Medical Management Director jobs in Anaheim, CA

Medical Management Director directs and oversees the operations and strategic planning of the organization's medical management initiatives and programs. Establishes case management, utilization review, quality and outcome management, and community education programs to provide high quality, cost effective health care services. Being a Medical Management Director develops and implements clinical guidelines for care designed to improve outcomes while managing costs. Requires a bachelor's degree. Additionally, Medical Management Director typically reports to top management. The Medical Management Director typically manages through subordinate managers and professionals in larger groups of moderate complexity. Provides input to strategic decisions that affect the functional area of responsibility. May give input into developing the budget. Capable of resolving escalated issues arising from operations and requiring coordination with other departments. To be a Medical Management Director typically requires 3+ years of managerial experience. (Copyright 2024 Salary.com)

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Senior Director Medical Management
  • Max Populi, LLC
  • Cerritos, CA FULL_TIME
  • Our client is a Fortune 50 company that has an integrated healthcare model that is proving to be successful in the market.    We are seeking a Director of Medical management who will report into the CMO of the organization. Primary duties may include, but are not limited to oversee care management operations across a wide range of products, clients and states including meetings with key major account clients.  This is not a remote position.

    This is an awesome opportunity to lead strategy and operations for the centralized National Utilization Management function in the organization.  The ideal candidate will oversee a team of 45 and will work closely with the Sr. Medical Director on all UM functions.  The immediate challenge will be to modernize processes and create the best in class UM function.
     
    Responsibilities:
    • Leads and participates in cross functional corporate teams which design and implement new care management programs that may impact multiple lines of business.
    • Develops and implements process and program redesigns.
    • Leads multiple teams of clinicians charged with promoting quality member outcomes, to optimize member benefits, and to promote effective use of resources.
    • May direct multiple medical management programs including utilization management, case management, demand management and disease management programs, which typically support multiple lines of business.
    • May also manage appeals for services denied. Staff size is typically large, located in multiple sites and/or states and utilizes multiple systems.
    • Ensures adherence to all contract, regulatory and accreditation requirements. Develops short/long-term objectives and monitors processes and procedures to ensure consistency with the enterprise and compliance with state and federal regulations.
    • Collaborates with matrix Care Management partners (such as IM or PE&C) to resolve issues or find solutions. Manages budget and special projects. Hires, trains, coaches, counsels, and evaluates performance of direct reports.
     
    Qualifications
    Requires a BS in nursing or related health care field
    A minimum of 8 years of experience in a health care environment (i.e. acute care) including management experience; or any combination of education and experience, which would provide an equivalent background.
    MS or advanced degree in a clinical nursing specialty, business or healthcare-related field preferred.
     Current active unrestricted RN license to practice as a health professional within the scope of practice in applicable state(s) or territory of the United States required.
    Must have significant experience in care delivery, case management and/or population health.
    Accomplishments should include identifying UM opportunities to drive cost of care down
    Requires strong oral, written and interpersonal communication skills, problem-solving skills, facilitation skills, and analytical skills.
  • 17 Days Ago

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Director of Risk Management
  • WKS Restaurant Group
  • Cypress, CA FULL_TIME
  • Pay Range: $125,000 - $140,000 per year Listed wages are based on company-wide ranges. Actual earnings will vary based on factors such as: restaurant brand, experience, education, geography, applicabl...
  • 19 Days Ago

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Director of Revenue Management
  • Marriott Laguna Cliffs Resort & Spa
  • Anaheim, CA FULL_TIME
  • The role of the Director Revenue-Hotel is to provide direction to property teams to identify develop and implement all potential revenue opportunities for 1 full service premium select and/or independ...
  • 7 Days Ago

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Director, Materials Management
  • AHMC Healthcare
  • Anaheim, CA OTHER
  • Overview This position is responsible for all materials management activities, i.e., demand/utilization management, order management, supplier management, logistics management, and inventory/ assets m...
  • 1 Month Ago

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Director, Client Management_Kerry
  • Acosta Group
  • Chino, CA FULL_TIME
  • **Do you have a passion for food?** Are you looking for a company where you can learn, grow, and WIN? CORE Foodservice is a North American Foodservice Sales Agency that blends engaged leadership with ...
  • 1 Month Ago

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Medical Assistant - Pain Management
  • Providence
  • Fullerton, CA OTHER
  • DescriptionThe Medical Assistant (MA II) works under the delegation of a licensed practitioner to perform duties as directed to assist in providing patient care to assigned patients. A Medical Assista...
  • 13 Days Ago

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0 Medical Management Director jobs found in Anaheim, CA area

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Managing Director - Architecture
  • Elite Sourcing LLC
  • Los Angeles, CA
  • Job Description Job Description Elite Sourcing LLC, on behalf of our client, a leading Design Collaborative with offices...
  • 4/23/2024 12:00:00 AM

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Product Management Director
  • ClientSolv Technologies
  • Los Angeles, CA
  • Company Description ClientSolv Technologies is an IT solution firm with over a decade of experience serving Fortune 1000...
  • 4/23/2024 12:00:00 AM

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SOX Managing Director
  • CNM LLP
  • Los Angeles, CA
  • Job Description Job Description We are currently searching for a Managing Director to join our high performing SOX team ...
  • 4/22/2024 12:00:00 AM

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Managing Director
  • Corecruitment Ltd
  • Los Angeles, CA
  • Managing Director - Entertainment Los Angeles $200,000 - $250,000 My client is an amazing, rapidly growing entertainment...
  • 4/22/2024 12:00:00 AM

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Operations Management Director
  • Brown & Root
  • Los Angeles, CA
  • Job DescriptionWith general autonomy may manage a large project, or multiple smaller complex/independent/unrelated proje...
  • 4/22/2024 12:00:00 AM

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Managing Director - Architecture
  • Elite Sourcing Llc
  • Los Angeles, CA
  • Job Description Job Description Elite Sourcing LLC, on behalf of our client, a leading Design Collaborative with offices...
  • 4/22/2024 12:00:00 AM

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Managing Director - Construction Disputes
  • Lvi Associates
  • Los Angeles, CA
  • LVI are currently seeking a senior-level construction manager or engineer to provide direction and exceptional leadershi...
  • 4/21/2024 12:00:00 AM

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Managing Director
  • COREcruitment Ltd
  • Los Angeles, CA
  • Managing Director - Entertainment Los Angeles $200,000 - $250,000 My client is an amazing, rapidly growing entertainment...
  • 4/20/2024 12:00:00 AM

Anaheim (/ˈænəhaɪm/) is a city in Orange County, California, part of the Los Angeles metropolitan area. As of the 2010 United States Census, the city had a population of 336,265, making it the most populous city in Orange County and the 10th-most populous city in California. Anaheim is the second-largest city in Orange County in terms of land area, and is known for being the home of the Disneyland Resort, the Anaheim Convention Center, and two major sports teams: the Anaheim Ducks ice hockey club and the Los Angeles Angels baseball team. Anaheim was founded by fifty German families in 1857 and...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Medical Management Director jobs
$170,537 to $228,377
Anaheim, California area prices
were up 3.2% from a year ago

Medical Management Director in Montgomery, AL
Work in areas of specialty as varied as Life & Disability Underwriting, Pre-Sales, Retention and Implementation, Risk Analysis and Medical Evidence Underwriting.
December 13, 2019
Medical Management Director in Santa Ana, CA
Leads and participates in cross functional corporate teams which design and implement new care management programs that may impact multiple lines of business.
December 11, 2019
Medical Management Director in Lancaster, PA
Health Plan Management | Health & Disease Management | Online Services | EDI | Stop-Loss | Request a Proposal.
January 19, 2020