• Medical Director -Pharmacy Appeals

    Humana (Sacramento, CA)
    …interpretation skills, with prior experience participating in teams focusing on quality management , utilization management , or similar activities **Preferred ... community and help us put health first** The Medical Director relies on broad clinical expertise to review Medicare...Integrated Delivery Systems, health insurance, or clinical group practice management + Utilization management experience… more
    Humana (08/22/25)
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  • Field Medical Director , Oncology

    Evolent (Sacramento, CA)
    …Senior Medical Director in research activities/questions related to the Utilization Management process, interpretation, guidelines and/or system support. . ... and costly health conditions. Working across specialties and primary care , we seek to connect the pieces of fragmented...Oncology, you will be a key member of the utilization management team. We can offer you… more
    Evolent (08/19/25)
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  • Field Medical Director , Physical Medicine…

    Evolent (Sacramento, CA)
    …Senior Medical Director in research activities/questions related to the Utilization Management process, interpretation, guidelines and/or system support. + ... and costly health conditions. Working across specialties and primary care , we seek to connect the pieces of fragmented...Rehab you will be a key member of the utilization management team. We can offer you… more
    Evolent (07/24/25)
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  • Medical Director (US)

    Elevance Health (Corona, CA)
    …agency.*_ **Preferred Skills, Capabilities and Experiences:** + 3-5 years minimum Utilization Management experience strongly preferred. + Strong oral, written, ... entire clinical program and/or independently performs clinical reviews. The Medical Director typically has program management responsibilities including clinical… more
    Elevance Health (08/23/25)
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  • Program Director

    Sevita (Suisun City, CA)
    …strategy to manage census, maintain occupancy, improve daily attendance, and/or maximize utilization + Financial Management + When applicable, approve purchase ... us today, and experience a career well lived. **Program Director IDD Services Host Home** **Compensation - $68,640** Are...- $68,640** Are you an experienced QIDP professional with management ability and the energy and focus to run… more
    Sevita (08/26/25)
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  • Medical Director , John George Psychiatric…

    Alameda Health System (San Leandro, CA)
    …leader of the department to ensure delivery of safe, timely, high-value, equitable care . The Medical Director works with department Lead Physicians to oversee ... Medical Director , John George Psychiatric Hospital + San Leandro,...volunteers. 8. Assures that the facility complies with all utilization review and case management requirements of… more
    Alameda Health System (08/08/25)
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  • Behavioral Health Medical Director

    Elevance Health (Walnut Creek, CA)
    …Capabilities and Experiences:** + Child and Adolescent experience preferred. + Utilization Management experience. + Applied Behavior Analysis (ABA) experience. ... **Behavioral Health Medical Director -Psychiatrist Appeals** **Location:** California. This role enables associates...services, to ensure the appropriate and most cost-effective medical care is received. May be responsible for developing and… more
    Elevance Health (08/15/25)
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  • Director , Performance Suite Analytics

    Evolent (Sacramento, CA)
    … functions + Knowledge of healthcare underwriting methodologies + Familiarity with value-based care and utilization management + Understanding of data ... people with most complex and costly health conditions. Working across specialties and primary care , we seek to connect the pieces of fragmented health care more
    Evolent (07/09/25)
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  • Director , Client Engagement (Marketing)

    Stanford Health Care (Palo Alto, CA)
    …Day - 08 Hour (United States of America) **This is a Stanford Health Care job.** **A Brief Overview** A front-facing marketing leader and relationship builder for ... across the Enterprise, that may include Stanford Medicine Partners, Stanford Health Care Tri-Valley, Digital Health, Corporate Partners and Accountable Care more
    Stanford Health Care (08/21/25)
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  • Radiation Therapy Director , Clinical…

    Cedars-Sinai (Los Angeles, CA)
    …engages finance to ensure adequate financial performance, effective expense reduction, utilization management , budget control and new revenue generation. + ... **Job Description** The Director , Clinical Operations for Radiation Oncology will be...for Radiation Oncology will be responsible for the overall management and leadership in the delivery of comprehensive, high-quality… more
    Cedars-Sinai (08/28/25)
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