- Highmark Health (Sacramento, CA)
- …and improve the care of our members **ESSENTIAL RESPONSIBILITIES** + Conduct electronic review of escalated cases against medical policy criteria, which may ... DOL regulations at all times. In addition to utilization review , the incumbent participates as the physician member of...outpatient, or private practice) **Preferred** + 1 year in Medical Management in a Health Insurance Plan;… more
- Centene Corporation (Sacramento, CA)
- …management, cost containment, and medical quality improvement activities. + Performs medical review activities pertaining to utilization review , quality ... medical review of complex, controversial, or experimental medical services, ensuring timely and quality decision making. + Supports effective implementation… more
- Gilead Sciences, Inc. (Foster City, CA)
- …on role), paid time off, and a benefits package. Benefits include company-sponsored medical , dental, vision, and life insurance plans*. For additional benefits ... Gilead, you will further our mission to address unmet medical needs and improve life by advancing the care...role is responsible for leading the Phase 4 RC review process and portfolio management of Gilead and Externally… more
- VCA Animal Hospitals (Sacramento, CA)
- …in such circumstances and revises protocols when appropriate. + Along with the RMD, medical record review of associate DVM's as needed. + Determines in ... practices in Northern California, is looking for a **Specialty Medical Director** to lead our growing team. VCA SVRC...performs yearly associate DVM reviews + Participates in yearly review of lead technician (s) with HM + Supports… more
- Evolent (Sacramento, CA)
- …Surgery is a key member of the Medical leadership team, providing timely medical review of service requests. Oversees the Surgery Field Medical Directors ... coordinating education and findings with matrixed Physician Business Manager. + Provides medical direction to the support services review process. Responsible… more
- HCA Healthcare (Thousand Oaks, CA)
- …growth, we encourage you to apply for our Division Director of Graduate Medical Education opening. We promptly review all applications. Highly qualified ... based at Riverside Community Hospital or Los Robles Regional Medical Center. The leader **must be able** to attend...with each facility to ensure ongoing readiness for Institutional review by ACGME and meets with all programs to… more
- HCA Healthcare (Riverside, CA)
- …satisfaction and personal growth, we encourage you to apply for our Medical Staff Credentialing Coordinator opening. We promptly review all applications. ... integrity. We care like family! Jump-start your career as a(an) Medical Staff Credentialing Coordinator today with Riverside Community Hospital. **Benefits**… more
- HCA Healthcare (Riverside, CA)
- …21 states and the United Kingdom. We are looking for a Chief Medical Officer for our Riverside Community Hospital team where excellence creates excellence. ... and retirement of our colleagues. The available plans and programs include: + Comprehensive medical coverage that covers many common services at no cost or for a low… more
- Humana (Sacramento, CA)
- …Medical management organizations, hospitals/ Integrated Delivery Systems, health insurance , other healthcare providers, clinical group practice management. + ... Utilization management experience in a medical management review organization, such as Medicare...such as Medicare Advantage, managed Medicaid, or Commercial health insurance . + Experience with national guidelines such as MCG(R)… more
- Ascendis Pharma (Palo Alto, CA)
- …Liaises with Medical Monitors in Clinical Development to ensure that appropriate medical review and assessment is provided for adverse event reports and ... 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… more