- Humana (Sacramento, CA)
- …care management, provider relations, quality of care, audit, grievance and appeal and policy review . The Behavioral Health Medical Director will develop and ... operations team and healthcare organization. The Medical Director 's work includes computer based review of...management + Utilization management experience in a medical management review organization, such as Medicare… 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 ... caring community and help us put health first** The Medical Director relies on medical ...management. + Utilization management experience in a medical management review organization, such as Medicare… 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 ... within the regulatory timeframe of the request. + Utilizes medical /clinical review guidelines and parameters to assure...process. + On a requested basis, may function as Medical Director for selecting health plans or… more
- Evolent (Sacramento, CA)
- …timely and accurate manner. . May assist the Senior Medical Director in research activities/questions related to the Utilization Management process, ... the culture. **What You'll Be Doing:** As a Field Medical Director , Oncology, you will be a... and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission (URAC) and National… more
- Evolent (Sacramento, CA)
- …timely and accurate manner. + May assist the Senior Medical Director in research activities/questions related to the Utilization Management process, ... the culture. **What You'll Be Doing:** As a Field Medical Director you will be a key... and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission (URAC) and National… more
- Elevance Health (CA)
- ** Medical Director ** _Please note that per...state or territory of the United States when conducting utilization review or an appeals consideration and ... for employment, unless an accommodation is granted as required by law._ The ** Medical Director ** is responsible for the administration of physical and/or… more
- Elevance Health (Walnut Creek, CA)
- **Behavioral Health Medical Director -Psychiatrist Appeals** **Location:** California. This role enables associates to work virtually full-time, with the ... PST. Half day Saturday rotation, once a month.** The ** Medical Director ** is responsible for the administration...state or territory of the United States when conducting utilization review or an appeals consideration and… more
- Alameda Health System (San Leandro, CA)
- Medical Director , John George Psychiatric Hospital + San Leandro, CA + John George Psychiatric Hospital + Physicians JGP ER + Full Time - Day + Management + ... + FTE:1 + Posted:August 8, 2025 **Summary** **SUMMARY:** The Medical Director of John George Psychiatric Hospital...volunteers. 8. Assures that the facility complies with all utilization review and case management requirements of… more
- Genesis Healthcare (Carmichael, CA)
- …Area Director ). 10. Assumes responsibility for daily staffing and utilization with input from treating therapists, consideration of clinical requirements, and ... Powerback is the place for you. **Why Powerback?** + **Benefits:** We offer Medical , Dental, and Vision plans to Full-Time team members. We offer Dental and… more
- Sedgwick (Sacramento, CA)
- …Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Sr VP Medical Director (Hourly) The ideal candidate would work 8-20 hours per week. ... including making a recommendation of specialty for the Independent Medical Review process. + Developing and delivering...required to include one (1) to three (3) years utilization review experience and three (3) years… more