- AIG (San Francisco, CA)
- Claims Complex Director - Healthcare Professional Liability (HPL) Join us as a Claims Complex Director to take on key responsibilities within ... an impact + This position will ensure high quality claims handling within the Healthcare Professional Liability...+ 7+ years of medical malpractice / professional liability complex claims and/or complex litigation… more
- Humana (Sacramento, CA)
- …understand how to operationalize this knowledge in their daily work. The Medical Director 's work includes computer-based review of moderately complex to ... of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement to make determinations… more
- Evolent (Sacramento, CA)
- …support value-based healthcare across all lines of business, particularly in complex conditions such as oncology and cardiology. We are advocates for creating ... humility, adaptability, intellectual curiosity, and accountability as we solve complex business problems. **Collaboration Opportunities:** The Director ,… more
- Prime Healthcare (Ontario, CA)
- …including Claims and Customer Service, to provide guidance on complex Authorizations, Referrals, Denials and Appeals. + Integrates and coordinates services using ... 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 Management… more
- Otsuka America Pharmaceutical Inc. (Sacramento, CA)
- …Founded on Otsuka's rich history in delivering breakthrough innovations to solve complex problems for patients, Otsuka Precision Health (OPH) is the next step ... transform the health experience, one connection at a time, together. The ** Director , Digital Health Corporate Counsel** will be responsible for providing legal… more
- Humana (Sacramento, CA)
- … relies on medical background and reviews health claims . The Medical Director work assignments involve moderately complex to complex issues where ... The Medical Director 's work includes computer based review of moderately complex to complex clinical scenarios, review of all submitted clinical records,… more
- Humana (Sacramento, CA)
- … relies on medical background and reviews health claims . The Medical Director work assignments involve moderately complex to complex issues where ... or data requires an in-depth evaluation of variable factors. The Medical Director provides medical interpretation and decisions about the appropriateness of services… more
- Evolent (Sacramento, CA)
- …to ensure clean and consistent tracking of Evolent's covered membership and claims + Synthesize complex analyses into succinct presentations for communication ... providers to achieve better outcomes for people with most complex and costly health conditions. Working across specialties and...connected care journey. We are hiring for a Senior Director to join our Finance Team. The candidate selected… more
- J&J Family of Companies (Irvine, CA)
- At Johnson & Johnson, we believe health is everything. Our strength in healthcare innovation empowers us to build a world where complex diseases are prevented, ... we are uniquely positioned to innovate across the full spectrum of healthcare solutions today to deliver the breakthroughs of tomorrow, and profoundly impact… more
- Evolent (Sacramento, CA)
- …rates, turnaround times, PMPM, trend drivers), with a working knowledge of healthcare claims and reimbursement methodologies. + Experience presenting actionable ... Doing:** + **Strategic Data Analytics & Insights:** Lead advanced analyses of healthcare authorization, claims , membership data, and clinical outcomes to uncover… more
- Otsuka America Pharmaceutical Inc. (Sacramento, CA)
- **Otsuka Pharmaceutical Company is a global healthcare company with the corporate philosophy: "Otsuka-people creating new products for better health worldwide." ... for the maintenance of everyday health** **As the** **Associate Director ,** **Statistical** **Programming** **, you will** **be** **responsible for** **managing**… more
- Humana (Sacramento, CA)
- …Medical Director (CMD) relies on medical background to review health claims and preservice appeals. The Corporate Medical Director works on problems ... and complexity ranging from moderate to substantial. The Corporate Medical Director provides medical interpretation and decisions regarding the appropriateness and… more
- Pfizer (Sacramento, CA)
- …+ Leadership in innovative project start-up and management + Understanding of the complex business environment within the US healthcare system as well as ... **ROLE SUMMARY** The Oncology Field Medical Outcomes, Director is a field-based medical colleague responsible for...role will interact with accounts in the region including Healthcare Decision Makers (HCDM) affiliated with organized customers. The… more
- Cardinal Health (Sacramento, CA)
- …can get life-changing therapies to patients who need them-faster. The Associate Director , Access and Patient Support (APS) is responsible for the tactical execution ... collaboration and integration with cross functional teams. The Associate Director oversees revenue and budget accountability, organizational development, and… more
- Highmark Health (Sacramento, CA)
- …experience selling broad range of SaaS, PaaS, BPaaS and professional services in a complex healthcare sales cycle environment + 8 years of experience with proven ... healthcare technology products especially in Clinical, Digital, Provider, Claims , Enrollment, Billing, Benefits, Products and Services. Knowlege of Provider… more
- Otsuka America Pharmaceutical Inc. (Sacramento, CA)
- The Director , Global Medical Publications will support Otsuka in leading and developing an overall scientific communication strategy for publications and congresses, ... Skills: + Minimum 10 years of experience in the healthcare /pharmaceutical sector with 5+ years of experience in Medical...messages succinctly + Understand detailed technical information and convey complex ideas to a variety of audience types and… more
- Humana (Sacramento, CA)
- …The Corporate Medical Director relies on medical background and reviews health claims . The Corporate Medical Director works on problems of diverse scope and ... complexity ranging from moderate to substantial. The Corporate Medical Director provides medical interpretation and decisions about the appropriateness of services… more
- Providence (Irvine, CA)
- …Are you a strategic genius with a fervent passion for revolutionizing healthcare ? Do you excel in navigating multifaceted challenges and steering the course ... towards the future of healthcare delivery? If this resonates with you, we have...unparalleled opportunity awaiting you! **The Role** As the Senior Director of Product Development, you will spearhead the successful… more
- Evolent (Sacramento, CA)
- …Codes, CPT Codes, RVUs, bundled payments, etc. + Working knowledge of healthcare claims ; specifically, differences between institutional vs professional billing ... providers to achieve better outcomes for people with most complex and costly health conditions. Working across specialties and...Stay for the culture. **What You'll Be Doing:** The Director of Performance Analytics - **Oncology and Member** focus… more
- UCLA Health (Los Angeles, CA)
- …Bring We're looking for a strategic, analytical finance leader who thrives in a complex healthcare environment. The ideal candidate will have: * A bachelor's ... Description Shape the Future of Healthcare Finance at UCLA Health Take your career...one of the nation's top academic health systems. As Director of Reimbursement, you'll play a pivotal role in… more