- BeOne Medicines (Emeryville, CA)
- …market access segments within the geography: both Pharmacy and Medical benefit contacts/teams, including Commercial, Medicaid, Medicare (MAC's and CAC's). ... highly motivated individual to join our team as a Director , Payor Accounts (DPA). The ideal candidate will represent...geography: Medicare carrier directors, Payor and PBM medical and pharmacy directors, state Medicaid directors.… more
- Humana (Sacramento, CA)
- …clinical expertise to review Medicare drug appeals (Part D & B). The Medical director work assignments involve moderately complex to complex issues where the ... in accordance with Medicare and Humana policy. **Please note that this Medical Director position is non-benefitted, and compensated hourly * **Use your… more
- Elevance Health (Los Angeles, CA)
- **Clinical Pharmacy Account Director - Clinical Account Management** **Location:** This role requires associates to be in-office 3 days per week, fostering ... accommodation is granted as required by law. The **Clinical Pharmacy Account Director ** is responsible for building...data and experience in supporting commercial as well as Medicare business are essential, as are strong communication and… more
- Humana (Sacramento, CA)
- **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 ... Medical Director work assignments involve moderately complex to complex issues...group practice management. + Utilization management experience in a medical management review organization, such as Medicare … 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 ... the necessary co-management of our members related to their medical , behavioral health and pharmacy needs. This...+ 5 years' experience as an HMO Health Plan Medical Director . + California Physicians and Surgeons… more
- UCLA Health (Los Angeles, CA)
- …Health Medicare Advantage Plan is looking for a dedicated and forward-thinking Associate Medical Director to help shape the future of our plan. In this key ... leadership role, you'll work closely with the UHMAP Medical Director and play a vital part...policy that's grounded in the latest scientific research and Medicare guidelines. Your work will directly support our Health… more
- Merck (Sacramento, CA)
- …with HSO MADs + Serves as a resource for the PM MAD-HSO Team Lead, HSO Executive Director Medical Affairs, and other members of US Medical Affairs on other ... **Job Description** + The Precision Medicine - Medical Affairs Director - Health Systems...research \#eligibleforERP **Required Skills:** Benefit Programs, Clinical Data, Clinical Pharmacy , Clinical Studies, Medical Affairs, Medical… more
- Centene Corporation (Sacramento, CA)
- …+ Managed Care and Medi-Cal experience, preferred **Position Purpose:** Assist the Chief Medical Director to direct and coordinate the medical management, ... implementation of performance improvement initiatives for capitated providers. + Assists Chief Medical Director in planning and establishing goals and policies… more
- AbbVie (San Francisco, CA)
- …growth and development of individuals + Experience selling and/or managing Buy & Bill, Specialty Pharmacy , Medicare Part B, and Medicare Part D products is ... that solve serious health issues today and address the medical challenges of tomorrow. We strive to have a...major airport within this region. The Neuroscience Regional Sales Director leads the sales performance and professional development of… more
- Molina Healthcare (San Bernardino, CA)
- …under-utilization. * Educates and interacts with network, group providers and medical managers regarding utilization practices, guideline usage, pharmacy ... JOB DESCRIPTION Job Summary Provides medical oversight and expertise in appropriateness and ...leadership and quality improvement teams. * Facilitates conformance to Medicare , Medicaid, NCQA and other regulatory requirements. * Reviews… more
