Managed Care Director Jobs in Corona, CA

The Director of Integrated Care Management oversees the Integrated Care Management teams to ensure compliance with regulatory guidelines and the implementation of new programs. This role involves coll...

The Director of Care Management is responsible for designing and implementing care management strategies and programs for SCAN's Special Needs Plans and other products across all markets. This role in...

The Care Management Director will lead the Care Management Department, providing strategic oversight and direction for various care management functions, including Behavioral Health and Care Coordinat...

The Medical Director, Utilization Management at Blue Shield of California is responsible for clinical review activities, including utilization management and provider claims dispute reviews. The role...

The Executive Director of Care Coordination oversees system Case Management, Social Work Service programs, and Utilization Management to ensure high-quality, cost-effective patient care and revenue cy...

The Director of Case Management is responsible for strategic planning, development, and operations of Care Management and Social Services for the hospital, ensuring achievement of long-term and short...

The Director of Case Management provides leadership and management of clinical care coordination, utilization management, discharge planning, and outcomes management. They oversee processes and outcom...

The Director of Case Management provides leadership and management of clinical care coordination, utilization management, discharge planning, and outcomes management. They oversee processes and outcom...

The Care Management Specialist II is responsible for managing a caseload of complex and vulnerable members, utilizing clinical skills to coordinate healthcare benefits and facilitate access to care. T...

Optum is seeking a Medical Director in Orange County to lead medical management functions, collaborate with providers, and improve quality care. The role involves providing medical leadership, conduct...

Direct function and personnel of the care management department, oversee budget, reports, and relationships with stakeholders and agencies.

The Medical Director- Medicare (CA) serves as the primary liaison between administration and medical staff, ensuring the development and implementation of policies and procedures that support medical...

The Program Manager is responsible for managing all aspects of educational programming, including tactical initiatives, organizational updates, and performance measurement. The role involves creating...

The Manager, Care Management at SCAN oversees daily operations and continuous quality improvement of care management programs. The role focuses on delivering high-quality, evidence-based care to addre...

The Director of Utilization Management is responsible for developing, managing, and directing utilization management programs in a healthcare setting to ensure appropriate admissions and review of car...

The Program Director, Enhanced Care Management position provides direct leadership and oversight for AltaMed's Enhanced Care Management services for clinically and social complex patients...

The Director, Medicare & Medi-Cal Utilization Management at Blue Shield of California is responsible for overseeing utilization management and care coordination for Medicare and Medi-Cal membership, e...

The Director of Case Management (Behavioral Health) at Blue Shield of California will oversee the behavioral health program for all product lines, serving as a subject matter expert and leader for uti...

The Managed Care Contract Analyst develops pricing models for proposals, provides consultation to maximize profit, and supports hospital contracting activities through financial and network pricing mo...

The Medical Director - Medicare is responsible for overseeing medical staff services, ensuring quality patient care, and compliance with regulatory requirements. This role requires a Doctorate Degree...

The Medical Director, Outpatient Case Management is responsible for reviewing pre-service requests for services, making determinations, and collaborating with healthcare professionals to ensure cost-e...

The Director and Medical Management Subject Matter Expert (SME) will manage consulting engagements and business development opportunities related to payer or provider medical management areas, while m...

The Director, Commercial Utilization Management at Blue Shield of California is responsible for leading the utilization management team in delivering care coordination for Commercial membership, ensur...

The Community Medical Director (CMD) is responsible for implementing strategic healthcare initiatives and designing clinical services to enhance quality healthcare delivery in the community. This role...

The Director, Utilization Management is responsible for developing and overseeing utilization processes, protocols, and policies across multiple teams in a value-based care model. The role requires ad...