Managed Care Director Jobs in Los Angeles, CA

Drive end-to-end operational excellence for stop-loss and funding processes. Oversee program administration, manage relationships with vendors, and enhance operational efficiency while leading high-pe...

Join a dynamic team to enhance risk adjustment strategies and initiatives. Lead transformative projects, ensure compliance and optimize clinical documentation to support organizational growth and effi...

Drive strategic business development initiatives in the Medicare landscape, fostering key partnerships with national payers to enhance care access. Collaborate cross-functionally to accelerate growth...

Shape the future of healthcare by providing expert clinical oversight in utilization management, ensuring appropriate care delivery and regulatory compliance while leading initiatives to mitigate frau...

Champion operational excellence by leading membership status determinations, ensuring accuracy and compliance while driving improvements and utilizing AI tools to optimize workflows in a fast-paced, i...

Lead the development of provider networks through complex contract negotiations and relationship management with health systems and providers, driving value-based initiatives and serving as a key expe...

Engage in complex provider network management through strategic contracting, negotiations, and relationship development with major health systems. Drive initiatives that enhance value-based care while...

Shape the future of clinical policy by providing strategic oversight and leadership in developing and implementing evidence-based practices to enhance healthcare delivery, compliance, and operational...

Lead the charge in optimizing patient treatment through rigorous utilization management. Collaborate with multidisciplinary teams while ensuring compliance with clinical standards and healthcare regul...

Transform the enterprise reporting landscape by leading cross-functional initiatives, developing performance dashboards, and establishing data infrastructure to enhance decision-making and drive impac...

Unlock the potential of provider networks by leading complex negotiations and relationship building. Drive value-based initiatives while developing competitive contracts for large health systems and p...

Transform the future of healthcare interoperability by leading strategic initiatives, ensuring compliance, and collaborating across teams to enhance data exchange and clinical outcomes, while managing...

Join a collaborative team and lead initiatives in Utilization Management, ensuring quality medical service delivery while mentoring staff and enhancing efficiency within a fast-growing health plan org...

Lead the care management team to enhance healthcare outcomes through strategic oversight, compliance, and performance improvement, ensuring high-quality and cost-effective care for members. Foster col...

Join a dynamic team to provide medical leadership in quality improvement, utilization management, and patient care coordination while supporting initiatives that enhance cost-effectiveness and healthc...

Manage the design and implementation of health equity programs for vulnerable populations, enhancing care quality and cost-effectiveness while ensuring stakeholder alignment and program efficiency. Le...

Shape your career by managing complex program initiatives, improving business processes, and collaborating with leadership to drive strategic goals and operational excellence within a dynamic environm...

Transform regulatory reporting by leading a dynamic team, ensuring data integrity and compliance. Drive operations for accurate report generation and analysis, collaborating cross-functionally to meet...

Shape the future of claims management by leading a team of adjusters, ensuring regulatory compliance, and optimizing processes for complex Master Policy TLL and Contents Claims. Drive department effic...

Champion operational excellence in claims administration, ensuring compliance and accuracy while leading a high-performing team. Drive process improvements and strategic initiatives to align claims pr...

Develop comprehensive network strategies that optimize value, engage stakeholders, and enhance provider performance, ensuring alignment with market trends and regulatory requirements while leading cro...

Lead compliance for Medicare Advantage and ACO programs, overseeing regulatory adherence and operational excellence. Collaborate with internal teams and external partners to ensure effective complianc...

Empower insights by managing healthcare data analytics, optimizing benefit designs, and enhancing vendor performance to promote cost efficiency and member satisfaction. Drive strategic initiatives and...

Reimagine healthcare payer operations by driving AI strategies and product vision across claims, member management, and benefit configuration, ensuring innovative capabilities deliver measurable value...

Analyze financial and health information to support decision-making on healthcare revenue, costs, and outcomes. Collaborate to identify revenue opportunities and ensure accurate reporting while drivin...