- Elevance Health (Cerritos, CA)
- ** Medical Director - Utilization Management ** **Location: This is a hybrid position with the expectation to go into the office at least 1 day a week, ... within 50 miles of an Elevance Health location.** The Medical Director is responsible for the administration...state or territory of the United States when conducting utilization review or an appeals consideration and cannot be… more
- Molina Healthcare (Long Beach, CA)
- …, Group/IPA practice, capitation, HMO regulations, managed healthcare systems, quality improvement, medical utilization management , risk management , risk ... resource management . + Develops and implements a Utilization Management program and action plan, which...activity (QIA) in collaboration with the clinical lead, the medical director , and quality improvement staff. +… more
- Elevance Health (Cerritos, CA)
- …of applicable clinical criteria and relevant Carelon Medical Benefits Management policies pertaining to utilization review. + Demonstrate and maintain ... necessity of requests using clinical appropriateness guidelines. The **Associate Medical Director , Clinical Operations (Surgery)** is responsible for supporting… more
- Elevance Health (Costa Mesa, CA)
- **Clinical Ops Associate Medical Director - Ortho** **Location:** **This is a virtual position. Candidates must reside within 50 miles of an Elevance Health ... analytics to improve the delivery of care. The **Clinical Ops Associate Medical Director - Ortho** is responsible for performing pre-authorizations and… more
- Elevance Health (Cerritos, CA)
- … Medical Director , Clinical Operations** is responsible for supporting the medical management staff ensuring timely and consistent medical decisions ... testing. + Determine medical necessity of requests using Carelon Medical Benefits Management Medical Necessity Guidelines, client-specific health… more
- Elevance Health (Cerritos, CA)
- … Medical Director , Sleep Medicine** is responsible for supporting the medical management staff ensuring timely and consistent medical decisions to ... to work in a dynamic, fast-paced environment. + Preferred interest in Sleep management utilization review. For candidates working in person or remotely in… more
- Jacobs (Irvine, CA)
- As a Market Growth Director you report to your assigned Executive Director of Sales (EDS). You are responsible for the development of a water market strategy ... include input and create alignment with the Lead Account Strategist (LAS), the Director of Operations (DO) aligned to your market, and Market Solutions Leadership… more
- Banfield Pet Hospital (Fountain Valley, CA)
- …to do what they love, whether in primary, specialty, and emergency care or management and leadership. Role Purpose As a Director , Data Platform Engineering, you ... data operations, identifying and addressing issues and optimizing resource utilization . + Platform Access Management : Manage data...can spend time with the people you love. + Medical , dental, and vision insurance for you and your… more
- MicroVention, Inc. (Aliso Viejo, CA)
- …capabilities. + Stay current with industry trends, regulations, and best practices in medical device project management , and apply them to improve project ... **12579BR** **Title:** Director , Quality Engineering (Transfers) **Job Description:** Create, lead,...relevant field of study. 2. Strong knowledge of Quality Management Systems, medical device development, regulatory requirements,… more
- Skyworks (Irvine, CA)
- Sr. Director , EDA Engineering Apply now " Date:Nov 29, 2024 Location: Irvine, CA, US Company: Skyworks If you are looking for a challenging and exciting career in ... a strong focus on global collaboration, minimal layers of management , and the freedom to make meaningful contributions in...Requisition ID: 72376 Job Summary Skyworks seeks a Senior Director of EDA Engineering to lead advanced EDA engineering… more
- WM (Sun Valley, CA)
- …age, national origin, disability, or veteran status. We are seeking an experienced Director of Disposal for our Landfill Operations to lead the Landfill Disposal ... California, preferably near Los Angeles or Riverside County. Relocation also available. ** Director of Disposal Job Summary** This key leadership role will lead the… more
- AbbVie (Irvine, CA)
- …medicines and solutions that solve serious health issues today and address the medical challenges of tomorrow. We strive to have a remarkable impact on people's ... Facebook, Instagram, YouTube and LinkedIn. Job Description The Creative Director , Copy is known as a leader in the...closely with Editorial, Art, and Account, along with Creative Management , to ensure that clients are satisfied with the… more
- WSP USA (Irvine, CA)
- This Opportunity WSP is looking for a **Senior Vice President Transportation Director /Local Business Lead (LBL)** for **Orange County** , based in our Irvine office. ... efforts in coordination with Region, District, National Business Lines, and Pursuit Management . + Integrates as the "face of the company" locally and across… more
- J&J Family of Companies (Irvine, CA)
- … Management will work closely with the Sr. Manager, Contract Management , Director , Customer Operations, Corporate Accounts Managers, and commercial leaders, ... six (6) years of progressive experience in Contracting, Sales & Marketing or Finance Management , preferably in the medical device industry or an FDA regulated… more
- Dignity Health (Northridge, CA)
- **Overview** Founded in 1955 Dignity Health - Northridge Hospital Medical Center is a 394-bed acute care nonprofit community hospital located in Northridge ... cardiovascular center stroke center the Center for Assault Treatment Services a pediatric medical center and the only pediatric trauma center in the San Fernando… more
- Elevance Health (Costa Mesa, CA)
- …nursing judgment to determine whether treatment is medically necessary and provides consultation to Medical Director on cases that are unclear or do not satisfy ... care, eg, if services are not in line with diagnosis. + Provide consultation to Medical Director on particularly peculiar or complex cases as the nurse deems… more
- Elevance Health (Costa Mesa, CA)
- …in process improvement initiatives to improve the efficiency and effectiveness of the utilization reviews within the medical management processes. + Assesses ... be subject to review by more senior nurses or Medical Director . Primary duties may include but...orientation materials. + May complete quality audits and assist management with developing associated corrective action plans. + May… more
- Molina Healthcare (Long Beach, CA)
- …education, outreach and resolving provider inquiries. * In conjunction with the Director , Provider Network Management & Operations, develops health plan-specific ... quality initiatives. * Engages contracted network providers regarding cost control initiatives, Medical Care Ratio (MCR), non-emergent utilization , and CAHPS to… more
- Grant Thornton (Newport Beach, CA)
- …design and implement internal controls + Support engagement Manager and/or Senior Manager/ Director in project management activities, such as preparing and ... exceptional expertise and experience in healthcare providers, specifically hospitals, academic medical centers, and healthcare systems. This includes areas such as… more
- Panasonic Avionics Corporation (Irvine, CA)
- …functional status reporting on process utilization /execution. Supports Regional Director as required. ** Management of Integration Activities** + Identify ... program success. May perform as subject matter expert on Program Management processes, including development of documentation, training and mentoring on processes… more