- Humana (Sacramento, CA)
- …or data requires an in-depth evaluation of variable factors. The Medical Director for the National Medicare Outpatient Team provides medical ... caring community and help us put health first** The Medical Director relies on medical ...Prefer Medicaid experience + Utilization management experience in a medical management review organization, such as Medicare … more
- CVS Health (Sacramento, CA)
- …(work at home) based anywhere in the US.** Responsibilities of this Medical Director role are related to Regulated Medicare Appeals: * Direct daily work on ... 6 company, is one of the oldest and largest national insurers. That experience gives us a unique opportunity...* Board Certified in ABMS Recognized Specialty **Preferred Qualifications** Medical Management - Medicare Complaints, Grievance &… more
- Elevance Health (Costa Mesa, CA)
- ** Medicare Quality Management Health Planning Director Sr.** **Location:** This position will work in a hybrid model (remote and office). The ideal candidate ... 50 miles of one of our California Elevance Health PulsePoint locations. The ** Medicare Quality Management Health Planning Director Sr.** will be responsible for… 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...materials, internal teaching conferences, and other sources of expertise. Medical Directors will learn Medicare and … more
- Humana (Sacramento, CA)
- …determinations, clinical reference materials, internal teaching conferences, and other reference sources. Medical Director will learn National LTSS State ... community and help us put health first** The Long-term services and supports (LTSS) Medical Director 's primary responsibility is the review of medical … 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...group practice management. + Utilization management experience in a medical management review organization, such as Medicare … more
- Sharp HealthCare (San Diego, CA)
- …the position, and employer business practices. **What You Will Do** This Senior Medical Director position provides critical management and oversight for Sharp ... for all of Sharp Health Plan products, (Commercial, Exchange, Medicare , POS/PPO) services, and oversees the health care needs...+ 5 years' experience as an HMO Health Plan Medical Director . + California Physicians and Surgeons… 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)
- …our caring community and help us put health first** The Behavioral Health Medical Director responsible for behavioral health care strategy and/or operations. The ... Behavioral Health Medical Director work assignments involve moderately complex...compliance and assisted by diverse resources, which may include national clinical guidelines, state policies, CMS policies and determinations,… more
- Evolent (Sacramento, CA)
- …Evolent for the mission. Stay for the culture. **What You'll Be Doing:** As a Field Medical Director , Genetic Testing you will be a key member of the utilization ... recorded in a timely and accurate manner. + May assist the Senior Medical Director in research activities/questions related to the Utilization Management… more
- WelbeHealth (San Bernardino, CA)
- …is key to WelbeHealth's values, team culture, and mission. The Associate Medical Director performs in-person comprehensive assessments and coordinates with the ... plan for each participant. At the direction of the Medical Director , the Associate Medical ...national origin, ancestry, citizenship, physical or mental disability, medical condition, genetic information or characteristics (or those of… more
- HCA Healthcare (San Jose, CA)
- …candidate is hired below midpoint of the range. **Introduction** We are seeking a Director of Medical Staff Services with Good Samaritan Hospital to promote ... benefits may vary by location._** We are seeking a Director of Medical Staff Services for our...on Accreditation of Healthcare Organizations, California Title XXII regulations, Medicare Conditions of Participation, National Committee on… more
- Stanford Health Care (Palo Alto, CA)
- …age, national or ethnic origin, political beliefs, marital status, medical condition, genetic information, veteran status, or disability, or the perception of ... performing 450-500 heart, lung, liver, kidney, and pancreas transplants annually. The Director of Business Operations for Solid Organ Transplant will play a key… more
- Evolent (Sacramento, CA)
- …for the mission. Stay for the culture. **What You'll Be Doing:** **Associate Medical Director - Cardiovascular Medicine (Cardiologist) | Evolent Health** Are you ... to drive meaningful change beyond the bedside? Evolent Health is seeking an **Associate Medical Director - Cardiovascular Medicine** to play a critical role in… more
- Humana (Sacramento, CA)
- …our caring community and help us put health first** The Associate Director - Value-based Specialty and Vendor Support role builds templates, standard documentation, ... case studies, and disseminates best in class knowledge. The Associate Director requires a solid understanding of how organization capabilities interrelate across… more
- Genesis Healthcare (Los Angeles, CA)
- …Powerback is the place for you. **Why Powerback?** + **Benefits:** We offer Medical , Dental, and Vision plans to Full-Time and Part-Time team members. + **Support ... expertise with our Clinicians in Action professional development program. Responsibilities The Director of Rehab OT is responsible for the efficient management of… more
- Silicon Valley Power (Santa Clara, CA)
- ** Director of Silicon Valley Power** Print (https://www.governmentjobs.com/careers/cityofsantaclaraca/jobs/newprint/4865716) ** Director of Silicon Valley ... City of Santa Clara is looking for a forward-thinking ** Director of Silicon Valley Power (SVP)** who will shape...considered without regard to age, race, color, religion, sex, national origin, sexual orientation, disability, veteran status or any… more
- Neogen Care (Los Angeles, CA)
- …operate with ethics at the center of our Core Values. We are seeking a long-term Director of Patient Care Services to play a key role in continuing to grow our ... with our Kaiser partners while ensuring we maintain our core values, high Medicare quality ratings, and the highest possible patient outcomes. If you are seeking… more
- LA Care Health Plan (Los Angeles, CA)
- …and motivating direct-reports. Duties General Essential functions: Collaborating with the Medical Director , responsible for the operations, programming and ... LA Care members healthy and access appropriate services. The Director will also work with the CM Medical...department performs the following: All contracts [(ie Centers for Medicare and Medicaid Service (CMS), California Department of Health… more