- Highmark Health (Sacramento, CA)
- …URAC, CMS, DOH, and DOL regulations, etc.). Ensure that all aspects of the medical management process are consistent with community standards of care. + ... care (hospital, outpatient, or private practice) **Preferred** + 1 year in Medical Management in a Health Insurance Plan; strong knowledge of managed care… more
- Elevance Health (Los Angeles, CA)
- **Clinical Operations Medical Director ** **Carelon Medical Benefits Management ** **Post Acute Care Benefit Utilization Management ** **Schedule:** ... **Clinical Operations Medical Director ** is responsible for supporting the medical management staff ensuring timely and consistent medical decisions… more
- Elevance Health (Walnut Creek, CA)
- …**Clinical Operations Medical Director ** is responsible for supporting the medical management staff ensuring timely and consistent medical decisions ... **Clinical Operations Medical Director ** ** Medical Oncology** **Carelon Medical Benefit Management ** **Virtual** : This role enables associates to… more
- Humana (Sacramento, CA)
- …a Lead Medical Director , depending on the line of business. The Medical Director conducts Utilization Management or clinical validation of the care ... **Become a part of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement… more
- Evolent (Sacramento, CA)
- …accountability for utilization management while working in conjunction with the Senior Medical Director . May assist the Senior Medical Director ... Be Doing:** As a Physician Clinical Reviewer, Interventional Pain Management , you will be a key member of the...process. + On a requested basis, may function as Medical Director for selecting health plans or… more
- Select Medical (San Diego, CA)
- **Overview** **Select Specialty Hospital** **Critical Illness Recovery Hospital (LTACH)** ** Director of Case Management ** **Full Time: Monday - Friday 8-5pm** ... in social work and minimum three (3) years of medical case management or similar experience._** **Previous...doing well by doing what is right. As the Director of Case Management **,** you will… more
- Ventura County (Ventura, CA)
- …matters of VCHCP medical policy with the Health Care Agency Director and Insurance Administrator, Utilization Management staff and Quality Assurance Staff. ... Medical Director , Ventura County Health Care...will not be unduly influenced by fiscal and administrative management . + Ensures that comprehensive medical benefits… 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 ... **Become a part of our caring community and help us put health first** The Medical Director relies on medical background and reviews health claims. The … more
- Gilead Sciences, Inc. (Foster City, CA)
- …**Job Description** The Associate Director , Strategic Sourcing & Supplier Management , Medical Devices owns the business relationships with suppliers of ... This includes ownership of the strategy, selection, risk, and performance management of suppliers providing devices and device related components for development… more
- Humana (Sacramento, CA)
- **Become a part of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement ... will understand how to operationalize this knowledge in their daily work. The Medical Director 's work includes computer-based review of moderately complex to… more