- Elevance Health (Walnut Creek, CA)
- **Clinical Operations Medical Director ** ** Utilization Management of Medical Oncology Benefits** **Carelon Benefits Management ** **$20,000 Sign On ... proud member of the Elevance Health family of companies, Carelon Medical Benefits Management , formerly AIM Specialty Health, is a benefit- management leader in… 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 in ... with prior experience participating in teams focusing on quality management , utilization management , case ...management operational improvements, including those within the medical director area + Participate in call rotation + Develop… 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 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
- Dignity Health (Rancho Cordova, CA)
- …home.** **Position Summary:** Under the guidance and supervision of the department Manager/ Director , the Supervisor of Utilization Management is responsible ... (Medicare Guidelines, InterQual, Health Plan Benefit Interpretation Guidelines and Medical Management Policies, and DHMF Utilization Management guidelines… more
- CenterWell (Sacramento, CA)
- …a part of our caring community and help us put health first** **National** ** Director of Transitional Care and High-Risk Patient Management ** The Director ... Coordinate quality improvement activities to address high risk, high-utilizers/high-cost patient management through the utilization of the 5M's framework as… more
- GoTo (Sacramento, CA)
- …plenty of opportunities for growth and learning, blaze your own trail with us. As the Director of Product Management for the Data Team at GoTo.com, you will be ... drive business growth. **Your Day to Day** **As the Director , Product Management , you would be working...and customer success teams to ensure successful adoption and utilization . **Customer Focus:** + Engage with customers to understand… more
- Humana (Sacramento, CA)
- …interpretation skills, with prior experience participating in teams focusing on quality management , utilization management , case management , discharge ... Integrated Delivery Systems, health insurance, other healthcare providers, clinical group practice management . + Utilization management experience in a… more
- Humana (Sacramento, CA)
- …interpretation skills, with prior experience participating in teams focusing on quality management , utilization management , case management , discharge ... Integrated Delivery Systems, health insurance, other healthcare providers, clinical group practice management . + Utilization management experience in a… more
- Elevance Health (Walnut Creek, CA)
- …Develops and enhances relevant clinical guidelines. + Provides clinical leadership for Utilization Management , Case Management , Disease Management , ... is looking to hire a **National Solution Medical Director for Post Acute Care Solutions** . This high-performing...Business Strategy, Product Strategy. + Experience with Managed Care, Utilization Management , Prior Auth, and Benefits … more
- Elevance Health (Walnut Creek, CA)
- …Develops and enhances relevant clinical guidelines. + Provides clinical leadership for Utilization Management , Case Management , Disease Management , ... Administrative Medicine, Business Strategy, Product Strategy. + Experience with Managed Care, Utilization Management , Prior Auth, and Benefits Management … more
- Sunrise Senior Living (Danville, CA)
- …me, that's a big breath of fresh air."_** **_- Sunrise Leader_** The Executive Director is responsible for overall leadership, management , and success of their ... These responsibilities include but are not limited to financial management , hiring, supervising, training, team member relations and recognition, communication,… more
- Wolters Kluwer (Sacramento, CA)
- …data rich and can be effectively leveraged to maximize the efficiency, accuracy, and utilization of clinical data. As the Director , you will play a critical ... **BASIC FUNCTION** We are seeking a highly skilled and experienced Consulting Director of Solution Optimization within Health Language to lead the efforts for… more
- BrightSpring Health Services (Sacramento, CA)
- …of death and submit to State Health Services Director and Assigned Director , Clinical Practice* Review utilization report at least monthly to ensure adequate ... are coordinated with behavioral and programmatic staff in partnership with the Executive Director . The Director of Nursing is accountable for overseeing the… more
- Elevance Health (Walnut Creek, CA)
- …clinical program and/or independently performs clinical reviews. + The Medical Director typically has program management responsibilities including clinical ... within our Medicaid and Medicare programs.** The **Behavioral Health Medical Director ** is responsible for the administration of behavioral health medical services,… more
- CenterWell (Sacramento, CA)
- …under the PCO's Chief Medical Officer. This role reports to the National Director , High Risk Patient Management . Responsibilities will include: + Lead ... community and help us put health first** The National Director , Clinical Pharmacy is a strategic pharmacy leader responsible...care, high quality health outcomes, and improved cost and utilization in pharmacy-related care, and serve as a national… more
- Rocket Software (Sacramento, CA)
- …programs, and strategies to ensure effective, repeatable, and scalable project management , resource utilization practices, and reporting. + Foster global ... BELIEVE in what they're doing!** **Job Description Summary:** The Senior Director , Customer Solutions Engineering (CSE) is responsible for managing CSE Delivery… more
- CVS Health (Sacramento, CA)
- …consistent responses to members and providers. You will lead all aspects of utilization review/quality assurance, directing case management . In this role you ... Summary Aetna, a CVS Health Company, has an exciting opportunity for a Medical Director (Cardiology) that can be remote based, work from home. This role can be… more
- Sanofi Group (Sacramento, CA)
- Job Title: National Business Director - Thymoglobulin- West Location- Remote/US **About the Job** We are an innovative global healthcare company with a focus on ... + Working with payers in conjunction with the primary regional account director , implements strategies and tactics to support the growth of the kidney… more
- CVS Health (Sacramento, CA)
- …consistent responses to members and providers. In addition you will oversee utilization review/quality assurance, directing case management In this role you'll ... **This is a remote based (work from home) role.** In the Medical Director role you will provide oversight for medical policy implementation. You'll participate in… more
- Sutter Health (Sacramento, CA)
- …care units for cardiac and neurological patients. The Oncology Nursing Director provides administrative and nursing leadership in an assigned inpatient setting ... patient care. Establishes overall operating and capital budget with input from management team, ensuring financial targets are achieved and variances are addressed… more