- 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 ... **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 (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
- Conviva (Sacramento, CA)
- …community and help us put health first** The Medical Director relies on medical background and reviews health claims . The Medical Director work ... Physician Leadership in Population Health Strategy at Primary Care Organization. The Medical Director conducts Utilization Management of the care received by… more
- Humana (Sacramento, CA)
- … management or utilization management . **Additional Information** Reports to a Lead Medical Director . The Medical Director conducts Utilization ... a part of our caring community and help us put health first** The Medical Director relies on medical background and reviews preauthorization requests… more
- Merck (Sacramento, CA)
- **Job Description** **Role Summary** The Regional Medical Scientific Director is a credentialed (ie, PhD, PharmD, DNP, MD) therapeutic and disease expert who ... SLs, including questions about Company products. The work of an Regional Medical Scientific Director is aligned to: Scientific Exchange, Research, Scientific… more
- 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
- Humana (Sacramento, CA)
- …help us put health first** The Corporate Medical Director relies on medical background and reviews health claims . The Corporate Medical Director ... of diverse scope and complexity ranging from moderate to substantial. The Corporate Medical Director provides medical interpretation and decisions about the… more
- HomeSafe Alliance (Sacramento, CA)
- **Title:** Director of International, Global Household Goods Moving Services **_HomeSafe Alliance_** is the single global household goods movement manager of over ... the Role** HomeSafe Alliance is seeking a highly skilled and motivated Director of International, Household Goods Moving Services to drive optimization and improve… more
- Baylor Scott & White Health (Sacramento, CA)
- … claims data to uncover trends and assist in managing and understanding incurred medical and pharmacy cost. - The Director will design, develop, and support ... **Position Overview:** Reporting to the VP, Value-based Care Analytics, he Director of Healthcare Economics and Trend Analytics will support the Baylor Scott & White… more
- Sedgwick (Sacramento, CA)
- …Place to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer Director Pool Administration **PRIMARY PURPOSE** **:** Oversees higher complexity Sedgwick ... and otherwise on behalf of the pool including the integration and management of cross workstreams within the pool. + Represents the client's policies,… more
- Sedgwick (Sacramento, CA)
- …Care experience highly preferred + Ten (10) years of relationship building in the claims management or risk management area or equivalent combination of ... Place to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer Business Development Director **PRIMARY PURPOSE OF THE ROLE:** To expand and enhance the… more
- Takeda Pharmaceuticals (Sacramento, CA)
- …to bring life-changing therapies to patients worldwide. Join Takeda as Associate Director , Global Labeling Lead where you will be responsible for the development ... guidance. **How you will contribute:** With guidance from leadership: Management of Labeling Cross-Functional Teams + Independently leads Labeling cross-functional… more
- Dignity Health (Woodland, CA)
- …events reporting process, root cause analyses, investigations and requests from the claims team (including management of subpoenas, Summons and Complaints, and ... **Responsibilities** **Summary:** Responsible for the design, coordination, implementation and management of the Organization's Performance Improvement (PI) and Patient… more
- Sutter Health (Sacramento, CA)
- …+ Thorough knowledge of healthcare delivery systems, integrated delivery systems and medical group practices, especially in a managed care environment, as well as ... plan, including expert knowledge of key dimensions of health plan data: Claims , Enrollment, and Revenue. + Superior business acumen, exceptional analytical and… more
- HomeSafe Alliance (Sacramento, CA)
- **Title:** Operations Supervisor - Move Management (International Alaska) **_HomeSafe Alliance_** is the single global household goods movement manager of over ... directly or through PPM options + Provide consolidated oversight and management of coordinators under supervision + Monitor international operations performing… more
- CVS Health (Sacramento, CA)
- …and arranges for health care service delivery under the direction of nurse or medical director in the most appropriate setting at the most appropriate expense ... communication, both internally and externally to enhance effectiveness of medical management services (eg, health care providers,...- May assist in the research and resolution of claims payment issues. - Supports the administration of the… more
- Evolent (Sacramento, CA)
- …Stay for the culture. **What You'll Be Doing:** The **Coordinator, Intake Utilization Management ** at Evolent will serve as a point of contact for processing ... medical treatment requests in accordance with departmental policies, regulatory...contractual agreements. **Collaboration Opportunities** : The Coordinator, Intake Utilization Management reports directly to the Manager, Intake Utilization … more
- Evolent (Sacramento, CA)
- …and LPCs, Clinical Reviewers. Opportunities to work collaboratively with other Utilization Management Leaders including our Director may also be available. ... culture. **What You'll Be Doing:** The **Coordinator, Intake Utilization Management ** at Evolent will serve as a point of...also works with our clinical team, which includes our medical reviews: LVNs, LPNs, and RNs along with our… more
- Sedgwick (Sacramento, CA)
- …department or special projects as assigned by the Finance Manager or Director . + Process account collections/receivables. + Reconcile claims activity between ... To prepare the necessary reports and communicate the results to management . **ESSENTIAL FUNCTIONS and RESPONSIBILITIES** + Creates and maintains accurate and… more
- Sedgwick (Sacramento, CA)
- …powers authority or insurance company or have a background as a safety officer/ director within an organization or public agency, we would welcome the opportunity to ... and implements all state and federal laws related to safety and risk management . + Maintains/expands working knowledge of Cal OSHA regulations and other safety… more