Current jobs related to Medical Director, New Century Health Plan - Los Angeles, California - MedChi, The Maryland State Medical Society
-
Medical Director, Community Health
2 weeks ago
Los Angeles, California, United States L.A. Care Health Plan Full timeJob SummaryThe Medical Director, Community Health, serves as a key medical leader in the organization, collaborating with cross-functional teams to develop and oversee Community Health programs. This role ensures that programs align with operational systems and tools, while also performing utilization review of cases.Key ResponsibilitiesProvide and oversee...
-
Senior Director of Global Treasury
3 weeks ago
Los Angeles, California, United States Century Group Full timeJob Title: Senior Director, Global TreasuryWe are seeking a seasoned Senior Director to lead our Global Treasury team. As a key member of our finance leadership, you will be responsible for overseeing debt capital markets initiatives, ensuring compliance with credit agreements, and developing strategic plans for debt maturities, financing acquisitions, and...
-
Los Angeles, California, United States L.A. Care Health Plan Full timeJob SummaryThe Medical Director, Community Health, serves as a key medical leader in the organization, driving program development and oversight for Community Health initiatives. This role ensures that programs align with operational systems and tools, while also performing utilization review of cases.This position reports to the Senior Medical Director,...
-
Director of Financial Reporting
7 days ago
Los Angeles, California, United States Century Group Full timeJob Title: Director of Financial ReportingCentury Group is partnering with a client seeking a Director of Financial Reporting to lead their team. The expected starting base salary is $150,000 to $200,000 per year.Job Responsibilities:Develop and maintain internal controls over financial reporting.Oversee the preparation and filing of all SEC reports,...
-
HR Director
2 weeks ago
Los Angeles, California, United States Century Group Full timeJob OverviewCentury Group is partnering with a client seeking a seasoned HR Director to drive strategic initiatives and lead high-performing teams. The ideal candidate will possess a strong background in human resources, with a proven track record of developing and implementing effective HR strategies that align with business objectives.Key...
-
Director of Care Management
6 days ago
Los Angeles, California, United States L.A. Care Health Plan Full timeCare Management Leadership OpportunityThe Director of Care Management will lead the operational component of the Care Management Department at L.A. Care Health Plan. This role is responsible for improving key member health and access to appropriate services. The Director will work with Medical Directors and key staff to design, enhance, and implement...
-
Health Plan Operations Director
2 weeks ago
Los Angeles, California, United States Valere Staffing Full timeJob OverviewValere Staffing is seeking a seasoned Health Plan Operations Director to lead key functions such as TPA/BPO management, claims, utilization management, and pharmacy services. This role requires strong leadership skills and knowledge of Medicare and Medicaid regulations.Key ResponsibilitiesLead Health Plan Operations ensuring staff are trained and...
-
Senior Director Health Care Legal Services
2 weeks ago
Los Angeles, California, United States L.A. Care Health Plan Full timeJob SummaryThe Associate Counsel III Senior Director Health Care Legal Services serves as the second-in-command for the Legal Division and represents the Division at the Vice-Presidential level within the organization.This position reports directly to the Associate General Counsel and provides supervision for staff counsel, paralegals, and support...
-
Senior Financial Analyst
2 weeks ago
Los Angeles, California, United States Century Group Full timeJob OpportunityWe are seeking a highly skilled Senior Financial Analyst to join our team at Century Group. As a Senior Financial Analyst, you will play a critical role in developing and managing financial plans, budgets, and forecasts for our clients. Your expertise will be essential in ensuring fiscal compliance and optimizing agency funding.Key...
-
Finance Director
2 weeks ago
Los Angeles, California, United States Southern Medical Recruiters Full timeJob Title:Finance Director - Hospital Financial PlanningJob Summary:Southern Medical Recruiters is a leading healthcare recruitment organization seeking a highly skilled Finance Director to join our team. As a key member of our organization, you will be responsible for providing strategic financial planning and analysis to our hospital clients nationwide.Key...
-
Senior Financial Analyst
4 weeks ago
Los Angeles, California, United States Century Group Full timeJob OpportunityWe are seeking a highly skilled Senior Financial Analyst to join our team at Century Group. As a Senior Financial Analyst, you will play a critical role in developing annual operating budgets, managing contract refunding applications, and ensuring fiscal compliance for government and privately funded programs.Key Responsibilities:Collaborate...
-
Medical Director of Sexual Health Services
7 days ago
Los Angeles, California, United States APLA Health Full timeJob SummaryThe Medical Director of Sexual Health Services will provide primary medical care services under the direction of the Chief Medical Officer or Site Medical Director. This role will be responsible for providing STD-related medical care for adult patients at APLA Health's CDU/MLK STD testing and treatment facility.Key ResponsibilitiesProvide medical...
-
Claims Management Director
6 days ago
Los Angeles, California, United States L.A. Care Health Plan Full timeJob SummaryThe Claims Management Director will oversee the Claims Department, ensuring compliance with regulatory requirements and maintaining high-quality claims processing. This role requires strong leadership and analytical skills, with the ability to develop and implement policies and procedures to improve claims auto adjudication.The ideal candidate...
-
Senior Manager, Financial Planning and Analysis
2 weeks ago
Los Angeles, California, United States Century Group International Inc Full timeSenior Manager, Financial Planning and AnalysisCentury Group International Inc is seeking a highly skilled Senior Manager, Financial Planning and Analysis to join their team. This is a key role that requires a strong understanding of financial systems and software, as well as excellent analytical and problem-solving skills.Key Responsibilities:Lead the...
-
Health Plan Operations Manager
4 weeks ago
Los Angeles, California, United States myPlace Health Full timeTransforming Health Plan OperationsThis is an exceptional opportunity for a mission-driven leader to shape and lead health plan operations in a dynamic, integrated care delivery startup. Reporting to the Sr. Director of Health Plan Operations, this role will oversee key functions such as TPA/BPO management, claims, utilization management, medical records,...
-
Health Plan Operations Manager
2 weeks ago
Los Angeles, California, United States myPlace Health Full timeJob SummaryThis is an exceptional opportunity for a mission-driven leader to shape and lead health plan operations in a dynamic, integrated care delivery startup. Reporting to the Sr. Director of Health Plan Operations, this role will oversee key functions such as TPA/BPO management, claims, utilization management, medical records, PBM, and pharmacy...
-
Gift Planning Director
2 weeks ago
Los Angeles, California, United States University of California Los Angeles Full timeLead Gift Planning EffortsAs the Director of Gift Planning at UCLA, you will be responsible for developing and implementing strategic plans to secure major gifts from donors. You will work closely with the Senior Executive Director and other members of the fundraising team to identify and cultivate potential donors, create personalized giving plans, and...
-
Medical Director
2 weeks ago
Los Angeles, California, United States Enterprise Medical Recruiting Full timeEnterprise Medical Recruiting is assisting a Community Health Center in the recruitment of a Medical Director.About the Role:As a Medical Director, you will be responsible for the quality of good clinical practice and will play a key role in shaping the future of healthcare in our community. The position involves 60% management and 40% clinical delivery of...
-
Director of IT Quality Assurance
2 weeks ago
Los Angeles, California, United States L.A. Care Health Plan Full timeJob Title: Director, Information Technology Quality AssuranceJob Summary:The Director of Information Technology Quality Assurance is responsible for defining and promoting a quality mindset across IT, including planning, developing, and directing quality assurance policies, programs, and initiatives. This role evaluates and monitors tools, methodologies, and...
-
Senior Health Plan Analyst
7 days ago
Los Angeles, California, United States San Ysidro Health Center Full timeJob SummaryWe are seeking a highly skilled Senior Health Plan Analyst to join our team at San Ysidro Health Center. As a key member of our healthcare operations team, you will be responsible for developing and implementing best practices guidelines, policies, and procedures to ensure optimal healthcare outcomes for our patients.Key ResponsibilitiesDevelop...
Medical Director, New Century Health Plan
2 months ago
Job Summary:
We are seeking a dedicated and experienced clinical leader to join our team at MedChi, The Maryland State Medical Society. As a Medical Director, you will play a pivotal role in leading clinical efforts to optimize care delivery and outcomes for our members.
Key Responsibilities:
- Provide Clinical Leadership: Ensure the highest standards of care and cost-effectiveness through clinical oversight and leadership.
- Manage Utilization and Case Management: Drive efficiency and quality by managing utilization and case management activities.
- Oversee Appeals and Grievances: Ensure compliance with regulatory requirements by overseeing appeals, grievances, and potential quality issues.
- Develop Clinical Strategies: Improve health outcomes by developing and implementing clinical strategies.
- Collaborate with Senior Leaders: Enhance the overall performance of our organization by collaborating with senior leaders.
Qualifications:
- MD or DO Degree: Possess a degree from an accredited medical school.
- Board Certification: Hold board certification in a primary care specialty (Internal Medicine, Family Medicine, Geriatrics).
- Valid Medical License: Possess a valid and unrestricted medical license in California.
- Advanced Degree: Possess an advanced degree in healthcare management or a related field (highly desired).
- Clinical Experience: Possess 3 or more years of clinical practice experience.
- Medicare Advantage Experience: Possess 2 or more years of Medicare Advantage management experience.
- Healthcare Experience: Possess experience in a health plan or large healthcare organization (preferred).
- Regulatory Knowledge: Possess strong knowledge of Medicare regulations and CMS guidelines.
- Analytical and Communication Skills: Possess excellent analytical, problem-solving, and decision-making skills, as well as strong communication and interpersonal abilities.
- Leadership Abilities: Possess proven leadership abilities that demonstrate openness to change and a capacity for implementing creative programs that support strategic initiatives.
- Technical Skills: Possess proficiency in Microsoft Office applications (Word, Excel, PowerPoint).
