Top 8 Authorization nurse Jobs in Placerville, Ca

Care Management - Nurse, Senior
Blue Shield of California —El Dorado Hills, CA
- $90,860 - $136,290 a year
- Weekends as needed
- Hybrid work
- Background check
- Nursing
- 5 years
- Work from home
Sr. Licensed Vocational Nurse (LVN) Outpatient Specialty Care
UC Davis Health —Folsom, CA
- $38.61 - $48.04 an hour
- 8 hour shift
- Background check
- CPR Certification
- Nursing
- Continuing education credits
- Paid holidays
14d
Public Health Nurse Supervisor
County of El Dorado —Placerville, CA
- $106,225.60 - $129,126.40 a year
- Full-time
- CPR Certification
- Nursing
- RN License
- Disability insurance
- Flexible spending account
Licensed Vocational Nurse (LVN)
WESTERN SIERRA MEDICAL CLINIC INC —Auburn, CA
- $30 - $40 an hour
- Full-time
- Microsoft Word
- Spanish
- Nursing

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CA Telephonic Case Manager I
CorVel Corporation —Folsom, CA
URAC recognized Case Management certification (ACM, CCM, CDMS, CMAC, CMC, CRC, CRRN, COHN, COHN-S, RN-BC) required to be obtained within 3 years of hire if no…
$30.64 - $45.80 an hour
Quick Apply
Quality Assurance Nurse
CorVel Corporation —Folsom, CA
Develop and oversee case management manager mentor program to facilitate the onboarding of new supervision and management to equip field with the tools for…
$61,053 - $98,334 a year
Quick Apply
7d

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Utilization Review Specialist - Autism
Nationwide Children's Hospital —Columbus, OH
Bachelor’s Degree in Social Work, Psychology, or related field, required. Documents all case reviews and maintains accurate records of all clinical activities…
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Nurse Case Manager - Internal (Medical Review Nurse - PN 20014026)
State of Ohio - Health —Columbus, OH
Current and valid license to practice professional nursing as Registered Nurse (i.e., R.N.). Current and valid license to practice professional nursing as…
$34.96 - $36.65 an hour

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authorization nurse jobs near placerville, ca

Care Management - Nurse, Senior

Blue Shield of California -
El Dorado Hills, CA

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Job Details

Full-time
$90,860 - $136,290 a year

Benefits

Work from home

Qualifications

Collaborate with healthcare professionals
Care plan evaluation
Nursing
Managed care organization experience
5 years
Bachelor of Science
CMS
Master's degree
Managing patients as a nurse case manager
Transitional care planning in clinical case management
CMS regulatory compliance
Healthcare referral management
Overseeing care coordination
Evidence-based practice
Continuous improvement
Utilization management
Medical treatment knowledge
Decision making
Clinical outcome improvement
Bachelor of Science in Nursing
Multidisciplinary team collaboration for treatment planning
Bachelor's degree in nursing
Health insurance referral requirements
Certified Case Manager
Case referral
Senior level
Care coordination
Associate's degree
Associate Degree in Nursing
Cross-functional communication

Full Job Description

Your Role

The Care Management team independently manages complex and high-risk care management cases by applying advanced clinical judgment to assess medical necessity, develop cost-effective care plans, and support quality outcomes aligned with benefit and contract requirements. You will collaborate with providers, medical directors, and interdisciplinary teams to coordinate care, support discharge planning, evaluate barriers to care, and ensure members receive appropriate referrals and continuity of treatment. This position also requires ongoing reassessment of care plans, awareness of healthcare trends and clinical guidelines, and the ability to participate in a rotating evening and weekend on-call schedule.

Our leadership model is about developing great leaders at all levels and creating opportunities for our people to grow – personally, professionally, and financially. We are looking for leaders that are energized by creative and critical thinking, building and sustaining high-performing teams, getting results the right way, and fostering continuous learning.

Your Work

In this role, you will:

Work with minimal supervision to manage complex care management cases
Apply advanced clinical judgment to assess medical necessity and appropriateness of care
Design and implement treatment and care plans that promote quality, cost‑effective outcomes aligned with benefit and contract requirements
Coordinate discharge planning activities for complex and high‑risk cases
Determine appropriateness of referrals to care management and specialty programs
Collaborate with providers, medical directors, and interdisciplinary teams to support member treatment plans and care continuity
Evaluate member health behaviors, cultural influences, and belief systems to identify barriers to care
Contribute clinical input to medical directors and support informed decision making
Continuously improve outcomes by anticipating barriers and adjusting plans of care based on reassessment, clinical changes, and guideline updates
Maintain current knowledge of healthcare service trends, regulations, and clinical practice guidelines
Ability to work evenings and weekends as part of rotating on-call schedule
Perform other duties as assigned

Your Knowledge and Experience

Associate Degree in Nursing required or master's degree in relevant field for non-RN licensure.
Bachelor of Science in Nursing is preferred
5 years of experience in nursing, healthcare, or a related clinical field
3 years of managed care experience preferred
Certified Case Manager (CCM) is preferred
Ability to independently assess, evaluate, and interpret complex clinical information and care plans
Advanced knowledge of evidence based clinical practice guidelines, particularly for chronic conditions
Demonstrated competence in care management functions and standards of practice
Knowledge of community resources, treatment options, home health services, funding sources, and specialty programs
Working knowledge of regulatory and accreditation standards including CMS, DHCS, URAC, NCQA, DMHC, MHPAEA, and CA SB 855 is preferred

Hybrid Virtual Work

This role allows employees to work virtually full-time, however employees will be expected to come to the office based on business need.

ABOUT THE TEAM
About Blue Shield of California

As of January 2025, Blue Shield of California became a subsidiary of Ascendiun. Ascendiun is a nonprofit corporate entity that is the parent to a family of organizations including Blue Shield of California and its subsidiary, Blue Shield of California Promise Health Plan; Altais, a clinical services company; and Stellarus, a company designed to scale healthcare solutions. Together, these organizations are referred to as the Ascendiun Family of Companies.

At Blue Shield of California, our mission is to create a healthcare system worthy of our family and friends and sustainably affordable. We are transforming health care in a way that genuinely serves our nonprofit mission by lowering costs, improving quality, and enhancing the member and physician experience.

To achieve our mission, we foster an environment where all employees can thrive and contribute fully to address the needs of the various communities we serve. We are committed to creating and maintaining a supportive workplace that upholds our values and advances our goals.

Blue Shield is a U.S. News Best Company to work for, a Deloitte U.S. Best Managed Company and a Top 100 Inspiring Workplace. We were recognized by Fair360 as a Top Regional Company, and one of the 50 most community-minded companies in the United States by Points of Light. Here at Blue Shield, we strive to make a positive change across our industry and communities – join us!

Our Values:

Honest. We hold ourselves to the highest ethical and integrity standards. We build trust by doing what we say we're going to do and by acknowledging and correcting where we fall short.
Human. We strive to listen and communicate effectively, showing empathy by understanding others' perspectives.
Courageous. We stand up for what we believe in and are committed to the hard work necessary to achieve our ambitious goals.

Our Workplace Model

We believe in fostering a workplace environment that balances purposeful in-person collaboration with flexibility - providing clear expectations while respecting the diverse needs of our workforce. Our workplace model is designed around intentional in-person interaction, collaboration, connection, creativity and flexibility:

For most teams, this means coming into the office two days per week.
Employees living more than 50 miles from an office location, out of state employees, and employees in certain member-facing roles should work with their manager to determine in-office time based on business need.
For employees with medical conditions that may impact their ability to work in-office, we are committed to engaging in an interactive process and providing reasonable accommodations to ensure their work environment is conducive to their success and well-being.

The Company reserves the right to require more presence in the office based on business needs, and requirements are subject to change with periodic reviews.

Physical Requirements:

Office Environment - roles involving part to full time schedule in Office Environment. Based in our physical offices and work from home office/deskwork - Activity level: Sedentary, frequency most of work day.

Equal Employment Opportunity:

External hires must pass a background check/drug screen. Qualified applicants with arrest records and/or conviction records will be considered for employment in a manner consistent with Federal, State and local laws, including but not limited to the San Francisco Fair Chance Ordinance. All qualified applicants will receive consideration for employment without regards to race, color, religion, sex, national origin, sexual orientation, gender identity, protected veteran status or disability status and any other classification protected by Federal, State and local laws.

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Refine Your Search

authorization nurse jobs in placerville, ca

Care Management - Nurse, Senior

Sr. Licensed Vocational Nurse (LVN) Outpatient Specialty Care

Public Health Nurse Supervisor

Licensed Vocational Nurse (LVN)

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