- Humana (Sacramento, CA)
- …industry including Medicare Advantage and Managed Medicaid products, or other Medical management organizations, hospitals/ Integrated Delivery Systems, health ... other healthcare providers, clinical group practice management + Utilization management experience in a medical management review organization,… more
- Sharp HealthCare (San Diego, CA)
- …Works collaboratively with other plan functions that interface with medical management such as provider relations, member services , benefits and claims ... to support, provide assistance and direction in overall medical management effectiveness. Reports all issues of... Officer. + Plans, organizes, and directs the professional medical services program, consisting of all primary… more
- Centene Corporation (Sacramento, CA)
- …changes everything for our 28 million members as a clinical professional on our Medical Management /Health Services team. Centene is a diversified, national ... Medical Director to direct and coordinate the medical management , quality improvement and credentialing functions... medical review of complex, controversial, or experimental medical services , ensuring timely and quality decision… more
- Humana (Sacramento, CA)
- …Medicare Advantage, Managed Medicaid and/or Commercial products, or other Medical management organizations, hospitals/ Integrated Delivery Systems, health ... other healthcare providers, clinical group practice management . + Utilization management experience in a medical management review organization,… more
- The County of Los Angeles (Los Angeles, CA)
- SENIOR NURSING INSTRUCTOR (EMERGENCY MEDICAL SERVICES ) Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/3309230) Apply SENIOR NURSING ... INSTRUCTOR (EMERGENCY MEDICAL SERVICES ) Salary $122,010.72 - $182,634.24 Annually...delivery of other EMS Agency classes including: Hospital Disaster Management Training (HDMT), The Medical Management… more
- CVS Health (Sacramento, CA)
- …Holding, Inc. (AHH), a division of Aetna/CVS Health, is a URAC-accredited medical management organization founded in 1993. We provide flexible, cost-effective ... care management solutions that promote high-quality healthcare for members. We...gather necessary information. + Use established guidelines to authorize services or escalate to Medical Directors as… more
- The Cigna Group (Los Angeles, CA)
- …limited to, Claims Operations, Medical Management . Credentialing, Legal, Medical Economics, Compliance, Sales and Marketing and Service . + Contributes to ... in the Glendale/Los Angeles, CA area.** The **Manager, Provider Contracting Network Management ** serves as an integral member of the Provider Contracting Team and… more
- Travelers Insurance Company (Sacramento, CA)
- … capabilities to keep Travelers at the leading edge of the P&C industry. Develop medical management strategies that help injured employees return to work as soon ... **What Is the Opportunity?** Lead the strategy and operations of Travelers Claim Medical initiatives focusing on how developments in the broader medical … more
- Sharp HealthCare (San Diego, CA)
- …planning consistent with existing policies and/or principles. Responsible for managing medical management activities to include tracking, trending and analyzing ... care units, Medical -Surgical Nursing, and/or Home Health + 3 Years Medical Management experience, preferably in managed care, with supervisory experience +… more
- Humana (Sacramento, CA)
- …Systems, health insurance, or clinical group practice management + Utilization management experience in a medical management review organization such ... 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… more