
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...
11h
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...
11h
Job Type | Full Time |

Dental Director, Clinical Advisor
Rancho Cordova, California
Your Role The Medical Management team ensures that Blue Shield is on the cutting edge of medical, medication, and payment policy to accelerate the emergence of a value-based health care system in California. The Dental Director will report ...
11h
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...
11h
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...
11h
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...
11h
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...
11h
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...
11h
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...
11h
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...
11h
Job Type | Full Time |