- Centene Corporation (Sacramento, CA)
- …implementation of strategic sales and go-to-market plans for California large group managed care clients, ensuring alignment with organizational goals and market ... long term and short term sales objectives. + Oversee the pipeline of managed care /commercial market opportunities to enhance sales. + Ensure successful sales… more
- JPMorgan Chase (Palo Alto, CA)
- …Our mission is to enhance scalability, security, and reliability for CDAO-hosted managed services. As a Machine Learning Engineer within our platform operations ... meet employee needs, based on eligibility. These benefits include comprehensive health care coverage, on-site health and wellness centers, a retirement savings plan,… more
- Humana (Sacramento, CA)
- …clinical specialists with recent inpatient experience preferred** + Knowledge of the managed care industry including Medicare Advantage, Managed Medicaid ... and judgement to make determinations whether requested services, requested level of care , and/or requested site of service should be authorized. All work occurs… more
- Alameda Health System (Oakland, CA)
- …Title 22 and other regulatory agencies and overall hospital policies; integrates managed care contract criteria into overall Case Management functions. + ... Alameda Health System is hiring! Under the direction of the Vice President of Care Management, the Director of Inpatient System Care Management manages… more
- HCA Healthcare (Riverside, CA)
- …+ You will provide medical consultation on contracting, pricing, and analysis of managed care issues. Offers clinical support for appeals and denials process, ... serve as a resource and consultant to the Vice President Physician Services Group and/or Vice President ...regarding delegated utilization management and disease management operations under managed care contracts. You will meet all… more
- Sutter Health (Sacramento, CA)
- …Knowledge of accounting, healthcare reimbursement, financial forecasting, operations analysis, managed care contracting, capitation management, general finance, ... million patients through a network of hospitals, clinics, and care services. With a legacy of more than 100...Health leadership team and reporting to the Senior Vice President and Chief Financial Officer, collaborates and works closely… more
- Humana (Sacramento, CA)
- …services such as inpatient rehabilitation **Preferred Qualifications** + Knowledge of the managed care industry including Medicare Advantage and Managed ... The Behavioral Health Medical Director is responsible for behavioral health care strategy and/or operations. The Behavioral Health Medical Director work assignments… more
- Dignity Health (Santa Maria, CA)
- …company policy. CRE II Basic knowledge of the healthcare industry, Medicare, managed care , insurance reimbursement and accounting practices. Knowledge of ... will work with the Director, Business Development; Regional Vice President , Market Development; or Vice President , Sales...coach, responsible for the supervision of assigned CRE(s) and/or Care Transition Nurse(s). The CRE II is also the… more
- Sharp HealthCare (San Diego, CA)
- …the system. **Required Qualifications** + 3 Years experience in a hospital, ambulatory care and/or managed care pharmacy environment. + California Pharmacist ... State Board of Pharmacy -REQUIRED **Preferred Qualifications** + 3 Years experience with managed care , PBM and/or Medicare Part D, Medicaid, Commercial Health… more
- Sutter Health (Santa Rosa, CA)
- …understanding of the trends and issues affecting the healthcare industry, including managed care , clinical integration and quality outcomes. + Working knowledge ... Sonoma County, dating back to 1866, as a health care organization dedicated to providing the highest level of...SSRRH and system leaders. Reporting directly to the Division President , the CEO will work in collaboration with the… more