- 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
- HomeSafe Alliance (Sacramento, CA)
- …and motivated Assistant Claims Manager to assist in all aspects of claims management , to support and promote process improvement methodologies and best ... Raising awareness of any settlement practices, trends, or areas of concern to the Director of Claims . Responds to internal and external customer disputes and… 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
- 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
- Merck (Sacramento, CA)
- …needs to support collaboration to further differentiate our portfolio. The Oncology Regional Medical Scientific Director , RMSD, is a credentialed (ie, MD, PhD, ... **Job Description** Our Medical Affairs team advances patient care by engaging...and scientific community. Scientific exchange does not include promotional claims about any drug, vaccine or biologic product. RMSDs… more
- Cardinal Health (Sacramento, CA)
- …and delivers human resource programs and policies, including recruitment, talent management , diversity and inclusion, compensation and benefits, among others. This ... **_Job Summary_** We are seeking an experienced and strategic Director of US Benefits to lead and oversee the...Benefits to lead and oversee the design, implementation, and management of employee benefit programs. This role will be… more
- Sedgwick (Sacramento, CA)
- …Place to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer Assistant Pool Director /Administrator Are you looking for an impactful job where you can apply ... processes, pool structure, governing, documents, regulatory requirements, risk control, and claims for assigned pool(s). Acts as the main contact for all… more
- Centene Corporation (Sacramento, CA)
- …everything for our 28 million members as a clinical professional on our Medical Management /Health Services team. Centene is a diversified, national organization ... functions for the health plan business units. + Provides medical leadership for utilization management activities and...improve the quality and cost of care. + Reviews claims involving complex, controversial, or unusual or new services… more
- United Therapeutics (Sacramento, CA)
- …orphan diseases. **How you'll contribute** The Associate Analytics, Insights and Operations Director , Market Access will lead data support across all functions of ... Compliance, Legal, Information Technology, Sales & Marketing Operations, Finance, and Medical Affairs / HEOR. Additionally, this role will support special pricing… 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
- 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
- Merck (Sacramento, CA)
- …deliver measurable impact in commercial pharma landscape. + Knowledge in mining medical claims /EMR, social media, etc. data with a strategic/inquisitive mindset ... **Job Description** The Associate Director Data Science will be responsible for developing and communicating data-driven and actionable insights that drive greater… 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
- Zurich NA (Sacramento, CA)
- …Member of the Bar + Extensive experience in and in-depth knowledge of Casualty claims management + Highly detail-oriented with a strong focus on accuracy + ... AVP, Medical Bill Review Litigation 119916 Zurich Insurance is...and other legal filings + Maintain accurate and up-to-date claims documentation, ensuring compliance with best practices for high-complexity… more
- Sutter Health (Sacramento, CA)
- …the Director by presenting and escalating cases to senior management requiring administrative approval or intervention. * Works collaboratively with ... recent relevant experience **SKILLS AND KNOWLEDGE:** Knowledge of Accreditation Council for Medical Affairs (ACMA), Case Management Society of America (CMSA) 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