
Manager, Utilization Management Nurse Management
El Dorado Hills, California
Your Role The Utilization Management team reviews inpatient stays for our members and correctly applies the guidelines for nationally recognized levels of care for our Shared Services department including concurrent review, transplant and N...
10d
Job Type | Full Time |

Clinical Services Coordinator, Intermediate (BH Specialty Team)
Woodland Hills, California
Your Role The Behavioral Health Services (BHS) Specialty team manages continuity of care (CoC) requests, exception requests, and provides support for the clinical Behavioral Health Utilization Management team. The Behavioral Health (BH) Cli...
10d
Job Type | Full Time |

Behavioral Health Utilization Management Clinician, Experienced
Lodi, California
Your Role The Behavioral Health Utilization Management team performs prospective & concurrent utilization reviews and first level determinations for members using BSC evidenced based guidelines, policies, and nationally recognized clinal cr...
10d
Job Type | Full Time |

Behavioral Health Utilization Management Clinician, Senior
Woodland Hills, California
Your Role The Behavioral Health Utilization Management team performs prospective & concurrent utilization reviews and first level determinations for members using BSC evidenced based guidelines, policies, and nationally recognized clinal cr...
10d
Job Type | Full Time |

Utilization Management Nurse, Senior (Behavioral Health Post-Service Review)
San Diego, California
Your Role The Commercial Post Service Review team is responsible for clinically reviewing claims that are the result of a claim denial. The Commercial Post Service Review RN will report to the Manager, Post Service. In this role you will pe...
10d
Job Type | Full Time |

Sr. Director, Clinical Quality
San Francisco, California
Your Role Reporting to the VP, Quality, the role of the Sr Director is critical to the success of Blue Shield of California and the Clinical Quality department in realizing its goals and objectives. This individual will play a key role as p...
10d
Job Type | Full Time |

Medical Affairs Strategy, Senior Medical Director - Heme (Hybrid)
Boston, Massachusetts
Vertex Pharmaceuticals Incorporated
Job Description General Summary: Vertex seeks a dynamic and experienced Medical Affairs Physician/ Senior Medical Director for our Disease Area of Hematology within the Medical Affairs Strategy group. This individual will be responsible for...
10d
Job Type | Full Time |

The Medical Director is responsible for providing oversight, medical guidance and support to the full spectrum of WellSky's clinical management acute, emergency department, and post-acute care solutions and programs. The scope of this job i...
10d
Job Type | Full Time |

Jamaica Plain, Massachusetts
Responsibilities Chief Clinical Officer Opportunity - Full-Time At Arbour Hospital, we work diligently and compassionately to provide patients and their families with high-quality care and service excellence across a continuum of specialize...
10d
Job Type | Full Time |

Phoenix, Arizona
Responsibilities Valley Hospital Phoenix is seeking a dynamic and talented Assistant Director for Intake to join our team of compassionate, dedicated professionals. Under the direction of the Director of Intake, the Assistant Director of In...
10d
Job Type | Full Time |