- Alameda Health System (Oakland, CA)
- …Generous paid time off plans Role Overview: Alameda Health System is hiring! The Director of Utilization Management holds a critical role encompassing ... adapting to ad hoc duties as needed. In essence, they orchestrate efficient utilization management to deliver high-quality patient care. DUTIES & ESSENTIAL JOB… more
- One Medical (San Mateo, CA)
- …care services, on-site labs, and programs for preventive care, chronic care management , common illnesses and mental health concerns have been delighting people for ... that make One Medical unique. As an Office Medical Director , you'll have the chance to lead your local...priorities. You will be able to continually develop your management and leadership skills as you learn about our… more
- Alameda Health System (Oakland, CA)
- Director , Utilization Management + Oakland, CA + Highland General Hospital + SYS Utilization Management + Full Time - Day + Nursing + Req ... off plans **Role Overview:** Alameda Health System is hiring! The Director of Utilization Management holds a critical role encompassing operational… more
- Prime Healthcare (Inglewood, CA)
- …Workers, and Clinical Coordinators. This leader will oversee all facets of utilization management , discharge planning, and care coordination to ensure patients ... ie full-time or part-time. Responsibilities We are seeking a strategic and compassionate Director of Case Management to lead our dynamic Case Management… more
- 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 ... 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
- Humana (Sacramento, CA)
- …to the Lead Medical Director - North Central Medicaid Markets. The Medical Director conducts Utilization Management of the care received by members in ... community and help us put health first** The Medical Director relies on medical background and reviews health claims....with prior experience participating in teams focusing on quality management , utilization management , case … 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 relies on medical background and reviews health claims....with prior experience participating in teams focusing on quality management , utilization management , case … more
- Dignity Health (Bakersfield, CA)
- …, remote patient monitoring, and CRM. - Provide backup support to the Medical Director of Utilization Management in medical review activities, peer-to-peer ... primarily in the Bakersfield/Central CA region.** **Position Summary:** The Medical Director of Physician Engagement is responsible for developing and driving… more
- Ventura County (Ventura, CA)
- …and communicates matters of VCHCP medical policy with the Health Care Agency Director and Insurance Administrator, Utilization Management staff and Quality ... surgical procedures, referrals, tests, medication approvals requiring authorization.) + Develops utilization management standards and guidelines for approval by… more
- LA Care Health Plan (Los Angeles, CA)
- …observation) admission in the acute setting. Works with UM leadership, including the Utilization Management Medical Director , on requests where determination ... Utilization Management Admissions Liaison RN II...data presented and established criteria/guidelines, escalating to the medical director if needed. Triages and assesses members for admission… more
- Dignity Health (Bakersfield, CA)
- …the managed care populations. This leader will have direct oversight of the Medical Director of Utilization Management (UM) and the Medical Director ... and experience leading complex and innovative delivery models. + Experience in Utilization Management activities. + Strong communication skills, and ability to… more
- CenterWell (Sacramento, CA)
- …**Additional Information** Will report to the Director of Physician Strategy at Utilization Management . The Medical Director conducts Utilization ... 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 … more
- Sharp HealthCare (San Diego, CA)
- …the direction of the manager of in-patient care management and the Director of Utilization Management . **Required Qualifications** + 3 Years Experience ... Facility/Regional - SCMG Operations meetings and task forces.Facilitate regional Utilization Management committees and other working regional… more
- The County of Los Angeles (Los Angeles, CA)
- NURSING DIRECTOR , ADMINISTRATION ( Director , Workforce Management and Operations) Print ... (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/3110377) Apply NURSING DIRECTOR , ADMINISTRATION ( Director , Workforce Management and Operations) Salary $163,996.80… more
- Providence (Mission Hills, CA)
- …and screens phones. Schedules and coordinates all meetings attended by Administrative Director of Managed Care, Contract Manager, Case Managers and UM supervisors. ... ID:** 403694 **Company:** Providence Jobs **Job Category:** Health Information Management **Job Function:** Revenue Cycle **Job Schedule:** Full time **Job… more
- Evolent (Sacramento, CA)
- …Clinical Reviewer, Interventional Pain Management , you will be a key member of the utilization management team. We can offer you a meaningful way to make a ... + On a requested basis, may function as Medical Director for selecting health plans or regions, assuming overall...selecting health plans or regions, assuming overall accountability for utilization management while working in conjunction with… more
- University of Southern California (Los Angeles, CA)
- The Senior Director , Integrated Risk Management , is responsible for designing and executing the Keck Medicine of USC Office of Integrated Risk Management at ... mitigate and monitor the Health System's Clinical Risk. Senior Director will facilitate the identification of risk management...the management of Health System Integrated Risk Management Budget. * Ensures resource utilization in… more
- UCLA Health (Los Angeles, CA)
- …of multiple clinical programs and medical services with an emphasis on optimizing Utilization Management for the Faculty Practice Group (FPG) Management ... Description We are seeking a highly skilled and dynamic Director of Clinical Services to lead the development, evaluation,...the delivery of program functionalities in all aspects of Utilization Management and its integration with other… more
- Centene Corporation (Sacramento, CA)
- …of Certifying Board Service (Internal and Family Medicine, preferred) + Utilization Management experience and knowledge of quality accreditation standards. ... functions for the business unit. + Provides medical leadership of all for utilization management , cost containment, and medical quality improvement activities. +… more
- 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 ... of the rehabilitation department, including oversight related to case management , quality improvement, care planning, clinical utilization , and patient… more
