Remote ENT Medical Director - Claims & Compliance
UnitedHealth Group
- Remote job
UnitedHealth Group’s Optum division seeks a Medical Director to lead the Focus Claims Review program, guiding medical services and policies for claim reviews and provider interactions. The role supports remote work nationwide in the U.S. and requires ABMS/AOA ENT certification, MD/DO license, and 5 years of post-residency experience. Strong communication and MS Office skills are essential. The position offers a competitive salary with comprehensive benefits and opportunities for leadership #J-18808-Ljbffr UnitedHealth Group
$248.5k - $373k
...000/yearJob Area: Medical & Clinical OperationsCompany... ...part of the Focus Claims Review team at Optum, the Medical Director provides... ...flexibility to work remotely * from anywhere... ...NCQA, Regulatory Compliance, Confidentiality,... ...in Otolaryngology (ENT) 5+ years of clinical...Remote workClaimsMinimum wageFull timeWork experience placementWork at officeLocal area$248.5k - $373k
...34 Job category: Medical & Clinical Operations... ...part of the Focus Claims Review team at Optum, the Medical Director provides... ...flexibility to work remotely * from anywhere within... ...NCQA, Regulatory Compliance, Confidentiality,... ...in Otolaryngology (ENT) 5 years of clinical...Remote jobClaimsMinimum wageFull timeWork experience placementLocal area- UnitedHealth Group is seeking a Medical Director to lead the focus claims review program and oversee medical services quality. You will coordinate with... ...criteria for medical programs and services. The role allows remote work from anywhere in the United States and requires...Remote jobClaims
- ...is the pioneer in Contactless Remote Patient Monitoring (RPM),... ...Position Summary: The Compliance Manager is responsible for building... ...exclusivity rules before claims are released. • Monitor CMS... ...- A study at King George Medical University, Lucknow, and published...Remote workClaims16 hoursFull timeContract workLocal areaShift work
$200k - $225k
...Director Regulatory Promotional Compliance & Scientific Messaging Requisition ID: 8169... ...regulatory partner to Commercial, Medical, Legal, Market Access,... ...guidance on product claims, scientific messaging, payer... ...needs require. If based remotely, additional travel will...Remote workClaimsFlexible hours$119.1k - $186.56k
...today! Job Details The Director, Commercial Compliance serves as the primary Compliance... ...capabilities. USA - Remote Primary Duties and Responsibilities... ...patient-support programs, Medical Affairs independence,... ...-Kickback Statute, False Claims Act, FDA promotional...Remote workClaimsFull timeLocal area- ...Job Purpose The Senior Director Compliance will serve as MoonLake's senior... ...Statute and the False Claims Act; the Federal Food, Drug,... ...hospitality, HCP travel and expense, medical legal and regulatory review,... ...with hybrid flexibility. Remote or hybrid arrangements may...Remote workClaimsPermanent employmentContract workFor contractorsFixed term contractPrivate practiceWork at office
$248.5k - $373k
...500 - $373,000/yearJob Area: Medical & Clinical OperationsCompany:... ...clinical coverage and medical claims reviews. Our role is to... ...health care costs.The Medical Director provides physician support to... ...enjoy the flexibility to work remotely * from anywhere within the U....Remote workClaimsMinimum wageFull timeWork experience placementLocal area$174.07k - $374.92k
...a time. Position Summary: This is a remote based (work from home) role preferably resides... ...use of health care resources. In the Medical Director role you will: Provide oversight for... ...predetermination reviews and reviews of claim determinations. This includes Prior...Remote workClaimsHourly payFull timeTemporary workLocal areaWork from home$215.01k - $408.49k
...being the highest priority. Provides medical leadership for utilization management activities... ...the quality and cost of care. Reviews claims involving complex, controversial, or... ..., and a flexible approach to work with remote, hybrid, field or office work schedules....Remote workClaimsHourly payFull timePart timeReliefWork at officeFlexible hours$248.5k - $373k
...$373,000/yearJob Area: Medical & Clinical OperationsCompany... ....As part of the Focus Claims Review team at Optum, the Medical Director provides leadership,... ...the flexibility to work remotely * from anywhere within the... ...URAC, NCQA, Regulatory Compliance, Confidentiality, Conflict...Remote workClaimsMinimum wageFull timeWork experience placementWork at officeLocal area$280.84k - $393.18k
...Health Services, the Senior Medical Director Policy & Outcomes (Sr. Medical... ...health, and other compliance and regulatory activitiesLead... ...experience, provider relations, and claims.Serve as a liaison with... ...work schedule. (Mon & Fri - remote, Tues - Thurs onsite in Rancho...Remote workClaimsTemporary workLocal area$236.5k
Position Purpose:Assist the Chief Medical Director to direct and coordinate the medical management... ...and health care quality.Reviews claims involving complex, controversial, or unusual... ..., and a flexible approach to work with remote, hybrid, field or office work schedules...Remote workClaimsFull timePart timeWork at officeFlexible hoursWeekend work$211k - $287k
...Financial job title for this position is Medical Sr. Consultant*Position SummaryAt Securian... ...underwriting decisions, evaluate claims, and shape forward-looking risk management... ...32-40 hours/week). The position is fully remote, with travel to our St. Paul, MN home office...Remote workClaimsFull timeHome officeFlexible hours$174.07k - $374.92k
...at a time. Position Summary: This is a remote based (work from home) role preferably resides... ...use of health care resources. In the Medical Director role you will: Provide oversight for... ...predetermination reviews and reviews of claim determinations. This includes Prior Authorization...Remote workClaimsHourly payFull timeTemporary workWork experience placementLocal areaWork from home$134.14k - $176.05k
Hi, we're Oscar. We're hiring a Claims Compliance Associate Director to join our Claims team.Oscar is the first... ...Compliance.Work Location: This is a remote position, open to candidates who... ...are eligible for benefits including: medical, dental, and vision benefits, 11 paid...Remote workClaimsFull timeContract workWork at office$152.8k - $259.2k
...efficiency, reduce security and compliance risk, and accelerate digital... ...Limited, used under license. Claim based on GitLab data. Fortune... ...world. All of our roles are remote, however some roles may carry... ...(including family medical history), discharge status from...Remote workClaimsFull timeRelocationFlexible hours$270k - $320k
...Pathways Job overview: The Medical Director, Medical Affairs will serve... ...practice. Location: Remote in the United States.... ...procedures Evaluate scientific claims, clinical data presentations... ...with Regulatory, Legal, Compliance, and other stakeholders to...Remote workClaimsPermanent employmentFull timeWork at officeVisa sponsorshipWork visa$240k - $250k
...Medical Director Utilization Management We are looking for physicians who have expertise in... ...backgrounds and perspectives. This is a remote-first role that may require travel to... ...authorization data with post-service claims validation, we're creating a transparent...Remote workClaimsFlexible hours$223.8k - $313.1k
...of our caring community The Medical Director relies on medical background and reviews health claims. The Medical Director work... ...information. Travel: While this is a remote position, occasional travel to... ...take affirmative action, in compliance with Section 503 of the...Remote workClaimsFull timeTemporary workApprenticeshipWork at officeLocal areaWork from homeHome officeMonday to FridayWeekend work$206.01k
...Molecular Diagnostics Medicare Medical Director at Palmetto GBA oversees... ...medical policies to ensure compliance and support Medicare coverage... ...week) Monday-Friday working REMOTE in the United States or ONSITE... ...matters. Develops claim adjudication criteria for situations...Remote workClaimsFull timeFor contractorsWork experience placementWork at officeLocal areaMonday to Friday- ...Medical Director At Allstate, great things happen when our people work... ...shared purpose. You can work remotely and will commute to a nearby... ...determinations, free from claims or financial influence. Supports... ...Partners with legal and compliance teams on escalated cases,...Remote workClaimsWork at officeWork visa
$177k - $221k
...Opportunity: The Associate Director, Compliance Training will own the design... ..., marketing, market access, medical affairs, patient services... ...-Kickback Statute, False Claims Act, OIG guidance, PhRMA Code... ...interactive learning. #LI-TS1 #LI-Remote The base pay salary range...Remote workClaimsFull timeLocal areaWorldwideHome officeShift work$174.07k - $374.92k
...company, has an outstanding opportunity for a Medical Director. Ready to take your career to the next... ...with a Fortune 6 company? This is a remote Work at Home position and can be located... ...support of the appeal process, clinical claim review process, and predetermination of...Remote workClaimsHourly payFull timeTemporary workLocal areaWork from home$134.14k - $176.05k
Oscar Health is seeking an Associate Director of Claims Compliance to lead a team of analysts ensuring adherence to state and federal regulations... ...the Senior Director, Claims Quality and Compliance and is remote for candidates residing in Dallas, TX, with potential hybrid...Remote jobClaims- UnitedHealth Group is seeking a Medical Director to lead the Focus Claims Review team. The role ensures quality and coordination of medical review services... ...including provider telephonic discussions and appeals. Remote work is allowed within the U.S., with opportunities to...Remote jobClaims
$120k - $135k
...Chemistry is looking for an Associate Director, Medical Strategy tojoin our growing team!Our Associate... ..., Chicago, Carmel, or San Francisco—or remotely within the US, depending on team and... ...payments to any unverified sources claiming to be connected to Real Chemistry. We are...Remote workClaimsWork at officeLocal area2 days per week- ...from attending important medical appointments. By recognizing... ...Executive Officer for compliance program matters, the Director of Legal and Compliance leads... ...; coordinates insurance claims, litigation, and outside... ...business hours. Remote work is not available for...Remote workClaimsContract workFor contractorsFor subcontractorWork at officeImmediate startFlexible hoursAfternoon shift
- ...positions are classified as hybrid, onsite or remote. While the majority of our employees are... ...but not limited to: Customer Service, Claims Processors, and Correspondence positions... ...job Responsible for ensuring overall compliance with all Corporate and Medicare...Remote workClaimsFull timeWork experience placementWork at office1 day per week
- CVS Health is seeking a Medical Director to oversee medical policy implementation and lead the development... ...evaluation of clinical programs. This remote role, preferably Florida-based, supports... ...review, predeterminations, and claim determinations, while directing case management...Remote jobClaims
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