- Providence (CA)
- …Program:** + Communicate with patients, claimants, caregivers, providers, leadership + Review and analyze medical records, interview witnesses, assist with ... to address coverage + Set appropriate indemnity and expense reserves + Select appropriate medical experts for case review + Develop a plan of action for… more
- BD (Becton, Dickinson and Company) (San Diego, CA)
- …their reports. **Responsibilities:** + Lead and develop direct report associates to ensure regulatory compliance + Problem solve and escalate regulatory and ... (510(k), Technical Files, etc.) + Develop and implement global regulatory strategy for MMS Dispensing Medical Device...for change controls and other RA/QA items from a review and approve level + Assists in preparing, auditing,… more
- Humana (Sacramento, CA)
- …will be a key enterprise leader, with responsibility for evolving Humana's Utilization Management of medical review by physician or nurse, with a focus on our 5+ ... 48 states. **Key Responsibilities** **:** + Lead an operational team of Medical Directors to review authorizations and ensure clinical decision-making skills… more
- Sutter Health (Emeryville, CA)
- …best practices. + Proficiency in utilization management processes: authorizations, concurrent review , and medical necessity criteria. + Thorough understanding of ... for our patients first-and our people always. About this opportunity: The Chief Medical Officer (CMO), Population Health Services and Health Plan Operations, is a… more
- Merck (Sacramento, CA)
- …growth opportunities and drive innovation. + In-depth expertise in local regulatory frameworks, ethical standards, and pharmaceutical compliance requirements. + ... Care, Cross-Functional Team Leadership, Executive Leadership, Healthcare Delivery Systems, Medical Affairs, Pharmaceutical Compliance , Scientific Communications, Scientific… more
- Alameda Health System (San Leandro, CA)
- …needed to achieve medical care goals. 11. Participates in licensure and compliance surveys and interacts with outside regulatory agencies. 12. Organizes and ... Medical Director, John George Psychiatric Hospital + San...8. Assures that the facility complies with all utilization review and case management requirements of Alameda County, AHS,… more
- BeOne Medicines (Emeryville, CA)
- …+ Presents relevant data at internal events (eg affiliate briefings) and provide medical education to internal stakeholders. Compliance + Acts in line with ... and assesses all IIS proposals as per BeOne IIS review process and ensures it is consistent with the...other medical functions team members and/or local medical teams on compliance with global standards,… more
- Edwards Lifesciences (San Diego, CA)
- …reporting and respond to ad hoc requests from internal stakeholders. + Maintain Regulatory Compliance : Stay current with training and ensure all activities align ... heart of everything we do. As part of our Medical Affairs team, you'll foster internal and external collaboration...to track educational grant applications and prepare documentation for review meetings. + Ensure Compliance & Documentation:… more
- Sharp HealthCare (San Diego, CA)
- …in-patient Care Management program that includes initial and concurrent review ; case management/discharge planning activities. Responsible for operational planning ... consistent with existing policies and/or principles. Responsible for managing medical management activities to include tracking, trending and analyzing UM data.… more
- J&J Family of Companies (Santa Clara, CA)
- …of Intravascular Lithotripsy (IVL) to treat complex calcified cardiovascular disease. Our Shockwave Medical portfolio aims to establish a new standard of care for ... medical device treatment of atherosclerotic cardiovascular disease through its...for the treatment of calcified plaque. **Position Overview** In compliance with FDA, European MDD/MDR & ISO regulations, the… more