Medicare Medical Director — Utilization & Care Oversight
$223.8k - $313.1kHumana Inc
Humana Inc. in Sacramento is seeking a Medical Director to oversee clinical policies and authorization processes regarding Medicare and Medicare Advantage services. You will leverage your clinical judgment to navigate complex cases, ensuring compliance with guidelines and regulatory standards. The ideal candidate will have an MD or DO, relevant experience, and demonstrated skills in conflict resolution. Flexible working options available, and competitive compensation range from $223,800 to $313,100 annually. #J-18808-Ljbffr Humana Inc
$223.8k - $313.1k
Become a part of our caring community The Medical Director National OP Medicare relies on medical background and reviews... ...Advantage requirements in daily utilization management and coverage determination... ...resource utilization. Provide oversight or input, as applicable,...SuggestedBi-weekly payFull timeTemporary workApprenticeshipRemote workWork from homeHome office- ...Description Join Our Team as a Center Medical Director! InnovAge’s Program of All-inclusive Care for the Elderly (PACE) is an... ...is also responsible for oversight of day-to-day medical operations... ...budget, quality initiatives, utilization and resource management and providing...SuggestedTemporary workFlexible hours
- ...enrolled participants. The Center Medical Director provides medical care for InnovAge PACE enrolled... ...Director is also responsible for oversight of day-to-day medical operations at... ...department budget, quality initiatives, utilization and resource management. Physical...SuggestedTemporary workLocal areaMonday to FridayFlexible hoursNight shiftWeekend work
$230.9k - $384.8k
...ROLE SUMMARY The I&I Field Medical, Gastroenterology (GI)/ Endocrine Director is responsible for providing therapeutic... ...changing and evolving external health care environment Demonstrate change... ...technical skills Rapidly adopt and utilize new digital technology and other resources...SuggestedPermanent employmentH1bLocal areaRemote workWorldwideVisa sponsorshipWork visaRelocation packageFlexible hours$223.8k - $313.1k
...Overview Become a part of our caring community and help us put health first The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing Home Health... ...Intermediate to advanced skills utilizing Microsoft Office and Internet navigation...SuggestedFull timeTemporary workApprenticeshipWork at officeRemote workWork from homeMonday to Friday- ...proactively supervising team to provide complex direct patient care, drug utilization, and educational programs related to ambulatory care to... ...supervising team and may also provide direct patient care for medication initiation, medication selection, dosage titration, drug...InternshipLocal area
$223.8k - $313.1k
Become a part of our caring community The Medical Director relies on medical background and reviews health claims... ...Medicine, or those experienced in Utilization Review are encouraged to apply.... ...utilization management or inpatient review (Medicare Advantage, Managed Medicaid, or...Bi-weekly payFull timeTemporary workApprenticeshipWork at officeLocal areaRemote workWork from homeHome officeMonday to FridayWeekend work- ...Regional Medical Director Opportunity – Los Angeles, CA A well-established... ...health & value-based care • Oversight of inpatient + outpatient... ...Focus on quality improvement, utilization management, and reducing... ...✔ Managed Care / IPA / Medicare Advantage experience Looking...
$122.3k - $158.9k
...About the job Clinical Supervisor RN - Recuperative Care (Medical Respite) About WellSpace Health: WellSpace Health is the... ...populations. What You'll Do: - Provide clinical leadership and oversight to a team of 2 LVNs and 8-12 Clinical Support Specialists -...Flexible hours- ...leading provider of end-of-life care, and has the resources and... ...JOB DESCRIPTION The medical director of VITAS fulfills two primary... ...insurance and intermediaries (i.e. Medicare) Ensure that all... ...: Ensure medications are utilized within accepted standards of...Local areaFlexible hours
$70.66k - $115.63k
Behavioral Health Care Manager I A proud member of the Elevance Health family of companies... ...assess member needs to ensure access to medically necessary quality behavioral healthcare... ...Qualifications Previous experience in utilization management with a broad range of...Full timeContract workWork experience placementWork at officeLocal area$126.36k - $140.6k
...looking for a compassionate clinical leader to ensure quality patient care and guide a clinician team. With responsibilities including... ...alongside a $10K sign-on bonus and comprehensive benefits including medical coverage and retirement plans. #J-18808-Ljbffr Carbon HealthRelocation package- ...Description We are seeking a Clinical Care Manager – CA to join our team at Independent... ...care plans for patients with complex medical needs. Coordinate communication among... ...Collaborate with insurance providers and case management teams to optimize resource utilization....
- ...Summary Advise clients on network strategy, utilization performance, and provider market... ...Understanding of service line strategy and site-of-care optimization (ASC vs HOPD, home-based... ...competitive suite of benefits including medical, dental, vision, life, and long-term...Live inWork at officeLocal areaWork from home
$220k - $240k
South Sacramento Pet Hospital is looking for a skilled Medical Director Veterinarian to provide high-quality veterinary care in Sacramento, California. The ideal candidate will have excellent communication skills and a commitment to compassionate care, overseeing a team...Relocation package- Ascension St Vincent is seeking a Pediatric Hematology/Oncology Medical Director in Sacramento, CA. This leadership role involves overseeing... ...hematology and oncology program while actively practicing clinical care. Candidates should possess an MD or DO with board...
$220k - $240k
South Sacramento Pet Hospital seeks a compassionate Medical Director Veterinarian in Sacramento, California. The ideal candidate will ensure high-quality veterinary care, manage clinical operations, and support an experienced team. Responsibilities include overseeing medical...Relocation package$220k - $240k
Accreditation Council for Graduate Medical Education is looking for a Medical Director Veterinarian in Sacramento, California. This role requires a strong commitment to high-quality veterinary care and excellent communication skills to build relationships with clients....- Nahse seeks a qualified Medical Pediatric Hematologist/Oncologist Director in Sacramento, CA, to lead our pediatric hematology and oncology program while engaging in direct patient care. This role combines visionary leadership with clinical responsibilities, including overseeing...Flexible hours
$105k - $140k
...Powerback Rehabilitation Director $10,000 BONUS... ..., and home-based care. We're proud to... ...Benefits: We offer Medical, Dental, and... ...daily staffing and utilization with input from treating... ..., including oversight related to case management... ...knowledge of Medicare and third party billing...Full timePart timeH1bWork from homeVisa sponsorshipRelocation package- ...Summary Incumbent serves as the Medical Instrument Technician Supervisor that provides oversight over medical instrument... ...Department of Veterans Affairs Health Care Personnel (HCP). Acceptable... ...REAL ID compliant cannot be utilized as an acceptable form of...Permanent employmentFull timePart timeWork experience placementSeasonal workLocal areaRemote workRelocation packageMonday to Friday
$105k - $140k
...clinics, and home-based care. We're proud to... ...: We offer Medical, Dental, and Vision... ...Responsibilities The Director of Rehab is... ...daily staffing and utilization with input from treating... ..., including oversight related to case management... ...knowledge of Medicare and third party...Full timePart timeH1bWork from homeVisa sponsorshipRelocation package$72.8k - $130k
...opportunities with Angels of Mercy Home Care, a part of LHC Group, a... ...home health benefits, medical necessity, and ongoing insurance... ...trending to clinical director Reviews, evaluates, and supervises... ...appropriateness of care and utilization of services, equipment, and supplies...Minimum wageFull timeWork experience placementLocal areaWeekend work$270.8k - $378.8k
...Become a part of our caring community The National Medical Director of Clinical Excellence & Safety is a pivotal leadership position within CenterWell... ...primary care network. Patient Safety Provide oversight for patient safety activities, including policy management...Full timeTemporary workApprenticeshipWork at officeRemote work$122.3k - $158.9k
...Nurse to take on a leadership role at their medical respite program in Sacramento. This position involves providing oversight to clinical staff, managing medication workflows... ..., developing policies, and ensuring quality care for patients experiencing homelessness....- ...Executive Medical Director About the Company Respected biotechnology (BioTech) company developing... ...design, implementation, and scientific oversight of clinical development programs in... ...Travel Percent 25% Functions ~ Medical Care/Hospital Administration...Flexible hours
- A leading healthcare provider is seeking a Medical Director to review health claims and ensure compliance with clinical standards. The ideal candidate will have a strong clinical background, excellent analytical and communication skills, and the ability to work collaboratively...Remote job
- Medical Director (05-18-26) Revibe Men's Health Sacramento, California, United States Medical... ...Health, we believe exceptional patient care starts with exceptional leadership. We’... ...replacement therapy, medical weight loss utilizing GLP‑1 medications, erectile dysfunction...Full timePart time
$75k - $85k
...at Park Centre Animal Hospital in California. This role involves driving revenue, managing operations, and ensuring top-tier patient care and customer service. The ideal candidate will have 3-5 years of managerial experience and a Bachelor's degree in business....- ...and Associate Training Director of the Clinical Child... ...responsible for patient care in the Sacramento... ...adolescents and their families utilizing evidence-based... ...combination of administrative oversight of the training... ...setting within an academic medical center or comparable...Temporary workTraineeshipInternshipLocal area
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