• Director , Utilization

    Alameda Health System (Oakland, CA)
    Director , Utilization Management + Oakland, CA + Highland General Hospital + SYS Utilization Management + Full Time - Day + Nursing + Req ... plans **Role Overview:** Alameda Health System is hiring! The Director of Utilization Management holds...or applicant for employment based on race, color, religion, national origin, age, gender, sex, ancestry, citizenship status, mental… more
    Alameda Health System (08/08/25)
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  • Director of Case Management

    Prime Healthcare (Inglewood, CA)
    …Workers, and Clinical Coordinators. This leader will oversee all facets of utilization management , discharge planning, and care coordination to ensure patiens ... ie full-time or part-time. Responsibilities We are seeking a strategic and compassionate Director of Case Management to lead our dynamic Case Management more
    Prime Healthcare (07/18/25)
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  • Utilization Management Admissions…

    LA Care Health Plan (Los Angeles, CA)
    …observation) admission in the acute setting. Works with UM leadership, including the Utilization Management Medical Director , on requests where determination ... Knowledge of National Committee for Quality Assurance (NCQA) requirements for Utilization Management or CM. Knowledge of Department of Health Care Services… more
    LA Care Health Plan (08/02/25)
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  • Nursing Director , Administration…

    The County of Los Angeles (Los Angeles, CA)
    NURSING DIRECTOR , ADMINISTRATION ( Director , Workforce Management and Operations) Print ... (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/3110377) Apply  NURSING DIRECTOR , ADMINISTRATION ( Director , Workforce Management and Operations) Salary $163,996.80… more
    The County of Los Angeles (06/05/25)
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  • Medical Director , Ventura County Health…

    Ventura County (Ventura, CA)
    …and communicates matters of VCHCP medical policy with the Health Care Agency Director and Insurance Administrator, Utilization Management staff and Quality ... surgical procedures, referrals, tests, medication approvals requiring authorization.) + Develops utilization management standards and guidelines for approval by… more
    Ventura County (08/04/25)
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  • Senior Medical Director - Sharp Health Plan…

    Sharp HealthCare (San Diego, CA)
    …to accrediting and regulatory agency feedback. + Supports pre-admission review, utilization management , and concurrent and retrospective review Process. Performs ... + Participates in risk management reviews. + Assists in pharmacy utilization management , catastrophic case review, outreach programs, HEDIS reporting, site… more
    Sharp HealthCare (07/19/25)
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  • Medical Director - National Medicare

    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 in ... community and help us put health first** The Medical Director relies on medical background and reviews health claims....with prior experience participating in teams focusing on quality management , utilization management , case … more
    Humana (07/21/25)
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  • Director , Inpatient System Care…

    Alameda Health System (Oakland, CA)
    Director , Inpatient System Care Management + Oakland, CA + Highland General Hospital + SYS Care Coordination + Full Time - Varies + Management + Req ... Alameda Health System is hiring! Under the direction of the Vice President of Care Management , the Director of Inpatient System Care Management manages the… more
    Alameda Health System (08/08/25)
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  • Director of Clinical Services, Faculty…

    UCLA Health (Los Angeles, CA)
    …of multiple clinical programs and medical services with an emphasis on optimizing Utilization Management for the Faculty Practice Group (FPG) Management ... Description We are seeking a highly skilled and dynamic Director of Clinical Services to lead the development, evaluation,...the delivery of program functionalities in all aspects of Utilization Management and its integration with other… more
    UCLA Health (06/22/25)
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  • Associate Director , Planisware Clinical…

    Gilead Sciences, Inc. (Santa Monica, CA)
    …Kite and help create more tomorrows. **Job Description** + The **Associate Director , Planisware Clinical Trial Planning, Resource Management , and Reporting** is ... and clinical plans + update project templates and styles.Resource Management & Reporting: + Support Director of...+ Stakeholder communication + Risk assessment & mitigation + Utilization of project management core principles (PMP… more
    Gilead Sciences, Inc. (07/09/25)
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