- Rady Children's Hospital San Diego (San Diego, CA)
- …This position is part time with full benefits with a remote work option. The Medical Director , UM is a clinical subject-matter expert for the Utilization ... with the Rady Children's Health Network. The Utilization Management Medical Director will collaborate closely with the...Team and shall assist in the oversight of all UM activities. This position serves as a resource to… more
- Evolent (Sacramento, CA)
- …Appropriately identifies and refers quality issues to the Senior Director of Medical Management or Medical Director . + Appropriately identifies potential ... opportunity to make a meaningful impact by providing exceptional support to internal and external customers through positive interactions, and timely delivery of… more
- Sharp HealthCare (San Diego, CA)
- …the position, and employer business practices. **What You Will Do** This Senior Medical Director position provides critical management and oversight for Sharp ... Officer. **Required Qualifications** + Doctor of Medicine (MD) - Internal Medicine or Family Practice + **OR** Doctor of...+ 5 years' experience as an HMO Health Plan Medical Director . + California Physicians and Surgeons… more
- Alameda Health System (Oakland, CA)
- Director , Utilization Management + Oakland, CA + Highland General Hospital + SYS Utilization Management + Full Time - Day + Nursing + Req #:40826-30155 + FTE:1 + ... time off plans **Role Overview:** Alameda Health System is hiring! The Director of Utilization Management holds a critical role encompassing operational oversight,… more
- CVS Health (Sacramento, CA)
- …Internal Medicine or Internal Medicine/Pediatrics (Med/Peds) Board Certification. In the Medical Director role, you will provide oversight for medical ... and consistent responses to members and providers. As a Medical Director you will focus primarily on...UM (Utilization Management) experience *Active and current state medical license without encumbrances *M.D. or DO, Board Certification… more
- CVS Health (Sacramento, CA)
- …(work from home) role preferably resides in Pacific or Mountain Time Zone. In the Medical Director role you will provide oversight for medical policy ... staff ensuring timely and consistent responses to members and providers. As a Medical Director you will focus primarily on overseeing utilization review /… more
- Sharp HealthCare (San Diego, CA)
- …as a physician executive in a managed care environment, preferably as an HMO Medical Director . + California Physicians and Surgeons License - Medical ... of CA -REQUIRED **Other Qualification Requirements** + Board certified in a medical discipline ( internal medicine or family practice preferred). **Essential… more
- LA Care Health Plan (Los Angeles, CA)
- …the needs of LA Care's culturally diverse membership. The position supports the UM Manager/ Director . This role also assists UM Educator/Manager/ Director ... required to achieve that purpose. Job Summary The Supervisor of Utilization Management ( UM ) RN is responsible for executing the day-to-day operations of the UM… more
- Sutter Health (Burlingame, CA)
- …with care management, UM staff and health care team members and medical directors of third-party payers to discuss the needs of patient's and alternative levels ... regarding physician practice patterns, over- and under-utilization of resources, medical necessity, documentation best practices, level of care progression, denial… more
- Magellan Health Services (San Diego, CA)
- …relationships at all levels within HAI-CA. Interact with HAI-CA CMC Chief Clinical Officer, Medical Director and Associate Medical Director , Physician ... customer's site. Including, but not limited to, Network, QI, UM , and DVOD meetings. + Track agenda and follow...utilization data; under the direction of the supervisor or Medical Director , assists with discharge planning and… more