- Humana (Sacramento, CA)
- …role, you will be a key enterprise leader, with responsibility for evolving Humana's Utilization Management of medical review by physician or nurse, with ... performing utilization management for inpatient authorizations training medical director team to assist and facilitate...**Key Responsibilities** **:** + Lead an operational team of Medical Directors to review authorizations and ensure… more
- Evolent (Sacramento, CA)
- …per inter-rater reliability process. + May assist the Senior Medical Director in research activities/questions related to the Utilization Management process, ... culture. **What You'll Be Doing:** As a Cardiology, Field Medical Director you will be a key... and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission (URAC) and National… more
- Evolent (Sacramento, CA)
- …per inter-rater reliability process. + May assist the Senior Medical Director in research activities/questions related to the Utilization Management process, ... the culture. **What You'll Be Doing:** As a Field Medical Director , MSK Surgery you will be... and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission (URAC) and National… more
- Humana (Sacramento, CA)
- …care management, provider relations, quality of care, audit, grievance and appeal and policy review . The Behavioral Health Medical Director will develop and ... operations team and healthcare organization. The Medical Director 's work includes computer based review of...management + Utilization management experience in a medical management review organization, such as Medicare… more
- 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 ... caring community and help us put health first** The Medical Director relies on medical ...management. + Utilization management experience in a medical management review organization, such as Medicare… more
- Evolent (Sacramento, CA)
- … utilization and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission (URAC) and National Committee for Quality ... within the regulatory timeframe of the request. + Utilizes medical /clinical review guidelines and parameters to assure...process. + On a requested basis, may function as Medical Director for selecting health plans or… more
- Humana (Sacramento, CA)
- …part of our caring community and help us put health first** The Medical Director relies on broad clinical expertise to review Medicare drug appeals (Part D & ... and medical necessity. The Medical Director 's work includes computer based review of...management + Utilization management experience in a medical management review organization such as Medicare… more
- Evolent (Sacramento, CA)
- …timely and accurate manner. . May assist the Senior Medical Director in research activities/questions related to the Utilization Management process, ... the culture. **What You'll Be Doing:** As a Field Medical Director , Oncology, you will be a... and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission (URAC) and National… more
- Elevance Health (Corona, CA)
- ** Medical Director ** _Please note that per...state or territory of the United States when conducting utilization review or an appeals consideration and ... for employment, unless an accommodation is granted as required by law._ The ** Medical Director ** is responsible for the administration of physical and/or… more
- Evolent (Sacramento, CA)
- …timely and accurate manner. + May assist the Senior Medical Director in research activities/questions related to the Utilization Management process, ... the culture. **What You'll Be Doing:** As a Field Medical Director , Physical Medicine and Rehab you... and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission (URAC) and National… more