- Humana (Sacramento, CA)
- …a Lead Medical Director , depending on the line of business. The Medical Director conducts Utilization Management or clinical validation of the care ... **Become a part of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement… more
- Evolent (Sacramento, CA)
- …accountability for utilization management while working in conjunction with the Senior Medical Director . May assist the Senior Medical Director ... Be Doing:** As a Physician Clinical Reviewer, Interventional Pain Management , you will be a key member of the...process. + On a requested basis, may function as Medical Director for selecting health plans or… more
- Highmark Health (Sacramento, CA)
- …URAC, CMS, DOH, and DOL regulations, etc.). Ensure that all aspects of the medical management process are consistent with community standards of care. + ... care (hospital, outpatient, or private practice) **Preferred** + 1 year in Medical Management in a Health Insurance Plan; strong knowledge of managed care… more
- Humana (Sacramento, CA)
- …to the Lead Medical Director - North Central Medicaid Markets. The Medical Director conducts Utilization Management of the care received by members ... **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 … more
- WestCare Foundation (Fresno, CA)
- …oversight and assistance to all treatment programs in the region; + To assist the Medical Director and management staff with the design of treatment ... Degree Salary Range $115000.00 - $135000.00 Salary/year Job Category Management Description Position Summary: Person in this position will...to identify clinical trends and provides analysis to the Medical Director ; + Assists in grant planning… more
- Humana (Sacramento, CA)
- … Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members ... **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 … more
- Humana (Sacramento, CA)
- … medical management operational improvements, including those within the medical director area + Participate in call rotation + Develop collaborative ... Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members in an… more
- Dignity Health (Bakersfield, CA)
- … management , remote patient monitoring, and CRM. - Provide backup support to the Medical Director of Utilization Management in medical review ... offices primarily in the Bakersfield/Central CA region.** **Position Summary:** The Medical Director of Physician Engagement is responsible for developing… more
- Sharp HealthCare (San Diego, CA)
- …for the position, and employer business practices. **What You Will Do** This Senior Medical Director position provides critical management and oversight for ... Management Program and Quality Improvement Program, in conjunction with the Director of PHM/ Medical Management and Quality Improvement Director . +… more
- Elevance Health (Walnut Creek, CA)
- …for an entire clinical program and/or independently performs clinical reviews. The Medical Director typically has program management responsibilities ... ** Medical Director ** _Please note that per...**Preferred Skills, Capabilities and Experiences:** + 1-2 years Utilization Management experience strongly preferred. + Strong oral, written, and… more
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