- CenterWell (Sacramento, CA)
- **Become a part of our caring community and help us put health first** The Medical Director , Primary Care relies on medical background and reviews health ... claims. The Medical Director , Primary Care work assignments involve moderately complex to...data requires an in-depth evaluation of variable factors. The Medical Director relies on medical … more
- Humana (Sacramento, CA)
- …our caring community and help us put health first** The Behavioral Health Medical Director is responsible for behavioral health care strategy and/or operations. ... The Behavioral Health Medical Director work assignments involve moderately complex to complex issues where the analysis of situations or data requires an… 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...data requires an in-depth evaluation of variable factors. The Medical Director actively uses their medical… more
- Humana (Sacramento, CA)
- **Become a part of our caring community and help us put health first** The Medical Director relies on fundamentals of CMS Medicare Guidance on following and ... reviewing home health, SNF, DME, dual Medicare/Medicaid and Waiver requests. The Medical Director provides medical interpretation and determinations whether… more
- Humana (Sacramento, CA)
- **Become a part of our caring community and help us put health first** The Medical Director relies on fundamentals of CMS Medicare Guidance on following and ... reviewing home health, SNF, DME, dual Medicare/Medicaid and Waiver requests. The Medical Director provides medical interpretation and determinations whether… more
- Humana (Sacramento, CA)
- …a part of our caring community and help us put health first** The Medical Director relies on medical background and reviews preauthorization requests ... for services. The Medical Director work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth… more
- Wellpath (Yuba City, CA)
- …for training, education, and point of care support. **About this role** As a Medical Director , you will be responsible for providing medical oversight ... documentation of services is provided to the Regional or Corporate Medical Director or designee to monitor services and compliance with facility/client contract.… more
- Wellpath (Woodland, CA)
- …for training, education, and point of care support. **About this role** As a Medical Director , you will be responsible for providing medical oversight ... documentation of services is provided to the Regional or Corporate Medical Director or designee to monitor services and compliance with facility/client contract.… 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 to ... understand how to operationalize this knowledge in their daily work. The Medical Director 's work includes reviewing of all submitted medical records,… more
- CVS Health (Sacramento, CA)
- …day. **Position Summary** Aetna, a CVS Health company, has an outstanding opportunity for a Medical Director . Ready to take your career to the next level with a ... and can be located anywhere in the United States. In this role as Medical Director MPO ( Medical Policy & Operations) you will be responsible for providing… more
- Parexel (Sacramento, CA)
- …we are expanding our esteemed Medical Sciences Team and seeking an Associate/ Medical Director to support the growth of our Global Immunology and Inflammation ... Therapeutic Franchise. As an Associate / Medical Director , you will work closely with some of the best and brightest in the industry and assist our clients in… more
- Evolent (Sacramento, CA)
- …the mission. Stay for the culture. **What You'll Be Doing:** As a Cardiology, Field Medical Director you will be a key member of the utilization management team. ... on-going training per inter-rater reliability process. + May assist the Senior Medical Director in research activities/questions related to the Utilization… more
- Evolent (Sacramento, CA)
- …in a non-clinical setting? Join our Utilization Management team as a Field Medical Director , Cardiovascular Specialist and use your expertise in interventional ... on-going training per inter-rater reliability process. + May assist the Senior Medical Director in research activities/questions related to the Utilization… more
- Humana (Sacramento, CA)
- **Become a part of our caring community and help us put health first** The Medical Director relies on broad clinical expertise to review Medicare drug appeals ... (Part D & B). The Medical director work assignments involve moderately complex to complex issues where the analysis of situations or data requires a case by case… more
- Evolent (Sacramento, CA)
- …mission. Stay for the culture. **What You'll Be Doing:** As a Vascular Surgery, Field Medical Director you will be a key member of the utilization management ... on-going training per inter-rater reliability process. + May assist the Senior Medical Director in research activities/questions related to the Utilization… more
- Parexel (Sacramento, CA)
- …Patients First, Quality, Respect, Empowerment & Accountability. **Parexel is looking for a Medical Director with a very strong background in Ophthalmology to ... role can be based remo** t **ely in the US or Canada.** The Medical Director is a medical expert with specialized therapeutic expertise and some experience… 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, ... of performance improvement initiatives for capitated providers. + Assists Chief Medical Director in planning and establishing goals and policies to improve… more
- Humana (Sacramento, CA)
- …a part of our caring community and help us put health first** The Corporate Medical Director relies on medical background and reviews health claims. The ... Corporate Medical Director works on problems of diverse scope and complexity...and complexity ranging from moderate to substantial. The Corporate Medical Director provides medical interpretation… more
- Evolent (Sacramento, CA)
- …per inter-rater reliability process. + On a requested basis, may function as Medical Director for selecting health plans or regions, assuming overall ... accountability for utilization management while working in conjunction with the Senior Medical Director . May assist the Senior Medical Director in… more
- CVS Health (Sacramento, CA)
- …anywhere in the US.** Aetna, a CVS Health Company, has an exciting opportunity for a Medical Director (Spine) that can be remote based, work from home. The ... Medical Director (Spine) will be a Subject Matter Expert (SME) with a background in Orthopedic Spine OR Neurosurgery, including post-graduate direct patient care… more