Strategic Director of Healthcare Utilization

Company Overview">Blue Shield of California is a leading health insurance company dedicated to providing high-quality healthcare services to its members. The organization values innovation, excellence, and teamwork in achieving its goals.Job Summary">We are seeking an experienced Healthcare Executive Director for Utilization Management to lead our team in...

Job Summary:We are seeking a skilled Healthcare Utilization Specialist to join our team at Blue Shield of California. In this role, you will be responsible for conducting clinical reviews, discharge planning, and presenting cases to the Medical Director.About Us:Blue Shield of California is a leading health insurance provider committed to delivering...

**Overview**At Blue Shield of California, we are committed to delivering exceptional healthcare services. We are seeking a highly skilled Medical Director, Utilization Management Specialist to join our team.**Salary Range**The estimated salary range for this role is $165,990.00 - $248,930.00 per year, based on experience and location.**Job Description**As a...

Job OverviewIn this role, you will be responsible for reviewing inpatient stays and ensuring medical necessity in compliance with state and federal regulations. This position involves conducting clinical reviews, discharge planning, and presenting cases to the Medical Director.We are seeking a Senior Utilization Management Nurse who is dedicated to...

Job OverviewWe are seeking a Senior Healthcare Utilization Specialist to join our team at Blue Shield of California.Job SummaryThe Senior Healthcare Utilization Specialist is responsible for reviewing inpatient stays and determining medical necessity in compliance with state and federal regulations. This role involves conducting clinical reviews, discharge...

Job OverviewThis role is a critical component of Blue Shield of California's success in achieving its goals and objectives. As a key member of the Utilization Management team, you will play a pivotal part in delivering and collaborating on all aspects of utilization management and care coordination for our Medicare and Medi-Cal membership.

At Blue Shield of California, we are seeking a seasoned Senior Healthcare Operations Director to lead our Utilization Management department. This critical role plays a vital part in ensuring timely and cost-effective care for our Commercial members.In this position, you will oversee the development and implementation of operational efficiencies through...

About the RoleWe are seeking a seasoned healthcare professional to lead our Utilization Management team at Blue Shield of California. As Senior Healthcare Manager, Utilization Excellence, you will play a critical role in ensuring our members receive timely and cost-effective care.Key ResponsibilitiesStrategic Leadership: Develop and implement utilization...

Job Summary:The Director of Healthcare Operations for Commercial Utilization Management at Blue Shield of California oversees the delivery of high-quality, cost-effective care to our Commercial members. This role requires a seasoned leader who can develop and implement operational strategies to drive efficiency, improve member outcomes, and ensure compliance...

Job SummaryWe are seeking a seasoned Healthcare Operations Director to oversee Utilization Management and care coordination for Medicare and Medi-Cal beneficiaries at Blue Shield of California. As a key member of our team, you will be responsible for managing prior authorization processes, developing UM strategies using data analytics, and ensuring...

About the Role:The Director, Medicare & Medi-Cal Utilization Management plays a pivotal part in the success of Blue Shield of California by overseeing utilization management and care coordination for Medicare and Medi-Cal beneficiaries.This position involves managing prior authorization processes, developing UM strategies using data analytics, and ensuring...

About The RADZ GroupWe are a family of companies dedicated to raising the collective impact through authentic culture, heart-centered leadership, and unparalleled experiences. Our core values of Curiosity, Optimism, Drive, and Evolution guide everything we do.Job OverviewThe Strategic People Operations Director is a key leader within our organization,...

About the RoleWe are seeking a skilled Utilization Management Nurse, Senior to join our team at Blue Shield of California. In this role, you will conduct clinical reviews to assess the medical necessity of inpatient admissions and length of stay, ensuring compliance with regulations.

About the Role">We are seeking a skilled Healthcare Operations Director to lead our Medicare and Medi-Cal Utilization Management team at Blue Shield of California. As a critical member of our organization, you will play a key role in delivering and collaborating on all aspects of utilization management and care coordination for our Medicare and Medi-Cal...

Job SummaryIn this challenging and rewarding role as a Senior Utilization Management Nurse at Blue Shield of California, you will be responsible for reviewing inpatient stays to ensure medical necessity in compliance with state and federal regulations. Your expertise in clinical review, discharge planning, and presenting cases to the Medical Director will...

Your RoleAs a Senior Manager of Utilization and Care Coordination at Blue Shield of California, you will play a critical role in realizing the company's goals and objectives. This position is key to the success of the Utilization Management department and requires an individual who can provide direction and leadership in compliance with regulatory...

About PURE Property ManagementPURE Property Management is a leading provider of comprehensive property management services. With a strong focus on customer satisfaction and exceptional results, we strive to deliver unparalleled service to our clients.Job DescriptionWe are seeking an experienced Strategic Property Operations Director to lead our Sacramento...

Lead the Way in Clinical Policy InnovationWe are seeking a Strategic Medical Director for Clinical Policy Innovation to join our team at Blue Shield of California.About the Role:In this role, you will be responsible for providing clinical oversight and input for medical policy operations. You will chair the Medical Policy Committee and work closely with...

Genie Healthcare, a leading travel nurse agency in the USA, is seeking an experienced Travel Healthcare Professional to fill the role of Director of Nursing for a travel nursing job in Cordova, Alaska.About the Role:Director of NursingRN with 8 hours shifts and 40.0 hours per weekSalary and Benefits:The estimated salary for this position is $150-$200 per...

Overview: Blue Shield of California seeks a skilled Utilization Management Nurse, Senior to review inpatient stays and ensure medical necessity compliance with state and federal regulations.About the Role:In this critical position, you will conduct clinical reviews, discharge planning, and present cases to our Medical Director. You will work closely with...