Remote Medical Director: Medicare Quality & Compliance

Virtix Health LLC

Virtix Health LLC is seeking a board-certified Medical Director to oversee Medicare clinical services, ensuring CMS compliance and driving care delivery improvements. After mentored training, you will review records, discuss cases, and guide clinical teams remotely.

Collaborating with multidisciplinary teams, you will participate in quality initiatives, maintain documentation, and support peer-to-peer prior authorizations.

#J-18808-Ljbffr

Apply

Vacancy posted 5 days ago

Similar jobs that could be interesting for youBased on the Remote Medical Director: Medicare Quality & Compliance in United States vacancy

Remote Medical Director CMS Quality & Compliance
...Virtix Health LLC seeks a Medical Director to assess the quality of clinical services for Medicare beneficiaries, ensure CMS guideline compliance, and drive improvements in care delivery. After... ...to confirm best practices. This remote role requires board certification,...
Remote work
Virtix Health LLC
New York, NY
3 days ago
Remote Medical Director - Clinical Quality & CMS Compliance
...Virtix Health is seeking a highly skilled Medical Director to join our remote team. The role focuses on assessing the quality of clinical services for Medicare beneficiaries, ensuring CMS compliance, and driving improvements in care delivery. The position requires...
Remote work
Virtix Health LLC
United States
2 days ago
Assoc. Director, Clinical Quality Assurance
$188k - $204k
...passion for clinical quality and can thrive in a fast... .... The Associate Director GCP Quality is responsible... ...experience in GCP and compliance, leadership, and communication... ...in-person teamwork, remote options will be... ...in pharma/biotech or medical device industries, with...
Remote work
Contract work
Work at office
Immediate start
Worldwide
Kiniksa Pharmaceuticals
Lexington, MA
6 days ago
Director, Clinical Quality Assurance
...Lexington, MA is hiring an Associate Director, Clinical Quality Assurance to lead GCP/GLP/GPV quality... ...investigations, and inspections, ensuring compliance with FDA, EU, ICH guidelines, and... ...SOPs. Office-based with potential remote options for highly qualified...
Remote work
Work at office
Kiniksa Pharmaceuticals
Lexington, MA
5 days ago
Remote Neurology Medical Director CMS Quality
...healthcare organization is seeking a Neurologist Medical Director to ensure compliance with clinical guidelines for Medicare beneficiaries. The role involves conducting... ...active medical license. This position is primarily remote, offering a full-time work schedule with...
Remote work
Full time
Virtix Health
New York, NY
3 days ago
Remote Director of Clinical Quality (Remote)
$155k - $185k
...ABOUT THE ROLE The Director of Clinical Quality owns the strategic design,... ...of Cartwheel's quality and compliance function. This is a builder... ...equity package Location: Remote Start date : Summer 20... ...~ Generous PPO medical, vision, and dental/ortho...
Remote work
Full time
Summer work
Flexible hours
Cartwheel
Atlanta, GA
4 days ago
Remote Medical Director (MD/DO) - Medicare Quality Lead
...CorroHealth, Inc. is seeking a highly skilled Medical Director to oversee the quality of clinical services for Medicare beneficiaries, ensuring CMS compliance and high standards of care. The... ...during training and a flexible remote work arrangement from any U.S. state....
Remote work
Hourly pay
Flexible hours
CorroHealth, Inc.
United States
2 days ago
Associate Director, Clinical Quality (Remote Eligible)
$171k - $223k
...meaningful therapeutics to patients. This role delivers strategic GCP quality oversight across Denali's clinical trial portfolio, anchoring... ...the clinical development lifecycle. It sets the standard for compliance and ethical conduct across study teams, site leadership, and...
Remote work
Local area
Denali Therapeutics
United States
3 days ago
Remote Medical Director: Utilization & Care Quality Leader
...Humana Inc. seeks a Medical Director to authorize services and determine level of care in a remote, US-based role. You will review... ...interpret guidelines, and ensure compliance with CMS and Humana policies... ...-acute rehabilitation and Medicare Advantage requirements. You...
Remote work
Humana
United States
2 days ago
Associate Director, Clinical Quality Assurance
$154.5k - $195.7k
...The Quality team at EyePoint ensures that the highest standards of... ...quality, safety, and regulatory compliance are upheld across all... ...retinal diseases. The Associate Director of Clinical Quality Assurance... ...compliance. This position is remote and will report to the Director...
Remote work
BioSpace, Inc.
New York, NY
4 days ago
Clinical Quality Assurance Coordinator (32949)
...Clinical Quality Assurance Coordinator (32949) Craving... ..., integrity, and compliance with client agreements... ...documentation review, or medical necessity assessments.... ...This Role Rocks: 100% Remote - Enjoy the flexibility... ..., bill reviews, Medicare compliance, case management...
Remote work
Local area
Work from home
Monday to Friday
Flexible hours
ExamWorks
New York, NY
3 days ago
Clinical Quality Assurance Coordinator (32981)
...dynamic team as a Clinical Quality Assurance Coordinator... ...The position is 100% remote with a schedule of... ...from reputable medical journals and/or publications... ...highest quality and in compliance with company standards... ..., bill reviews, Medicare compliance, case management...
Remote work
Local area
Monday to Friday
ExamWorks
Madison, WI
4 days ago
Director, Health Plan Quality Program Management & Performance (Remote in New York)
$97.3k - $227.68k
...Leads and directs team responsible for quality management and quality performance improvement... ...improvement activities to maintain compliance with quality program requirements and reporting... ...-sponsored programs (Medicaid, Medicare, Marketplace). • State quality improvement...
Remote work
Full time
Contract work
For subcontractor
Work at office
Night shift
Molina Healthcare
Remote
4 days ago
Director - Enterprise Quality Methologies, Governance & Enablement
$187.9k - $258.5k
...associate experiences. The Director, Enterprise Quality Methodologies,... ..., methodologies, compliance alignment, quality intelligence... ...: While this is a remote position, occasional... ..., Humana provides medical, dental and vision... ...for people with Medicare and Medicaid, families...
Remote work
Full time
Temporary work
Apprenticeship
Work at office
Work from home
Home office
Humana
New York, NY
4 days ago
Medical Director - Medicare Appeals
$174.07k - $374.92k
...and prioritize safety and quality in everything we do.... ...resources. **This is a remote based (work at home) based... ...of this Medical Director role are related to Medicare Appeals: * Direct daily... ...with Medicare Quality and Compliance on an ongoing basis *...
Remote work
Hourly pay
Full time
Temporary work
Local area
Work from home
Weekend work
CVS Health
Connecticut
10 days ago
Manager, Clinical Quality Assurance
$130k - $145k
DescriptionSummaryThis position supports the Arcus Clinical Quality Assurance (CQA) team in support of CQA... ..., report development, and tracking compliance with ICH-GCP and Arcus Standard... ..., CA location (preferred) or can be remote based. The anticipated salary range for...
Remote work
Work at office
Flexible hours
Arcus Biosciences
Hayward, CA
4 days ago
Remote Medical Director, Utilization & Quality Oversight
$190k - $200k
...A healthcare management company is seeking a fully remote Medical Director to support their team in utilization management and clinical oversight... ...leadership, conducting case reviews, and collaborating on quality improvement initiatives. Salary ranges from $190,000 to $20...
Remote work
SPECTRAFORCE
United States
2 days ago
Director, National Medicare Stars & Quality Improvement (Enterprise) - REMOTE
...DESCRIPTION Job Summary Leads and directs team responsible for Medicare Stars quality improvement (QI) programs and activities. Oversees... ...with and escalates gaps and barriers in implementation and compliance to department leadership, including proposed resolution. Monitors...
Remote job
Contract work
Work at office
Molina Healthcare Inc
New York, NY
1 day ago
Remote Medical Director, Utilization & Quality Oversight
...Medical Review Institute of America is seeking a Medical Director (Physician Advisor) to lead clinical utilization management, peer review activities, and clinical quality management. This remote role reports to MRIoA leadership and offers a comprehensive compensation...
Remote work
Medical Review Institute
Salt Lake City, UT
2 days ago
Remote Medical Director: Utilization & Care Quality
...Humana Inc. is seeking a Medical Director to oversee utilization management, determine service appropriateness, and ensure compliance with national guidelines and CMS requirements. The role emphasizes collaboration with clinicians and interdisciplinary teams across inpatient...
Remote work
Humana
Montpelier, VT
4 days ago
Remote Enterprise Medical Director: Quality & Utilization
...Ladders is seeking an Enterprise Medical Director for a remote leadership role in the Finance & Insurance space. You will guide medical decision-making, quality improvement, and clinical oversight across core operations, partnering with business and clinical stakeholders...
Remote work
Ladders
New York, NY
5 days ago
Remote Medical Director: Appeals & Quality Leadership
...Ladders seeks a Remote Medical Director - Appeals to lead medical oversight of utilization management, quality improvement, and appeals processes. The role involves reviewing complex... .... The position emphasizes regulatory compliance, performance improvement, and serving...
Remote work
Ladders
United States
3 days ago
Remote Medical Director: Utilization & Quality
...The Judge Group is seeking a Medical Director – Utilization Management to provide... ...utilization management, appeals, quality, and clinical operations. This remote, full-time role reports to... ...and external providers to optimize outcomes and compliance. #J-18808-Ljbffr
Remote work
Full time
The Judge Group
United States
4 days ago
Remote Medical Director - Quality & Utilization
...Centene Management Company LLC is seeking a Board-certified physician to assist the Chief Medical Officer in directing medical management, quality improvement, credentialing, and utilization review for the Georgia-based program. The role requires active medical practice...
Remote work
Weekend work
Centene Management Company LLC
United States
2 days ago
Remote Medical Director - Part-Time Utilization & Quality
Centene Corp seeks a Medical Director PRN to support the CMO in directing the physician component... ...the health plan units. The position is remote in Indiana, part-time (~20 hours/week),... ...required. Will lead reviews, appeals, and quality-improvement efforts. #J-18808-Ljbffr
Remote work
Part time
Relief
Centene Corporation
United States
2 days ago
Remote Medical Director - Quality, Cost & Care Innovation
...Elevance Health seeks a Medical Director to oversee medical services for national accounts, offering virtual work with occasional required... ...person training. The role involves clinical leadership to improve quality, cost, and outcomes, plus advisory support across the...
Remote work
Elevance Health
United States
2 days ago
Remote Medical Director: Clinical Leadership & Quality
...Elevance Health is seeking a Medical Director (US) to oversee medical services for national accounts, in a virtual, full-time capacity with... ...experience. You will lead utilization management and clinical operations to drive quality and cost improvements. #J-18808-Ljbffr
Remote work
Full time
The Elevance Health Companies, Inc.
Indianapolis, IN
16 hours ago
Remote Medical Director, Medicaid Quality Lead
...CVS Health, through its Aetna Better Health Louisiana program, seeks a Medical Director to advance Medicaid quality, access and outcomes. This work‑from‑home role supports Louisiana while assisting other plans as needed, driving utilization management and care reviews...
Remote work
Work from home
CVS Health
United States
3 days ago
Director of Clinical Quality
...Control the quality of the systems that let us... ...touch. Location: Remote Type: Full-time... ...advocacy to guide Medicare patients through diagnoses, medical bills, and care plans... ...Exists As a Director of Clinical Quality... ...role does not own: Compliance or outcomes strategy...
Remote work
Full time
Dearest Care
Bismarck, ND
16 hours ago
Medical Director, Quality
$206.31k
...often (in days) to receive an alert: Medical Director, Quality Job Category: Clinical... ...member-centered care while ensuring compliance with all federal, state regulations,... ...Information Set (HEDIS), Centers for Medicare and Medicaid Services (CMS) Stars, Covered...
Full time
L.A. Care
Los Angeles, CA
1 day ago

Do you want to receive more vacancies?

Subscribe and receive similar vacancies to Remote Medical Director: Medicare Quality & Compliance. Be the first to apply!