- Alameda Health System (Oakland, CA)
- …Title 22 and other regulatory agencies and overall hospital policies; integrates managed care contract criteria into overall Case Management functions. + ... Director , Inpatient System Care Management +... Director , Inpatient System Care Management + Oakland, CA + Highland General...hiring! Under the direction of the Vice President of Care Management, the Director of Inpatient System… more
- Sharp HealthCare (San Diego, CA)
- …a system that gives feedback to providers individually and collectively regarding managed care effectiveness of individual providers and networks. + Assists ... business practices. **What You Will Do** This Senior Medical Director position provides critical management and oversight for Sharp...plans to address issues and improve plan and network managed care performance. + Collaborates with Chief… more
- Ventura County (Ventura, CA)
- …through division managers, a comprehensive system of integrated behavioral health services, managed care operations and administrative services; + Assists the ... best practices of behavioral health program planning and administration including managed care operations; recruitment, supervision and personnel management;… more
- Humana (Sacramento, CA)
- …services such as inpatient rehabilitation. **Preferred Qualifications** + Knowledge of the managed care industry including Medicare Advantage, Managed ... a medical management review organization, such as Medicare Advantage, managed Medicaid, or Commercial health insurance. + Experience with...size of region or line of business. The Medical Director conducts Utilization Management of the care … more
- CommonSpirit Health (Rancho Cordova, CA)
- …The Market Director , Payer Strategy and Relationships (PSR), is responsible for managed care policies, goals and objectives related to contract language and ... payer relationships, negotiations, organizational contractual obligations, and developments in the managed care marketplace including Fee For Service and… more
- Scripps Health (San Diego, CA)
- * Director position is eligible for new hire incentives*...and full global risk HMO, PPO, and Ancillary services managed care agreements with health plans on ... *Participates in the Director Incentive Plan.* *Located in La Jolla, San Diego...in the analysis, management, accounting, and budgeting of all managed care agreements. Establish effective lines of… more
- Humana (Sacramento, CA)
- …management, or similar activities **Preferred Qualifications:** + Knowledge of the managed care industry, Integrated Delivery Systems, health insurance, or ... community and help us put health first** The Medical Director relies on broad clinical expertise to review Medicare...responsibilities as determined necessary to support optimal value based care in accordance with Medicare and Humana policy. The… more
- University of Southern California (Los Angeles, CA)
- …(MBA) or Health Administration (MHA) or related. . Knowledge and experience in managed health care . General understanding including but not limited to: claims ... Associate Director , Health PlansApply (https://usc.wd5.myworkdayjobs.com/ExternalUSCCareers/job/Los-Angeles-CA University-Park-Campus/Associate- Director --Health-Plans\_REQ20160798/apply) Keck… more
- Grifols Shared Services North America, Inc (Modesto, CA)
- …presentations to appropriate groups such as the following: key accounts, managed care organizations, integrated systems, national medical associations, and ... more than 110 countries and regions. The primary responsibility of the MSL Field Director is the management, performance, and coaching of a team of MSL direct… more
- Sutter Health (Sacramento, CA)
- …MARKET VALUE ANALYSIS. Provides Clinical Informatics leadership with focus on Ambulatory Primary Care to maximize the health of patients we serve at Sutter Health ... + Leadership and management experience within a complex multi-site matric managed healthcare environment. + Understanding of and proven experience in utilizing… more