- Elevance Health (Walnut Creek, CA)
- … medical necessity of requests using clinical criteria. + Performs physician -level case review of musculoskeletal utilization requests. + Conducts ... **Clinical Operations Associate Medical Director** **Orthopedic Spine Surgery** **Carelon Medical...peer-to-peer consultation with ordering physicians, physician assistants and advanced practice nurses regarding established guidelines… more
- Sharp HealthCare (San Diego, CA)
- …administered including two (2) patient identifier verification. Assists with Medical Assistant medication verification in immediate area. No medication errors.Able ... problem and routes to physicians. Returns phone calls according to physician instruction. May schedule patient appointments.In partnership with physician ,… more
- Humana (Sacramento, CA)
- …The Medical Director may speak with contracted external physicians, physician groups, facilities, or community groups to support regional market priorities, ... health insurance, other healthcare providers, clinical group practice management. + Utilization management experience in a medical management review… more
- Sharp HealthCare (San Diego, CA)
- …utilization management venues.Escalate and refers cases for consultation with Physician Advisor or Medical Director as appropriate.Oversee preparation, ... a comprehensive plan of care for each patient/family in collaboration with the physician , social worker and all members of the interdisciplinary team in the… 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 + $96.70 - ... Req #:42565-31593 + FTE:1 + Posted:August 8, 2025 **Summary** **SUMMARY:** The Medical Director of John George Psychiatric Hospital is responsible for the… more
- Travelers Insurance Company (Sacramento, CA)
- … Consortiums and other medical resources as appropriate. Train and evaluate physician and non- physician medical review personnel and activities. + Stay ... **What Is the Opportunity?** Lead the strategy and operations of Travelers Claim Medical initiatives focusing on how developments in the broader medical … more
- Humana (Sacramento, CA)
- …Health Medical Director may speak with contracted external physicians, physician groups, facilities, or community groups to support regional market priorities, ... health insurance, other healthcare providers, clinical group practice management + Utilization management experience in a medical management review organization,… more
- Veterans Affairs, Veterans Health Administration (San Diego, CA)
- …range of medical clinicians across multiple disciplines (eg medical doctors, nurse practitioners, physician assistants, psychologists, psychiatrists, social ... in a team based model. Members of a team may include Lead Medical Support Assistants, Program Support Assistants (PSA), Registered Nurses (RN) and AMSAs.… more
- Alameda Health System (Oakland, CA)
- …the last 3 years, experience in Case Management in an acute setting or utilization review at a medical group or health plan. Required Licenses/Certifications: ... Care Management provides Care Coordination, Compliance, Transition Coordination, and Utilization Management. **DUTIES & ESSENTIAL JOB FUNCTIONS** NOTE:The following… more
- Trinity Health (Fresno, CA)
- …also continues to have success with its six accredited physician residency and fellowship programs (https://www.samc.com/graduate- medical -education/programs) and ... AGNES** Founded by the Sisters of the Holy Cross in 1929, Saint Agnes Medical Center has provided the highest quality and most compassionate care for Valley… more