discrimination based on the perception that anyone has any of those characteristics or is associated with a person who has, or is perceived as having, any of those characteristics. If you are a qualified individual with a disability or a disabled veteran, you may request a reasonable accommodation at (714) 246-8400 if you are unable or limited in your ability to access job openings or apply for a job on this site as a result of your disability. To apply, please visit: <a href="https://apptrkr.com/6687180" target="_blank">https://jobs.caloptima.org/jobs/supervisor-utilization-management-prior-authorization-505-city-parkway-west-california-united-states</a> Copyright 2025 Jobelephant.com Inc. All rights reserved. <a href="https://www.jobelephant.com/" target="_blank">Posted by the FREE value-added recruitment advertising agency</a> jeid-501b7ec506de63449aa238e8339c5068

Supervisor Utilization Management (Prior Authorization)

<h3>Job Description</h3>
Novaris Search are working with a growth minded Behavioral Healthcare provider that specialise in MH &amp; SUD. They are actively seeking an executive level Clinical Director to join the company, ensure quality care based on evidence-based practice, and maintain compliance.
 
Role:
<ul>
<li>Ensure quality of patient care is optimum</li>
<li>Supervise and train program directors.</li>
<li>Responsible for recruitment and hiring of clinical staff</li>
<li>Manage the budget, planning, reporting, and auditing</li>
<li>Meet established program targets through census maintenance and service delivery.</li>
<li>Provide administrative oversight of all program functions, including management of support staff.</li>
</ul>
 
Candidate:
<ul>
<li>Licensed psychologist (Psy.D or Ph.D. preferred)</li>
<li>5yrs+ supervisory experience</li>
<li>8yrs+ experience in MH &amp; SUD</li>
</ul>
 
If you feel you are suitable for this role, please apply below.
 
Due to the high volume of applications, we are unable to notify unsuccessful applicants. If you have not been notified of the outcome of your application within one week of the closing date, please assume you have been unsuccessful

Clinical Director - Behavioral Health

<h3>Job Description</h3>
If you want to make a significant impact as an Occupational Therapist in a Skilled Nursing Facility - SNF setting this California position might be what you are looking for!
 
Responsibilities:
<ul>
<li>Assess patients' needs and develop individualized treatment plans</li>
<li>Provide therapy to enhance functional abilities and promote independence</li>
<li>Collaborate with healthcare teams to ensure comprehensive patient care</li>
<li>Educate patients and families on adaptive strategies and equipment use</li>
<li>Monitor and document patient progress and treatment outcomes</li>
<li>Implement interventions in various settings</li>
<li>Participate in discharge planning and transitional care coordination</li>
</ul>
 
Qualifications:
<ul>
<li>Master's degree in Occupational Therapy</li>
<li>Active California Occupational Therapy Licensure</li>
<li>Ability to work effectively in a Skilled Nursing Facility (SNF) setting</li>
<li>Strong communication, time management, and clinical decision-making skills</li>
</ul>
 
Preferred Skills and Qualifications
<ul>
<li>One or more years of experience in a Skilled Nursing Facility (SNF) setting</li>
<li>Familiarity with electronic documentation systems</li>
<li>Demonstrated commitment to professional growth and patient-centered care</li>
</ul>
 
Job details:
<ul>
<li>Pay: $2,306.09 - $2,377.41 / week</li>
<li>Location: California</li>
<li>Assignment Length: 17</li>
<li>Shift: Day</li>
<li>Setting: Skilled Nursing Facility - SNF</li>
<li>Workplace: On-site</li>
</ul>
 
About Pioneer Healthcare Services:
Pioneer Healthcare Services specializes in staffing and travel recruiting for healthcare professionals across the U.S., with a focus on top school and medical opportunities. Our reputation is built on trust, rapid communication, and a commitment to your success. With a people-first culture, we ensure that the best clinicians are matched with leading school districts and healthcare facilities, offering competitive compensation and comprehensive benefits, including medical, dental, vision insurance, 401K, and relocation assistance. Experience unparalleled support from our award-winning team, available 24/7, as you transition into your dream role.

Occupational Therapist - Earn $2,306.09 - $2,377.41 Per Week

<h3>Job Description</h3>
Occupational Therapist (OT) – School &amp; Clinical Roles | Local &amp; Travel Opportunities Nationwide
Pioneer Healthcare Services is hiring Occupational Therapists for rewarding opportunities across the U.S. Whether you thrive in school-based settings, clinical environments, or a mix of both, we have positions tailored to your goals. Local and travel assignments available! 
What You’ll Do:
<ul>
<li>Assess patients’ needs and develop personalized treatment plans </li>
<li>Provide therapy to enhance functional abilities and promote independence </li>
<li>Deliver interventions in schools, outpatient clinics, hospitals, skilled nursing facilities, or home health settings </li>
<li>Educate patients, families, and staff on adaptive strategies and equipment use </li>
<li>Collaborate with interdisciplinary healthcare teams for comprehensive care </li>
<li>Monitor and document patient progress and treatment outcomes </li>
<li>Participate in IEP meetings, discharge planning, and transitional care coordination </li>
</ul>
What You Need:
<ul>
<li>Master’s Degree in Occupational Therapy (ACOTE-accredited program) </li>
<li>Active OT license (or eligibility) in assigned state </li>
<li>Open to new grads and experienced Occupational Therapists </li>
</ul>
What We Offer:
<ul>
<li>Competitive weekly pay </li>
<li>Medical, dental, vision + 401(k) </li>
<li>Licensing &amp; relocation support </li>
<li>24/7 recruiter assistance </li>
<li>Travel stipends (if applicable) </li>
<li>Opportunities in both school and clinical settings </li>
</ul>
Why Pioneer?
We’re a nationally trusted healthcare staffing firm with a people-first culture. From top school districts to leading healthcare facilities, we connect Occupational Therapists with roles that align with their lifestyle and career goals. 
 
&amp;#x1F4CD; Location: Multiple U.S. cities 
 &amp;#x1F552; Schedule: Full-time, flexible start dates 
 &amp;#x1F4BC; Type: Local &amp; Travel Assignments 
Ready to explore your next role?
 Apply today and discover where Pioneer can take you. 
 
Questions? Our recruiters are available 24/7 to support your journey.

Occupational Therapist

<h3>Job Description</h3>
Speech-Language Pathologist (SLP) – School &amp; Clinical Roles | Local &amp; Travel Opportunities Available Nationwide
Pioneer Healthcare Services is hiring Speech-Language Pathologists for exciting opportunities across the U.S. Whether you prefer school-based settings, clinical environments, or a mix of both, we have a position tailored to your goals. Local and travel assignments are available!
What You'll Do:
<ul>
<li>Evaluate and treat individuals with communication and swallowing disorders</li>
<li>Create and implement individualized treatment plans</li>
<li>Provide therapy in schools, outpatient clinics, hospitals, or skilled nursing facilities</li>
<li>Collaborate with care teams, families, and educators</li>
<li>Monitor progress and adjust interventions as needed</li>
<li>Participate in IEP or discharge planning and follow-up care</li>
</ul>
 
What You Need:
<ul>
<li>Masters in Speech-Language Pathology (ASHA-accredited)</li>
<li>Active SLP license (or eligibility) in assigned state</li>
<li>Open to new grads and experienced SLPs</li>
</ul>
 
What We Offer:
<ul>
<li>Competitive weekly pay</li>
<li>Medical, dental, vision + 401(k)</li>
<li>Licensing &amp; relocation support</li>
<li>24/7 recruiter support</li>
<li>Travel stipends (if applicable)</li>
<li>Opportunities in both school and clinical settings</li>
</ul>
 
Why Pioneer?
We’re a nationally trusted healthcare staffing firm with a people-first culture. From top school districts to leading medical facilities, we connect SLPs with roles that align with their lifestyle and career goals.
 
Why Pioneer Healthcare Services? 
We specialize in staffing and travel recruiting for SLPs across the U.S., with a focus on top school and medical opportunities. Our reputation is built on trust, rapid communication, and commitment to your success. With a people-first culture, we ensure that SLPs are matched with leading school districts and healthcare facilities, offering competitive compensation and comprehensive benefits, including medical, dental, vision insurance, 401K, and relocation assistance. 
 
&amp;#x1F4CD; Location: Multiple U.S. cities
&amp;#x1F552; Schedule: Full-time, flexible start dates
&amp;#x1F4BC; Type: Local &amp; Travel Assignments
Ready to explore your next role? Apply today and discover where Pioneer can take you.
Questions? Our recruiters are available 24/7 to support your journey.

Speech Language Pathologist

<h3>Job Description</h3>
Community health is about more than just vaccines and checkups. It’s about giving people the resources they need to live their best lives. At Neighborhood, this is our vision. A community where everyone is healthy and happy. We’re with you every step of the way, with the care you need for each of life’s chapters. At Neighborhood, we are Better Together.
 
As a private, non-profit 501(C) (3) community health organization, we serve over 350k medical, dental, and behavioral health visits from more than 77k people annually. We do this in pursuit of our mission to improve the health and happiness of the communities we serve by providing quality care to all, regardless of situation or circumstance.
We have been doing this since 1969 and it is our employees that make this mission a reality. Regardless of the role, our team focuses on being compassionate, having integrity, being professional, always collaborating, and consistently going above and beyond. If that sounds like an organization you want to be a part of, we would love to have you.
ROLE OVERVIEW and PURPOSE
As a Neighborhood Physician you will be part of a Care Team that is focused on providing the very best in patient experience when it comes to receiving comprehensive medical care. Amazing patient experiences begin with amazing providers. Our patients know that every time they walk through our doors, they can expect quality treatment from professionals who care. Through our values of compassion, integrity, professionalism, collaboration, and going above and beyond we ensure that all patients receive the very best care and support possible. Making a difference in our community is made possible by the strong members that comprise the Care Team for each patient. Alongside our Physicians, we have nurses, medical assistants, and scribes to ensure that our patients feel connected to their experience with Neighborhood.
RESPONSIBILITIES
Direct Care:
<ul>
<li>Administers or prescribes treatments</li>
<li>Discusses potential side effects to medications and/or immunizations with patients</li>
<li>Promotes health by advising patients about diet, hygiene, and methods for disease prevention</li>
<li>Refers patients to medical specialists for consultant services for their well-being, as needed</li>
<li>Follows up with patients regarding progress in high risk or emergency cases</li>
<li>Conducts physical examinations to provide information needed for admission to schools, consideration for jobs, or eligibility for insurance coverage</li>
</ul>
Provider and Team Support:
<ul>
<li>Shares accountability for overall patient health outcomes by working in coordination with care teams</li>
<li>Operates to instill confidence in our care and in our facilities to patients, fellow employees, and other stakeholders</li>
<li>Assesses training needs and promotes developmental activities of medical staff</li>
</ul>
Clinical Administration:
<ul>
<li>Reviews patient files/records, including allergies, problems, medications, and immunization status</li>
<li>Elicits and records information about patient medical history</li>
<li>Examines patients for symptoms or physical information</li>
<li>Orders and executes various test, analyses, and diagnostic images to provide information on patient’s condition</li>
<li>Analyzes reports and findings of tests, examinations, and diagnoses to understand the patient’s current condition</li>
<li>Determines and prescribes patient medications, dosages and schedules dependent on their conditions and allergies</li>
<li>Prescribes and administers vaccinations to immunize patient from communicable diseases</li>
<li>Documents patient visits, including medical history, physical exam, diagnoses, and plan of action</li>
<li>Stays informed of organizational activities and promote mission and goals</li>
<li>Reviews and responds to all forms of communication, such as emails, postal mail, voice mails</li>
<li>Functions at highest level according to credentials and competency</li>
<li>Impacts patient experience by demonstrating courteous and helpful behavior and a commitment to accuracy</li>
</ul>
Customer Relations:
<ul>
<li>Maintains professional working relationships with all levels of staff, clients, and the public</li>
<li>Cooperates in accomplishing department goals and objectives</li>
</ul>
 
EDUCATION/EXPERIENCE
<ul>
<li>Doctorate in medicine is required</li>
<li>California Medical license in good standing is required</li>
<li>Valid DEA and CPR certification is required</li>
</ul>

ADDITIONAL QUALIFICATIONS (Knowledge, Skills and Abilities)
<ul>
<li>Excellent verbal and written communication skills, including superior composition, typing and proofreading skills</li>
<li>Ability to interpret a variety of instructions in written, oral, diagram, or schedule form</li>
<li>Knowledgeable about and experience with family medicine</li>
<li>Ability to successfully manage multiple tasks simultaneously</li>
<li>Excellent planning and organizational ability</li>
<li>Ability to work as part of a team as well as independently</li>
<li>Ability to work with highly confidential information in a professional and ethical manner</li>
</ul>
Physical Requirements
<ul>
<li>Ability to lift/carry 10 lbs/weight</li>
<li>Ability to stand for long periods of time</li>
</ul>
 
COMPLIANCE (Safety &amp; HIPPA)
<ul>
<li>Follows all safety procedures as outlined in Neighborhood Healthcare’s Illness and Injury Prevention Plan (IIPP) and report any injuries and/or unsafe conditions immediately</li>
<li>Maintains current knowledge of policies and procedures as they relate to safe work practices</li>
<li>Follows all safety procedures and report unsafe conditions</li>
<li>Uses appropriate body mechanics to ensure an injury free environment</li>
<li>Familiarity with location of nearest fire extinguisher and emergency exits</li>
<li>Follows all infection control procedures including blood-borne pathogen protocols</li>
<li>Maintains privacy of all patients, employee and volunteer information and access such information only on a need-to-know basis for business purposes</li>
<li>Complies with all regulations regarding corporate integrity and security obligations</li>
<li>Reports all behavior and/or activity that are unethical, fraudulent, or unlawful</li>
</ul>
Neighborhood Healthcare requires employees to be fully vaccinated (including a booster dose) against COVID-19 and demonstrate proof of vaccination/booster upon hire or receive approval for an exemption based on a medical reason, disability or religious belief. Proof of booster dose will be contingent upon booster eligibility. 
 
Pay range: 
<ul>
<li>Family Practice- $268k-360k, per year depending on experience. (DOE)</li>
<li>Internal Medicine- $281-380k, per year depending on experience. (DOE)</li>
</ul>

21,500 Healthcare Jobs in Orange, CA, USA