- 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
- 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
- Providence (CA)
- …to address coverage + Set appropriate indemnity and expense reserves + Select appropriate medical experts for case review + Develop a plan of action for ... must empower them.** **Providence is calling a Sr. Professional Liability Medical Claims Manager who will:** **Investigate, evaluate, and manage professional,… more
- Travelers Insurance Company (Diamond Bar, CA)
- …claims. Coordinate medical and indemnity position of the claim with a Medical Case Manager. Independently handles assigned claims of low to moderate ... possible outcome + Collaborate with our internal nurse resources ( Medical Case Manager) in order to integrate...20 days Paid Time Off annually, plus nine paid company Holidays. + **Wellness Program:** The Travelers wellness program… more
- J&J Family of Companies (Irvine, CA)
- …and/or eligible dependents may be eligible to participate in the following Company sponsored employee benefit programs: medical , dental, vision, life insurance, ... profoundly impact health for humanity. Learn more at https://www.jnj.com **Job Function:** Medical Affairs Group **Job Sub** **Function:** Medical Affairs - MD… more
- Elevance Health (CA)
- …external entities and/or serve on internal and/or external committees. + May chair company committees. + Interprets medical policies and clinical guidelines. + ... ** Medical Director** _Please note that per our policy...and external physicians. + May conduct peer-to-peer clinical appeal case reviews with attending physicians or other ordering providers… more
- Elevance Health (CA)
- …external entities and/or serve on internal and/or external committees. + May chair company committees. + Interprets medical policies and clinical guidelines. + ... ** Medical Director** **Location:** This role enables associates to...and external physicians. + May conduct peer-to-peer clinical appeal case reviews with attending physicians or other ordering providers… more
- Elevance Health (Walnut Creek, CA)
- …external entities and/or serve on internal and/or external committees. May chair company committees. + Interprets medical policies and clinical guidelines. May ... **Behavioral Health Medical Director-Psychiatrist Appeals** **Location:** California. This role enables...aspects of a program. + Conduct peer-to-peer clinical appeal case reviews with attending physicians or other ordering providers… more
- Elevance Health (CA)
- ** Medical Management Clinician Senior** **Location:** This role enables associates to work virtually full-time, with the exception of required in-person training ... - Friday 7:00 AM - 3:30 PM PST The ** Medical Management Clinician Senior** is responsible for ensuring appropriate,...May collaborate with healthcare providers. Focuses on relatively complex case types that do not require the training or… more
- Gilead Sciences, Inc. (Foster City, CA)
- …well as Inflammatory Diseases co. Gilead is a patient centric, science focused company . Reporting to the Vice President, Global Medical Strategy and Operations, ... case development, planning, implementation, operation, and management of medical affairs technology initiatives. + Proven experience articulating and advising on… more
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