- Evolent (Sacramento, CA)
- … utilization and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission (URAC) and National Committee for Quality ... Management, you will be a key member of the utilization management team. We can offer you a meaningful...the regulatory timeframe of the request. + Utilizes medical/clinical review guidelines and parameters to assure consistency in the… more
- Sevita (Suisun City, CA)
- …annual Program Supervisor and Mentor Recruiter evaluations in consultation with Area Director ; review and approve annual Program Services Clinical Coordinator ... all every day. Join us today, and experience a career well lived. **Program Director IDD Services Host Home** **Compensation - $68,640** Are you an experienced QIDP… 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 ... consideration of the Medicare rules, Humana policies and medical necessity. The Medical Director 's work includes computer based review of moderately complex to… more
- Alameda Health System (Oakland, CA)
- …contracted vendors. + Responsible for the coordination and support of the AHS Utilization Review Committee. + Responsible for overseeing patient, physician and ... Director , Inpatient System Care Management + Oakland, CA...the collection, analysis and presentation data relevant to the utilization of healthcare resources, including but not limited to… more
- Evolent (Sacramento, CA)
- … utilization and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission (URAC) and National Committee for Quality ... in a timely and accurate manner. . May assist the Senior Medical Director in research activities/questions related to the Utilization Management process,… more
- Evolent (Sacramento, CA)
- … utilization and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission (URAC) and National Committee for Quality ... in a timely and accurate manner. + May assist the Senior Medical Director in research activities/questions related to the Utilization Management process,… more
- Elevance Health (Corona, CA)
- …must be located in a state or territory of the United States when conducting utilization review or an appeals consideration and cannot be located on a US ... **Medical Director ** _Please note that per our policy t_...reviews with attending physicians or other providers to discuss review determinations, and patients' office visits with providers and… more
- Transdev (San Francisco, CA)
- Overview: We are seeking a strategic and operationally excellent Regional Director of Fleet Operations to lead and scale autonomous vehicle (AV) fleet operations ... across California. This leader will drive efficient fleet utilization , vehicle readiness, charging infrastructure, and yard management while embedding safety and… more
- Evolent (Sacramento, CA)
- … utilization and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission (URAC) and National Committee for Quality ... in a timely and accurate manner. + May assist the Senior Medical Director in research activities/questions related to the Utilization Management process,… more
- Elevance Health (Walnut Creek, CA)
- …must be located in a state or territory of the United States when conducting utilization review or an appeals consideration and cannot be located on a US ... **Behavioral Health Medical Director -Psychiatrist Appeals** **Location:** California. This role enables associates...with attending physicians or other ordering providers to discuss review determinations. + Serves as a resource and consultant… more