• Director , Utilization Management

    Alameda Health System (Oakland, CA)
    Director , Utilization Management + Oakland, CA + Highland General Hospital + SYS Utilization Management + Full Time - Day + Nursing + Req #:40826-30155 + ... plans **Role Overview:** Alameda Health System is hiring! The Director of Utilization Management holds a critical...Health System is hiring! The Director of Utilization Management holds a critical role encompassing operational oversight,… more
    Alameda Health System (11/07/25)
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  • Utilization Review Clinician (Santa Rosa)

    Sacramento Behavioral Healthcare Hospital (Santa Rosa, CA)
    …RANGE: LVN/LPT $35.00-44.19 Per Hour RN/LCSW/LMFT/LPCC $54.00-68.18 Per Hour REPORTS TO: Director of Utilization Review DESCRIPTION OF POSITION: Work as member ... and optimize reimbursement for external reviewers/third party payers. The Utilization Review Clinician maintains knowledge of, participates in further training… more
    Sacramento Behavioral Healthcare Hospital (12/11/25)
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  • Director of Case Management…

    Prime Healthcare (Inglewood, CA)
    …full-time or part-time. Responsibilities We are seeking a strategic and compassionate Director of Case Management to lead our dynamic Case Management Team consisting ... and Clinical Coordinators. This leader will oversee all facets of utilization management, discharge planning, and care coordination to ensure patients receive… more
    Prime Healthcare (10/18/25)
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  • Medical Director - Medicaid N. Central

    Humana (Sacramento, CA)
    …to the Lead Medical Director - North Central Medicaid Markets. The Medical Director conducts Utilization Management of the care received by members in the ... a part of our caring community and help us put health first** The Medical Director relies on medical background and reviews health claims. The Medical Director more
    Humana (10/25/25)
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  • Medical Director - Medicaid (remote)

    Humana (Sacramento, CA)
    Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members in an ... a part of our caring community and help us put health first** The Medical Director relies on medical background and reviews health claims. The Medical Director more
    Humana (12/07/25)
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  • PCO Medical Director - UM - Part Time…

    CenterWell (Sacramento, CA)
    …toadaptand the courage to innovate. **Additional Information** Will report to the Director of Physician Strategy at Utilization Management. The Medical ... a part of our caring community and help us put health first** The Medical Director , Primary Care relies on medical background and reviews health claims. The Medical … more
    CenterWell (11/06/25)
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  • Medical Director - IP Claims Management

    Humana (Sacramento, CA)
    …Lead Medical Director , depending on the line of business. The Medical Director conducts Utilization Management or clinical validation of the care received by ... of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement to make determinations… more
    Humana (12/11/25)
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  • Medical Director Managed Care Physician…

    Dignity Health (Bakersfield, CA)
    …patient monitoring, and CRM. - Provide backup support to the Medical Director of Utilization Management in medical review activities, peer-to-peer consultations, ... primarily in the Bakersfield/Central CA region.** **Position Summary:** The Medical Director of Physician Engagement is responsible for developing and driving… more
    Dignity Health (12/14/25)
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  • Medical Director , Ventura County Health…

    Ventura County (Ventura, CA)
    …communicates matters of VCHCP medical policy with the Health Care Agency Director and Insurance Administrator, Utilization Management staff and Quality Assurance ... Medical Director , Ventura County Health Care Plan Print (https://www.governmentjobs.com/careers/ventura/jobs/newprint/4924113) Apply  Medical Director , Ventura… more
    Ventura County (10/31/25)
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  • Director - Workforce Optimization

    Stanford Health Care (Menlo Park, CA)
    …with organizational goals, enhance operational performance, and ensure optimal resource utilization . The Director will collaborate closely with Human Resources, ... America) **This is a Stanford Health Care job.** **A Brief Overview** The Director - Workforce Optimization is a strategic leader responsible for driving labor… more
    Stanford Health Care (11/26/25)
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