• Medical Director - Claims

    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
    Humana (10/16/25)
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  • Medical Director - Florida

    Humana (Sacramento, CA)
    …community and help us put health first** The Medical Director relies on medical background and reviews health claims . The Medical Director work ... Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members in an… more
    Humana (10/03/25)
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  • Medical Director , Global…

    Otsuka America Pharmaceutical Inc. (Sacramento, CA)
    …medicines for those with CNS disorders, we are seeking a skilled and experienced Medical Director of CNS Early Assets, Global Medical Affairs, responsible ... , Franchise Lead CNS Early Assets. **Position Summary:** The Medical Director , Global Medical Affairs,...for any assigned assets in development. + Support lifecycle management initiatives and planning for assigned assets as applicable.… more
    Otsuka America Pharmaceutical Inc. (10/14/25)
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  • Remote Medical Director - California…

    Centene Corporation (Sacramento, CA)
    …the Chief Medical Director to direct and coordinate the medical management , quality improvement and credentialing functions for the business unit. + ... 28 million members as a clinical professional on our Medical Management /Health Services team. Centene is a...performance improvement initiatives for capitated providers. + Assists Chief Medical Director in planning and establishing goals… more
    Centene Corporation (08/15/25)
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  • Remote Behavioral Medical Director

    Centene Corporation (Sacramento, CA)
    …the Chief Medical Director to direct and coordinate the medical management , quality improvement and credentialing functions for the business unit. + ... 28 million members as a clinical professional on our Medical Management /Health Services team. Centene is a...performance improvement initiatives for capitated providers. + Assists Chief Medical Director in planning and establishing goals… more
    Centene Corporation (09/18/25)
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  • Manager, Medical Director

    Elevance Health (Walnut Creek, CA)
    **Manager, Medical Director - Transformation Initiatives** Location: This role requires associates to be in-office 3 days per week, fostering collaboration and ... is granted as required by law. Alternate locations may be considered. The **Manager, Medical Director ** will serve as a clinical and strategic advisor to… more
    Elevance Health (10/04/25)
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  • Medical Director - SIU (Special…

    CVS Health (Sacramento, CA)
    …and more compassionate. And we do it all with heart, each and every day. Medical Director - SIU (Special Investigations Unit) CVS Health - Special Investigations ... our mission to safeguard healthcare integrity and protect patient well-being. As the Medical Director of Healthcare Fraud Investigations, you'll lead our efforts… more
    CVS Health (10/01/25)
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  • Corporate Medical Director

    Humana (Sacramento, CA)
    …put health first** The Corporate Medical Director (CMD) relies on medical background to review health claims and preservice appeals. The Corporate ... Medical Director works on problems of diverse scope and complexity...focused on continuously improving consumer experiences **Preferred Qualifications** + Medical utilization management experience + Working with… more
    Humana (09/05/25)
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  • Provider Network Management Director

    Elevance Health (Walnut Creek, CA)
    **Provider Network Management Director ** **Location:** This role requires associates to be in-office 3 days per week, fostering collaboration and connectivity, ... is granted as required by law. The **Provider Network Management Director ** is responsible for developing and...not only in contracting but also solid understanding of claims , pricing, and system configuration. The ideal candidate must… more
    Elevance Health (10/18/25)
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  • Medical Director - Medicare…

    Humana (Sacramento, CA)
    …us put health first** The Corporate Medical Director relies on medical background and reviews health claims and preservice appeals. The Corporate ... Medical Director works on problems of diverse scope and complexity...focused on continuously improving consumer experiences **Preferred Qualifications** + Medical utilization management experience, + working with… more
    Humana (10/02/25)
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  • Director -Assistant Rehab

    Genesis Healthcare (Elk Grove, CA)
    …or In-Training (IT) Director of Rehab is responsible for assisting the Director of Rehab in the efficient management of rehabilitation services in his/her ... place for you. **Why Powerback?** + **Benefits:** We offer Medical , Dental, and Vision plans to Full-Time and Part-Time...rehabilitation services in all settings. The Assistant or IT Director of Rehab supports the delivery of the highest… more
    Genesis Healthcare (07/30/25)
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  • Senior Director , Global Clinical…

    Otsuka America Pharmaceutical Inc. (Sacramento, CA)
    …medicine and/or clinical pharmacology and associated disciplines (eg biostatistics, data management , medical writing). + An advanced understanding of clinical ... in support of domestic and international clinical development initiatives. The Senior Director , GCD works in a multidisciplinary matrix environment and supports the… more
    Otsuka America Pharmaceutical Inc. (10/14/25)
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  • Associate Director , Established Brands…

    Otsuka America Pharmaceutical Inc. (Sacramento, CA)
    **_Associate Director , Established Brands Marketing_** **Position Summary** The Associate Director , Established Brands Marketing is responsible for driving ... CNS portfolio. The individual will work closely with market access, sales, medical affairs, and finance to implement commercial strategies that sustain product… more
    Otsuka America Pharmaceutical Inc. (08/15/25)
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  • Director Pool Administration | California…

    Sedgwick (Sacramento, CA)
    …Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Director Pool Administration | California | Travel Required Find the support you ... your goals while building a fulfilling career as a Director Pool Administration. **PRIMARY PURPOSE OF THE ROLE** **:**...to hear from you. A client-focused mindset and program management experience are key. This hybrid role may also… more
    Sedgwick (09/23/25)
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  • Director , Global Value Evidence Operations

    Otsuka America Pharmaceutical Inc. (Sacramento, CA)
    **Position Summary:** The Director GVE Operations oversee and coordinates projects within the department to ensure alignment with organizational goals. This role is ... other integrated data generation initiatives. This position reports to the Senior Director , Global Integrated Evidence & Innovation Operations and can be based in… more
    Otsuka America Pharmaceutical Inc. (09/13/25)
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  • Medical Director (Southern CA)

    Molina Healthcare (Sacramento, CA)
    …retrospective reviews of claims and appeals and resolves grievances related to medical quality of care. * Attends or chairs committees as required such as ... JOB DESCRIPTION Job Summary Provides medical oversight and expertise in appropriateness and ...services provided to plan members. * Supports plan utilization management program and accompanying action plan(s), which includes strategies… more
    Molina Healthcare (10/02/25)
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  • Associate Director , Field Strategy,…

    Otsuka America Pharmaceutical Inc. (Sacramento, CA)
    **Associate Director , Field Strategy, Nephrology/Immunology** **Position overview:** The **Associate Director , Field Strategy** plays a critical role in enabling ... execution and provide feedback to optimize performance at all levels + **Compliance Management :** + Must comply with all state and federal laws, regulations and… more
    Otsuka America Pharmaceutical Inc. (09/03/25)
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  • Senior Director , MSAT Biologics

    Otsuka America Pharmaceutical Inc. (Sacramento, CA)
    **Position Overview:** The Senior Director , MSAT Biologics provides strategic and technical leadership for all late-stage and commercial manufacturing processes for ... through effective technology transfer, validation, process monitoring, and lifecycle management . This individual will serve as the primary technical steward… more
    Otsuka America Pharmaceutical Inc. (10/13/25)
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  • Associate Director , Performance Analytics

    Evolent (Sacramento, CA)
    …on oncology and member-centric products. This role plays a critical part in both ** Medical Cost Management ** and **Product Management ** , leveraging advanced ... mission with a company behind it. **What You'll Be Doing:** **Associate Director , Performance Analytics - Oncology & Member Product Focus** **Overview:** Evolent is… more
    Evolent (10/13/25)
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  • Lead Director , Network and Trend…

    CVS Health (Sacramento, CA)
    …needs. Develop and execute strategic initiatives through pricing, network curation, and medical management that lead to sustainable long-term growth and revenue. ... each and every day. **Position Overview** **Reports To: Executive Director , Region Development Officer** + Manages medical ... cost by partnering with Provider Contracting, MEU, Pharmacy, Claims Cost Management , Innovation, and Clinical to… more
    CVS Health (10/08/25)
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