Remote Medical Director: Utilization & Coverage
Sacbar
- Remote job
UnitedHealth Group is hiring a Medical Director to provide physician support for Enterprise Clinical Services. You will lead clinical coverage determinations, document reviews, and collaborate with network and non-network physicians to optimize medical necessity decisions. The role emphasizes utilization management, evidence-based medicine and cross-functional teamwork. Remote work within the United States is supported with comprehensive benefits. #J-18808-Ljbffr Sacbar
$275k - $325k
...for the better. For more information, visit Utilization Management Medical Director Oncology Work Location: REMOTE (work from home) California... ...to clarify and discuss treatment options and coverage. Evaluate clinical and utilization data to...Remote workWork from home- ...steps. Our partner is looking for a Medical Director, Utilization Management (Home Health, Acute & Post... ...as a key clinical authority within a remote utilization management environment.... ...CMS regulations, National and Local Coverage Determinations, MCG guidelines, and health...Remote workFull timePart timeLocal area
$150 per hour
The Utilization Review Medical Director is responsible for conducting clinical reviews of Durable Medical Equipment... ...and Additional Expectations: Remote role requiring consistent... ...Company-paid short term disability coverage (location restrictions may apply) ~...Remote workHourly payFull timeContract workTemporary workPart timeLocal area$217.17k - $369.93k
...Associate Medical Director Behavioral Health or Utilization Management Medical Director DOE Work from home within Oregon... ...Other roles as assigned. #LI-Remote Pay ranges vary based on the... ...include: Medical, dental and vision coverage for employees and their eligible...Remote workPart timeImmediate startWork from homeFlexible hours- ...CorroHealth is seeking a Medical Director, Concurrent Review, to evaluate hospitalizations nationwide... ...provide expert recommendations. This remote position offers a predictable schedule and a path to expand knowledge in Utilization Review. Ideal candidates hold an MD/DO...Remote work
- ...family, is seeking an experienced physician to join the Utilization Management team. The Medical Director for Utilization Management will support WellMed... ...determinations and suggesting program improvements. This remote-friendly role offers the chance to influence care on...Remote work
- ...Bickham Services Unlimited, LLC is seeking a Medical Director, Utilization Management to lead clinical utilization reviews for inpatient and post... ...align with CMS, policies, and evidence-based criteria. Remote opportunity in New Jersey for a board-certified physician...Remote work
$240k - $250k
...Medical Director Utilization Management We are looking for physicians who have expertise in Internal Medicine including medical and surgical... ...people of different backgrounds and perspectives. This is a remote-first role that may require travel to Boston, MA for new...Remote workFlexible hours- GuideWell Mutual Holding Corporation is seeking a Medical Director to lead all utilization management reviews (Pre-service, Post-service, Concurrent Review and Appeals) and to collaborate with physician providers and Case Managers on complex cases. The ideal candidate...Remote job
- SCAN is seeking an Utilization Management Physician Medical Director to lead medical necessity determinations, prior authorizations, and reviews. This physician will influence policy, provide clinical mentorship, and ensure compliant, evidence-based decision-making while...Remote job
- UnitedHealth Group is seeking a Medical Director to provide physician support for Enterprise Clinical Services, focusing on clinical coverage determinations and evidence-based decision-making... ...cost effectiveness.The role allows remote work from anywhere in the United...Remote job
- WellMed, part of the Optum family, seeks a Medical Director for Utilization Management to lead and optimize our UM program. This role focuses on medical... ...program improvements while fostering a collaborative, remote-friendly work environment across the U.S. You will drive...Remote job
$248.5k - $373k
...family medicine physician to join our Utilization Management team. Optum is a clinician-... ...the way clinicians work and live. The Medical Director for Utilization Management will support... ...You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you...Remote workMinimum wageFull timeWork experience placementWork at officeLocal areaWork from home- The Oncology Institute is seeking a Medical Director to provide clinical expertise in assessing medical necessity, appropriateness, and efficiency of oncology care with a focus on utilization management for case reviews and clinical decision making. In this collaborative...Remote job
- ...Medical Director Utilization Management Location: Remote Preference EST or nearby Pittsburgh PA, NY, WV Duration: 6+ Months Contract Role with possible extension. Position Overview As part of a physician team, the Medical Director ensures utilization management...Remote workContract workPrivate practice
$248.5k - $373k
...Medical Director For Utilization Management WellMed, part of the Optum family of businesses, is seeking an internal medicine or family medicine... ...Growing together. You'll enjoy the flexibility to work remotely from anywhere within the U.S. as you take on some tough challenges...Remote jobMinimum wageFull timeWork experience placementWork at officeLocal areaWork from home- Centene Corporation is seeking a clinical professional to lead Medical Management/Health Services for 28 million members. The role drives utilization management, quality improvement, and medical review across a national organization with flexible work options. The candidate...Remote jobFlexible hours
- ## Medical DirectorApply: Fully Remote: US - Remote: Full time: Posted Today: R35494At... ...management programs. The Medical Director is a highly experienced... ...judgment in support of coverage determinations, free from... ...appeals, grievances, utilization management, rescissions,...Remote workFull timeContract workWork at officeWork from homeWork visa
- ...Description: Manager of Clinical Utilization Management - Denial... ...Position Type: Hybrid (85% remote, 15% onsite in Northridge, CA... ...collaboration with physician reviewers, medical directors, and other relevant... ...Comprehensive healthcare coverage. Competitive 401k plan....Remote workPermanent employmentFull timeTemporary workFlexible hours
$223.8k - $313.1k
...our caring community The Medical Director relies on medical background... ...Medicine, or those experienced in Utilization Review are encouraged to... ...rotational weekend/holiday coverage (approx. 5 weekends per year... ...Travel: While this is a remote position, occasional travel...Remote workBi-weekly payFull timeTemporary workApprenticeshipWork at officeLocal areaWork from homeHome officeMonday to FridayWeekend work$173k - $250k
...5 years ago as Boston Medical Center HealthNet Plan,... ...Summary: The Medical Director will report to the... ...Senior Medical Director of Utilization Management, Member... ...criteria and determines coverage Works with the... ...performed in a typical remote interior/office work environment...Remote workWork at officeFlexible hours$200k - $300k
...Medical Director, Medicare Clinical Policy Molecular Pathology Preferred... ...Full-time, exempt | Remote Anticipated base salary... ...Prior Medicare, payer, or Local Coverage Determination experience is... ...credible connection to policy, utilization, quality, or medical review....Remote workFull timeFor contractorsLocal area$277.37k - $361.9k
...care Employee Benefits : Medical with full deductible... ...the Role The Medical Director assists the CMO in developing... ...to ensure adequate coverage to accommodate demands... ...and to maximize utilization of organizational resources... ...clinical performance remotely Ability to manage...Remote workHourly payInternshipLocal areaRelocation packageAfternoon shift$78.62k - $105.16k
...Pay Plan Title: NurseManager, Utilization Management Working Title: Nurse Manager, Utilization... ...$78,624 - $105,158 Office Location: Remote within North Carolina POSTING DETAILS... ...Insurance with no premium for employee coverage ~ Flexible Spending Accounts ~24...Remote workFull timeWork experience placementWork at officeLocal areaImmediate startWork from homeFlexible hours$174.07k - $374.92k
...West Virginia). **This is a remote based (work at home) based... ...Responsibilities of this Medical Director role are related to Medicaid... ...managed care experience in utilization management Prior experience... ...medical, dental, and vision coverage, paid time off, retirement savings...Remote workHourly payFull timeTemporary workLocal areaWork from home$174.07k - $374.92k
...resources. This is a remote based (work from home)... ..., MN, WI) and have a medical license without... ...states. In the Medical Director role you will provide... ...primarily on overseeing utilization review and quality assurance... ..., dental, and vision coverage, paid time off,...Remote workHourly payFull timeTemporary workLocal areaWork from home$223.8k - $313.1k
...community The Behavioral Health Medical Director provides clinical leadership... ...Medicaid behavioral health utilization management and makes timely,... ...requirements, and provide coverage during planned and unplanned... ...working effectively in a remote environment and using...Remote workFull timeTemporary workApprenticeshipWork at officeWork from homeHome officeMonday to Friday$190k - $200k
We're seeking a board‑certified Medical Director (Internal Medicine or Family Practice)... ...support our team. This role is fully remote and focuses on utilization management (UM), quality review,... ...Participate in occasional weekend or holiday coverage on a voluntary basis. Required MD...Remote workFull time- ...Job Description About The Role The Medical Director performs utilization review and medical necessity... ...standing review assignment. *This is a Remote Role Primary Responsibilities Renders... ..., site of service, and contested coverage decisions. Reviews and adjudicates...Remote workWork at officeLocal areaFlexible hours
$140 - $145 per hour
Medical Director - Surgery, Orthopedics & PM&R Role Summary Are you an accomplished... ...role focuses completely on utilization management, medical... ...days per week) to TriWest's remote administrative operations and... ...& Utilization Review Coverage Determinations: Evaluate complex...Remote workHourly payLocumPrivate practice3 days per week1 day per week
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Remote Medical Director: Utilization & Coverage. Be the first to apply!
- medical project manager Los Angeles, CA
- bcba clinical director Los Angeles, CA
- clinical operations supervisor Los Angeles, CA
- health economics manager Los Angeles, CA
- clinical supervisor lmft lcsw Los Angeles, CA
- remote medical coding supervisor Los Angeles, CA
- occupational health manager Los Angeles, CA
- entry level clinical data manager Los Angeles, CA
- lead clinical data manager Los Angeles, CA
- director of health and wellness Los Angeles, CA



