Top 32 Utilization management Jobs in Merced Ca

Bilingual Case Management Specialist (Remote Flexible, Spanish Speaking)
Pair Team —Merced, CA
- $22 - $25 an hour
- Email
- Background check
- Spanish
- HIPAA
- Dental insurance
- 401(k)
Quick Apply
7d
ECM Case Specialist
Livingston Community Health —Livingston, CA
- $24.93 - $28.66 an hour
- Extended hours
- Spanish
- Hospital
- Writing skills
12h
Hospital President
Dignity Health —Merced, CA
- $185.44 - $259.62 an hour
- Full-time
- Hospital
- 5 years
- Master's degree
PACE Associate Medical Director (PACE Merced)
Central Valley PACE —Merced, CA
- $290,000 - $345,000 a year
- Evenings as needed
- Clean driving record
- Medicine
- BC/BE
- 403(b) matching
- Relocation assistance
Quick Apply
Registered Nurse
Caring Hand Home Health Solutions, Inc. —Turlock, CA
- $110 - $130 a year
- Part-time
- Remote
- CPR Certification
- RN License
- BLS Certification
- Mileage reimbursement
- Flexible schedule
Quick Apply
14d
Bilingual Licensed Vocational Nurse (LVN) - Merced
LA FAMILIA —Turlock, CA
- $37.50 an hour
- Full-time
- Hybrid work
- Spanish
- Google Workspace
- Nursing
- Paid holidays
- Health insurance
Quick Apply
Physician - Primary Care Clinic
Community Health Centers of America —Merced, CA
- $300,000 - $350,000 a year
- Part-time
- Medicine
- Management
- Writing skills
- Relocation assistance
- Health insurance
Quick Apply
Clinic Physician - Endocrinologist
Community Health Centers of America —Merced, CA
- $250,000 - $350,000 a year
- Full-time
- Medicine
- Writing skills
- BLS Certification
- Relocation assistance
- Health insurance
Quick Apply
Clinic Physician - Gastroenterologist
Community Health Centers of America —Livingston, CA
- $250,000 - $350,000 a year
- Full-time
- Medicine
- Writing skills
- BLS Certification
- Relocation assistance
- Health insurance
Quick Apply
Physician - Pediatrics for Primary Care Clinic
Community Health Centers of America —Livingston, CA
- $280,000 - $300,000 a year
- Part-time
- Medicine
- Management
- Writing skills
- Relocation assistance
- Health insurance
Quick Apply
Hospital - Clinical Pharmacist Specialist (Bone Marrow Transplant)
UT Health Science Center at San Antonio —United States
- Hospital
- Outpatient experience
- 3 years
Quick Apply
Remote Physician (MD/DO), PMR or Neurology, Outpatient Prior Authorizations (REMOTE/FT) (IC to FTE)
Virtix Health —United States
- $125 an hour
- 8 hour shift
- Remote
- Background check
- Medicine
- Doctoral degree
- Work from home
Quick Apply
Family Medicine Medical Director Utilization Management
Amerihealth Caritas —United States
- Weekends as needed
- Hybrid work
- Medicine
- Physical & Rehabilitation Medicine
- 3 years
- Paid holidays
- Health insurance
Appeal Analyst RN | Remote | Contract
Walker Healthforce, LLC —United States
- Contract
- Remote
- Nursing
- Microsoft Outlook
- RN License
- Health insurance
- Dental insurance
Quick Apply
Physician Assistant/Nurse Practitioner (D), CVOR - Regional
Corewell Health —United States
- Weekends as needed
- Acute care
- Nursing
- Surgery
- Free parking
- Paid holidays

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utilization management jobs near merced ca

Bilingual Case Management Specialist (Remote Flexible, Spanish Speaking)

Pair Team -
Merced, CA

Quick Apply

Job Details

Full-time
$22 - $25 an hour
7 days ago

Benefits

Dental insurance
401(k)
Work from home
Vision insurance

Qualifications

Spanish
Interdisciplinary collaboration in health services social work
HIPAA
English
Driver's License
Video conferencing software
Collaborative technology platforms
Multidisciplinary team collaboration for treatment planning
Working with individuals from diverse cultural backgrounds
CRM system proficiency
Productivity software
Video conferences (communication methods)
Video conferencing systems operation

Full Job Description

About Pair Team

At Pair Team, we're an innovative, mission-driven company reimagining how Medicaid and Medicare serves the most underserved populations. As a tech-enabled medical group, we deliver whole-person care - clinical, behavioral, and social - by partnering with organizations deeply connected to the communities we serve.

We're building a care model that empowers clinicians and care teams to do what they do best: provide compassionate, high-impact care. At Pair Team, we leverage AI and automation to reduce administrative burden, streamline coordination, and ensure patients receive timely, personalized support.

Our work is powered by a deeply collaborative team of nurses, social workers, community health workers, and medical professionals working alongside product, technology, and operations to close care gaps and improve outcomes for high-need patients.

We're one of the largest Enhanced Care Management providers in California and are on track to build the nation's largest clinically integrated network supporting high-need patients. Our model has demonstrated real impact, including a 58% reduction in emergency department visits and a 29% reduction in hospital admissions.

At Pair Team, were not just delivering care - we're building the future of more equitable, community-driven healthcare.

Our Values

Lead with integrity: We keep our commitments and take responsibility for our actions. We are dependable and choose authenticity over perfection.
Embrace challenges: We leave our egos at the door and step forward into discomfort instead of back into safety. We help each other to learn and provide feedback using candor and kindness.
Break through walls: We go the extra mile for our patients, partners and one another, and we run toward hard things. We are resilient in our push for consistent improvement and challenge the status quo.
Act beyond yourself: We build each other up and respect boundaries. We seek first to understand and assume positive intent.
Care comes first: We hold ourselves to the highest standards for our patients. We are relentless in the pursuit of our mission, and ensure that we are taking care of ourselves in order to care for others.

In the News

Forbes: For Pair Team, Accessibility Is About Delivering Healthcare To Those Who Need It The Most
TechCrunch: Building for Medicaid's regulatory moment with Neil Batlivala from Pair Team
Axios: Pair Team collects $9M for Medicaid-based care

About the Opportunity

Pair Team is building a team of deeply passionate individuals ready to change primary care operations for those who need it most. We are looking for a highly motivated full-time Lead Care Manager who is willing to think creatively and empathically to help our team change the way people access healthcare.

We seek a full-time Lead Care Manager to play a critical role in our whole-person, interdisciplinary care model, responsible for directly outreaching and engaging with individuals living with Serious Mental Illness/ Substance Use Disorder, experiencing homelessness, and/or those who have high medical needs. We believe in the power of trust and relationships to successfully engage those who may have never received the kind of whole-health care that Pair Team can provide.

This position primarily allows for remote work; however, it includes 2-3 times a month on-site visits in the community alongside a fellow PairMate. You can expect to engage in these in-person activities 2-3 times per month, close to your city, while the majority of your duties, approximately 90%, will be performed from your home

What You'll Do

Maintain ongoing caseload of individuals through the utilization of evidence based approaches to promote engagement and achievement of health goals
Use relationship-based strategies to support members with social support navigation, understanding that many may have lived personal experiences causing them to be initially hesitant or distrusting of the health care system
Conducts periodic telephonic and SMS outreach to ensure timely follow-up to members
Work with member to identify health/wellness goals and incorporate goals into Health Action Plan/Shared Care Plan
Supports nurse care manager, behavioral health care manager, nurse practitioner and Community Engagement Specialist with delegated tasks
Collaborates on care issues with Enhanced Care Management team by participating in systematic case reviews and consulting with nurse care manager, behavioral health care manager, and nurse practitioner before taking clinical actions
Consistently meet monthly encounter metrics to ensure compliance with health plan regulations
Identify and break down barriers ensuring individuals' continuation with the program
Assists individuals in securing connection to community supports by scheduling appointments, managing referrals, and ensuring timely follow-ups
Coordinate physical care management appointments through collaboration with external and internal providers
Utilize external and internal online platforms to collaborate with team members and carry out daily tasks

What You'll Need

1+ years of general work experience (Case Management preferred)
You are physically located in California
- Field Ops requires you to maintain reliable transportation for engagement at clinic, community based organization, and health system partner locations
- Virtual Ops requires a quiet, HIPAA compliant and internet connected space
Bilingual – English/Spanish
Strong understanding of cultural fluency
High degree of empathy
Ability to work collaboratively in a multidisciplinary team
An eye for optimization
Organizational skills
Ability to remain patient when faced with adversity
Strong technical skills and comfort with technology innovation, past experience with CRM databases, basic Excel, Word, email, and video conferencing
A valid driver's license and auto liability insurance

Preferred Qualifications:

Demonstrated professional or personal lived experience working closely with individuals experiencing complex chronic needs, homelessness, or Severe Mental Illness/Substance Use Disorder
2+ years of case management experience
Experience with motivational interviewing
Knowledge of medical terminology
Zest for problem solving, seeking answers, and thinking outside the box
Detail-oriented and organized self-starter who is a rockstar multitasker
Reliable and comfortable in an ever-changing environment

Because We Value You

Salary: $22-$25/hour
Comprehensive health, vision & dental insurance
401k
Monthly $100 work from home expense stipend for your WFH days
Gas reimbursements for your on-site engagement days
- take the time you need to recharge!
We provide all of the equipment needed for the role
Opportunity for rapid career progression with plenty of room for personal growth!

Pair Team is an Equal Opportunity Employer. At Pair Team, we value diversity and strive to provide an inclusive environment for all applicants and employees. All applicants will be considered without regard to race, color, religion, sex (including pregnancy, gender identity, and sexual orientation), national origin, marital status, age, disability, political affiliation, military service, genetic information, or any other characteristic covered by federal, state, or local law.

Pair Team participates in E-Verify to verify employment eligibility for new hires.

Any offer of employment at Pair Team is conditioned upon passing a pre-employment background check. Following a conditional job offer, candidates will undergo comprehensive employment background checks, including; criminal history, reference checks, and driving records if a role requires vehicle use.

We do not conduct any TA business outside of our @pairteam.com emails. If you're ever concerned about spam or fraudulent activity, please reach out to [email protected].

Note: Please be aware that while we sincerely appreciate your interest, due to the high volume of requests, we're unable to respond to general position inquiries via email. To apply for a position with us, please submit your application for the role you are interested in. Our team regularly reviews applications and will reach out to candidates whose qualifications align with our current openings listed below. Thank you!

Quick Apply

Refine Your Search

utilization management jobs in merced ca

Bilingual Case Management Specialist (Remote Flexible, Spanish Speaking)

ECM Case Specialist

Hospital President

PACE Associate Medical Director (PACE Merced)

Registered Nurse

Bilingual Licensed Vocational Nurse (LVN) - Merced

Physician - Primary Care Clinic

Clinic Physician - Endocrinologist

Clinic Physician - Gastroenterologist

Physician - Pediatrics for Primary Care Clinic

Hospital - Clinical Pharmacist Specialist (Bone Marrow Transplant)

Remote Physician (MD/DO), PMR or Neurology, Outpatient Prior Authorizations (REMOTE/FT) (IC to FTE)

Family Medicine Medical Director Utilization Management

Appeal Analyst RN | Remote | Contract

Physician Assistant/Nurse Practitioner (D), CVOR - Regional