• Director , Utilization

    Alameda Health System (Oakland, CA)
    Director , Utilization Management + Oakland, CA + Highland General Hospital + SYS Utilization Management + Full Time - Day + Nursing + Req ... off plans **Role Overview:** Alameda Health System is hiring! The Director of Utilization Management holds a critical role encompassing operational… more
    Alameda Health System (05/06/25)
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  • Corporate Director of Clinical…

    Prime Healthcare (Ontario, CA)
    …Responsibilities The Corporate Director of Clinical ... individual and Company performance. Connect With Us! (https://careers-primehealthcare.icims.com/jobs/172723/corporate- director -of-clinical- utilization - management /job?mode=apply&apply=yes&in\_iframe=1&hashed=-336024306) FacilityPrime Healthcare… more
    Prime Healthcare (04/17/25)
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  • Medical Director , UM - Utilization

    Rady Children's Hospital San Diego (San Diego, CA)
    …team of physicians and nurses working with the Rady Children's Health Network. The Utilization Management Medical Director will collaborate closely with the ... ideal candidate will have a strong pediatric clinical background. Utilization management experience is a plus. This...with a remote work option. JOB SUMMARY: The Medical Director , UM is a clinical subject-matter expert for the… more
    Rady Children's Hospital San Diego (05/03/25)
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  • Director of Case Management

    Prime Healthcare (Inglewood, CA)
    …credentials and licensure. Connect With Us! (https://careers-primehealthcare.icims.com/jobs/200257/ director -of-case- management utilization - management ... Workers, and Clinical Coordinators. This leader will oversee all facets of utilization management , discharge planning, and care coordination to ensure patiens… more
    Prime Healthcare (03/15/25)
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  • Medical Director --Claims Management

    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 in ... community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement...with prior experience participating in teams focusing on quality management , utilization management , case … more
    Humana (05/08/25)
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  • Medical Director - Care Plus - Florida

    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 in ... community and help us put health first** The Medical Director relies on medical background and reviews health claims....with prior experience participating in teams focusing on quality management , utilization management , case … more
    Humana (04/24/25)
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  • Medical Director - Florida

    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 in ... community and help us put health first** The Medical Director relies on medical background and reviews health claims....with prior experience participating in teams focusing on quality management , utilization management , case … more
    Humana (04/24/25)
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  • Deputy Director , Mental Health (UC)…

    The County of Los Angeles (Los Angeles, CA)
    …service capacity and compliance with state and federal mandates. The Deputy Director oversees utilization management , provider expansion, and high-acuity ... DEPUTY DIRECTOR , MENTAL HEALTH (UC) - MANAGED CARE OPERATIONS...Operations, Treatment Authorization Requests, Intensive Care Services, and Bed Management . This role is responsible for budgeting, financial strategy,… more
    The County of Los Angeles (02/25/25)
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  • Medical Director , Ventura County Health…

    Ventura County (Ventura, CA)
    …and communicates matters of VCHCP medical policy with the Health Care Agency Director and Insurance Administrator, Utilization Management staff and Quality ... surgical procedures, referrals, tests, medication approvals requiring authorization.) + Develops utilization management standards and guidelines for approval by… more
    Ventura County (05/10/25)
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  • Manager, Care Management

    Alameda Health System (Oakland, CA)
    …UM information and reports to appropriate committees and in conjunction with the Director of Care Management identifies utilization issues affecting the ... the continuum. + Manages and assumes responsibility for day-to-day operations of utilization management , care coordination and discharge planning activities. +… more
    Alameda Health System (05/06/25)
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