- Prime Healthcare (Ontario, CA)
- …members to join our corporate team! Responsibilities The Corporate Director of Clinical Utilization Management (UM) provides comprehensive oversight ... or another relevant field + A minimum of seven (7) years' experience in Clinical Utilization Review or Case Management with a large Health Plan + An active CA… more
- Sharp HealthCare (San Diego, CA)
- …medical directors on utilization function. + Identifies physicians whose utilization and/or clinical practices are aberrant and recommends and participates ... **Facility:** Corporate Offices **City** San Diego **Department** **Job Status**...of private practice physicians. **Required Qualifications** + 5 Years clinical practice experience. + California Physicians and Surgeons License… more
- Humana (Sacramento, CA)
- **Become a part of our caring community and help us put health first** The Corporate Medical Director relies on medical background and reviews health claims and ... preservice appeals. The Corporate Medical Director works on problems of...+ Excellent communication skills + 5 years of established clinical experience + Knowledge of the managed care industry… more
- e CancerCare (Fresno, CA)
- Purpose: The Director , Clinical Trials & Research, for CCARE Physicians, PC, is responsible and accountable for the daily operations and management of staff, of ... in the department. Promote clinical excellence through applied clinical knowledge, leadership, team recommendations and research utilization . Ensure… more
- Humana (Sacramento, CA)
- …hospitals/ Integrated Delivery Systems, health insurance, other healthcare providers, clinical group practice management. + Utilization management experience ... a Regional Vice President of Health Services, Lead, or Corporate Medical Director , depending on size of...size of region or line of business. The Medical Director conducts Utilization Management of the care… more
- Humana (Sacramento, CA)
- …hospitals/ Integrated Delivery Systems, health insurance, other healthcare providers, clinical group practice management. + Utilization management experience ... a Regional Vice President of Health Services, Lead, or Corporate Medical Director , depending on size of...size of region or line of business. The Medical Director conducts Utilization Management of the care… more
- Humana (Sacramento, CA)
- …hospitals/ Integrated Delivery Systems, health insurance, other healthcare providers, clinical group practice management. + Utilization management experience ... a Regional Vice President of Health Services, Lead, or Corporate Medical Director , depending on size of...size of region or line of business. The Medical Director conducts Utilization Management of the care… more
- Centene Corporation (Sacramento, CA)
- …and utilization management programs in accordance with regulatory, state, corporate , and accreditation requirements. + Assists the Chief Medical Director ... Assists in the development and implementation of physician education with respect to clinical issues and policies. + Identifies utilization review studies and… more
- Humana (Sacramento, CA)
- **Become a part of our caring community and help us put health first** The Corporate Medical Director (CMD) relies on medical background to review health claims ... and preservice appeals. The Corporate Medical Director works on problems of...represents Humana at Administrative Law Judge hearings; exercises independent clinical judgment and decision making on complex issues regarding… more
- Evolent (Sacramento, CA)
- …in-depth analyses of healthcare data - including authorizations, claims, membership, and clinical outcomes to identify cost drivers, utilization patterns, and ... and earned a perfect score on the Human Rights Campaign (HRC) Foundation's Corporate Equality Index (CEI). This index is the nation's foremost benchmarking survey… more
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