- Evolent (Sacramento, CA)
- …Clinical Reviewer, Interventional Pain Management , you will be a key member of the utilization management team. We can offer you a meaningful way to make a ... utilization and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission (URAC) and National Committee for Quality… 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 +...financial analyses including cost of care to reimbursement, denials management , and non-reimbursed services, promoting effective resource utilization… more
- Centene Corporation (Sacramento, CA)
- …of Certifying Board Service (Internal and Family Medicine, preferred) + Utilization Management experience and knowledge of quality accreditation standards. ... functions for the business unit. + Provides medical leadership of all for utilization management , cost containment, and medical quality improvement activities. +… more
- Sharp HealthCare (San Diego, CA)
- …and responds to accrediting and regulatory agency feedback. + Supports pre-admission review , utilization management , and concurrent and retrospective rev1ew ... a managed care environment, preferably as an HMO Medical Director . + California Physicians and Surgeons License - Medical...process. + Participates in risk management , pharmacy utilization management , catastrophic case review ,… more
- City and County of San Francisco (San Francisco, CA)
- …Equity Action Plan (https://www.flysfo.com/sites/default/files/Racial\_Equity\_Plan-4.06.2021-v19.pdf) . ITT Project Management & Delivery Director Under the ... Transformation Officer (CDTO), the Information Technology and Telecommunications (ITT) Project Management and Delivery Director will provide strategic oversight… more
- Evolent (Sacramento, CA)
- …impact on patient care in a non-clinical setting? Join our Utilization Management team as a Field Medical Director , Cardiovascular Specialist and use your ... Senior Medical Director in research activities/questions related to the Utilization Management process, interpretation, guidelines and/or system support. +… more
- Gilead Sciences, Inc. (Santa Monica, CA)
- …Kite and help create more tomorrows. **Job Description** + The **Associate Director , Planisware Clinical Trial Planning, Resource Management , and Reporting** is ... and clinical plans + update project templates and styles.Resource Management & Reporting: + Support Director of...+ Stakeholder communication + Risk assessment & mitigation + Utilization of project management core principles (PMP… more
- Genesis Healthcare (Carmichael, CA)
- …The Director of Rehab is responsible for the efficient management of rehabilitation services in their assigned account(s). This position also assists ... Area Director ). 10. Assumes responsibility for daily staffing and utilization with input from treating therapists, consideration of clinical requirements, and… more
- Humana (Sacramento, CA)
- …. + Utilization management experience in a medical management review organization, such as Medicare Advantage, managed Medicaid, or Commercial ... operationalize this knowledge in their daily work. The Medical Director 's work includes computer based review of...size of region or line of business. The Medical Director conducts Utilization Management of… more
- Genesis Healthcare (Elk Grove, CA)
- …or In-Training (IT) Director of Rehab is responsible for assisting the Director of Rehab in the efficient management of rehabilitation services in his/her ... of Rehab with conducting or coordinating the timely completion of the annual merit review for therapy staff. 6. Assists in management of therapy staff. 7.… more