• Medical Director - Medicaid (remote)

    Humana (Sacramento, CA)
    …and interpretation skills, with prior experience participating in teams focusing on quality management , utilization management , case management , ... Case managers or Care managers on complex case management , including familiarity with social determinants...size of region or line of business. The Medical Director conducts Utilization Management of… more
    Humana (12/07/25)
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  • Director of Rehabilitation-OTA

    Genesis Healthcare (Elk Grove, CA)
    …of the rehabilitation department, including oversight related to case management , quality improvement, care planning, clinical utilization , and patient ... Director of Rehab is responsible for assisting the Director of Rehab in the efficient management ...of therapy staff. 7. Assists in daily staffing and utilization in cooperation with input from treating therapists, consideration… more
    Genesis Healthcare (11/25/25)
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  • Assistant Nursing Director , Administration

    The County of Los Angeles (Los Angeles, CA)
    …the following: + Additional experience in clinical nursing. + Supervisory** experience in Utilization Review and/or Case Management . SPECIAL REQUIREMENT ... appropriateness of the level of care. For this examination, Case Management is a collaborative process that...vacancy in Department of Health Services, Harbor-UCLA Medical Center, Utilization Management Division. May also be used… more
    The County of Los Angeles (10/18/25)
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  • PCO Medical Director - UM - Part Time…

    CenterWell (Sacramento, CA)
    …**Additional Information** Will report to the Director of Physician Strategy at Utilization Management . The Medical Director conducts Utilization ... prior experienceparticipatingin teams focusing on transitions of care, quality management ,utilizationmanagement, case management , discharge planning and/or… more
    CenterWell (11/06/25)
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  • Director of Rehab - Clinical

    Genesis Healthcare (Willows, CA)
    …of the rehabilitation department, including oversight related to case management , quality improvement, care planning, clinical utilization , and patient ... The Director of Rehab is responsible for the efficient management of rehabilitation services in their assigned account(s). This position also assists… more
    Genesis Healthcare (10/15/25)
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  • Director of Rehab - Clinical

    Genesis Healthcare (Hayward, CA)
    …of the rehab department, including oversight related to case management , quality improvement, care planning, clinical utilization , and patient identification ... Area Director ). 11. Assumes responsibility for daily staffing and utilization with input from treating therapists, consideration of clinical requirements, and… more
    Genesis Healthcare (09/20/25)
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  • Field Medical Director , Interventional…

    Evolent (Sacramento, CA)
    …impact on patient care in a non-clinical setting? Join our Utilization Management team as a Field Medical Director , Cardiovascular Specialist and use your ... Senior Medical Director in research activities/questions related to the Utilization Management process, interpretation, guidelines and/or system support. +… more
    Evolent (10/29/25)
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  • RN Case Manager - Care Coordination - Full…

    University of Southern California (Arcadia, CA)
    …timely and accurate information to payers. The role integrates and coordinates utilization management , care facilitation, and discharge planning functions. The ... follows up to resolve problems with payers as needed. + Completes utilization management for assigned patients. + Coordinates/facilitates patient cares… more
    University of Southern California (11/19/25)
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  • Medical Director , Medical…

    Highmark Health (Sacramento, CA)
    …:** **JOB SUMMARY** This job, as part of a physician team, ensures that utilization management responsibilities are performed in accordance with the highest and ... and DOL regulations at all times. In addition to utilization review, the incumbent participates as the physician member...need. **Preferred** + None **SKILLS** + Critical Thinking + Case Management + Customer Service + Oral… more
    Highmark Health (11/21/25)
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  • Medical Director - Medical Oncology

    Elevance Health (Walnut Creek, CA)
    **Clinical Operations Medical Director ** **Medical Oncology** **Carelon Medical Benefit Management ** **Virtual** : This role enables associates to work virtually ... domains, including radiology, cardiology and oncology._ The **Clinical Operations Medical Director ** is responsible for supporting the medical management staff… more
    Elevance Health (12/04/25)
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