- Humana (Sacramento, CA)
- …of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement to make determinations ... how to operationalize this knowledge in their daily work. The Medical Director 's work includes computer-based review of moderately complex to complex clinical… more
- Evolent (Sacramento, CA)
- …in a timely and accurate manner. . May assist the Senior Medical Director in research activities/questions related to the Utilization Management process, ... culture. **What You'll Be Doing:** As a Field Medical Director , Oncology, you will be a key member of...Oncology, you will be a key member of the utilization management team. We can offer you a meaningful… more
- Sevita (Hayward, CA)
- …Join us today, and experience a career well lived. **Program Management - Program Director IDD Services Host Home** **Salary - $68,640 per year** Are you an ... and the energy and focus to run a thriving Host Home program? As Program Director , you will be responsible for overseeing all services delivered within the Host Home… more
- Humana (Sacramento, CA)
- …of our caring community and help us put health first The Medical Director actively uses their medical background, experience, and judgement to make determinations ... how to operationalize this knowledge in their daily work. The Medical Director 's work includes reviewing of all submitted medical records, synthesizing complex… more
- Molina Healthcare (San Bernardino, CA)
- …of health care services provided to plan members. * Supports plan utilization management program and accompanying action plan(s), which includes strategies to ensure ... most appropriate care at the most effective setting. *Evaluates effectiveness of utilization management (UM) practices - actively monitoring for over and under-… more
- University of Southern California (Los Angeles, CA)
- The Senior Director , Integrated Risk Management, is responsible for designing and executing the Keck Medicine of USC Office of Integrated Risk Management at the ... evaluate, mitigate and monitor the Health System's Clinical Risk. Senior Director will facilitate the identification of risk management trends across various… more
- Humana (Sacramento, CA)
- …a part of our caring community and help us put health first** The Medical Director relies on broad clinical expertise to review Medicare drug appeals (Part D & B). ... The Medical director work assignments involve moderately complex to complex issues...prior experience participating in teams focusing on quality management, utilization management, or similar activities **Preferred Qualifications:** + Knowledge… more
- Elevance Health (Los Angeles, CA)
- **Behavioral Health Medical** ** Director -Psychiatrist** **Appeals** **Location:** This role enables associates to work virtually full-time, with the exception of ... Half day Saturday rotation, once a month.** The **Medical Director ** is responsible for the administration of behavioral health...state or territory of the United States when conducting utilization review or an appeals consideration and cannot be… more
- Evolent (Sacramento, CA)
- …of our specialty programs and administrative platform. **Role Overview** The Senior Director role on Client Analytics will lead the development and execution of ... visualization, this role will collaborate cross-functionally to influence the effective utilization of data to deliver actionable insights, drive recommendations and… more
- Evolent (Sacramento, CA)
- …in a timely and accurate manner. + May assist the Senior Medical Director in research activities/questions related to the Utilization Management process, ... Radiology you will be a key member of the utilization management team. We can offer you a meaningful...consistency in the MD review process to reflect appropriate utilization and compliance with SBU`s policies/procedures, as well as… more