- Highmark Health (Sacramento, CA)
- …current clinical standards. The incumbent reviews escalated cases electronically and using Medical Policy criteria sets to evaluate the medical necessity and ... of the requested treatment of service. Depending on the nature of the case , telephonic peer to peer discussions may be required. The incumbent ensures compliance… more
- Humana (Sacramento, CA)
- **Become a part of our caring community and help us put health first** The Medical Director relies on medical background and reviews health claims. The ... situations or data requires an in-depth evaluation of variable factors. The Medical Director provides medical interpretation and decisions about the… more
- ICW Group (Pleasanton, CA)
- …support from dedicated in-house counsel for litigation strategy and nurse case managers for medical management. **ESSENTIAL DUTIES AND RESPONSIBILITIES** ... to accelerate closure of high-cost, long-duration claims. + Collaborates with legal, medical , and financial experts to evaluate exposure and resolution pathways. +… more
- BluePearl (Del Rey Oaks, CA)
- …BluePearl Pet Hospital is seeking a collaborative, engaged, and experienced ** Medical Director** to lead our outstanding team of emergency and specialty ... **Why Choose BluePearl Monterey?** + **Collaborative Medicine:** Strong cross-departmental case management and support + **Existing Specialty Services:** Emergency,… more
- Robert Half Legal (Walnut Creek, CA)
- …witness files, and jury instructions + Conduct legal and factual research to support case strategy + Summarize depositions, medical records, and expert reports + ... Strong knowledge of discovery procedures and trial preparation + Proficiency with case management software and e-filing systems + Excellent organizational skills and… more
- Ventura County (Ventura, CA)
- …of sexual assault evidence collection kits (SAEKs). + Maintains accurate and detailed medical and forensic documentation for each case . + Monitors performance ... is assigned to ambulatory care programs affiliated with the Ventura County Medical Center and requires that incumbents demonstrate advanced competency skills and… more
- Sharp HealthCare (San Diego, CA)
- …End Time** Doctor of Medicine (MD); California Physicians and Surgeons License - Medical Board of CA; Doctor of Osteopathic Medicine (DO) **Hours** **:** **Shift ... position, and employer business practices. **What You Will Do** This Senior Medical Director position provides critical management and oversight for Sharp Health… more
- Ascendis Pharma (Palo Alto, CA)
- …mission of developing new and potentially best-in-class therapies to address unmet medical needs. Our culture fosters a place where skilled, adaptable, and highly ... for employees to grow and develop their skills. The Medical Director is involved in the design, monitoring, data...and/or academic realms may also be considered on a case -by- case basis). Those with less experience may… 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...where the analysis of situations or data requires a case -by- case consideration of the Medicare rules, Humana… more
- Rady Children's Hospital San Diego (San Diego, CA)
- JOB SUMMARY (MSW): The Medical Social Worker (MSW) applies principles of Social Work and other mental health practices to provide patients and families with ... assessment interventions, support, advocacy and case management as a primary provider and/or as ancillary...an independent practitioner or as a member of a medical team. Also may provide support and debriefing to… more