Sign up to access all features of our service.
  • Job search
  • Favorites
  • Create a CV
    New
  • Salaries
  • Subscriptions

Remote Medical Director, Utilization Management

Ishe

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 necessity, CMS criteria, and program improvements while fostering a collaborative, remote-friendly work environment across the U.S.

You will drive utilization management initiatives, monitor trends, and provide guidance to physicians and staff to ensure compliant, high-quality patient care.

#J-18808-Ljbffr
Vacancy posted 4 days ago
Similar jobs that could be interesting for youBased on the Remote Medical Director, Utilization Management in United States vacancy
  •  ...To support Utilization Management operations, the full-time Utilization Review Medical Director will conduct clinical reviews of Durable Medical Equipment (DME) requests remotely, ensuring compliance with Medicare and Medicaid guidelines while maintaining productivity... 
    Remote work
    Full time

    Virtual Vocations Inc

    United States
    2 days ago
  • $275k - $325k

     ...and growing, Starling Oncology is changing oncology for the better. For more information, visit  Utilization Management Medical Director Oncology Work Location: REMOTE (work from home)   California         Nevada               Arizona               Oregon... 
    Remote work
    Work from home

    Starling Oncology

    Cerritos, CA
    26 days ago
  •  ...Health is hiring a Radiation Oncology Medical Director to oversee oncology utilization, policy implementation, and review processes in a remote, home-based role. The position supports...  ..., peer-to-peer reviews, and case management. The role requires MD/DO, board certification... 
    Remote job
    Work from home

    ISHE

    Phoenix, AZ
    1 day ago
  • Starling Oncology is seeking a Medical Director to provide clinical expertise in utilization management for oncology care. You will review and guide medical necessity decisions, collaborating with physicians, operations, and payers to optimize outcomes and value-based... 
    Remote job

    Starling Oncology

    Miami, FL
    1 day ago
  • 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

    Oncology Institute, Inc.

    Cerritos, CA
    1 day ago
  • $248.5k - $373k

     ...family medicine physician to join our Utilization Management team. Optum is a clinician-led care...  ...clinicians work and live. The Medical Director for Utilization Management will support...  ...fluency *All employees working remotely will be required to adhere to UnitedHealth... 
    Remote work
    Minimum wage
    Full time
    Work experience placement
    Work at office
    Local area
    Work from home

    Sacbar

    United States
    2 days ago
  • $248.5k - $373k

     ...family medicine physician to join our Utilization Management team. Optum is a clinician-led care...  ...way clinicians work and live. The Medical Director for Utilization Management will support...  ...'ll enjoy the flexibility to work remotely * from anywhere within the U.S. as you... 
    Remote work
    Minimum wage
    Full time
    Work experience placement
    Work at office
    Local area
    Work from home

    St Cloud Orthopedics

    United States
    2 days ago
  • $150 per hour

    The Utilization Review Medical Director is responsible for conducting clinical reviews of Durable Medical Equipment...  ...to support Integra’s Utilization Management (UM) operations. Role functions...  ...Conditions and Additional Expectations: Remote role requiring consistent... 
    Remote work
    Hourly pay
    Full time
    Contract work
    Temporary work
    Part time
    Local area

    Integra Partners

    Troy, MI
    a month ago
  • 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 job
    Flexible hours

    Centene Corporation

    Wakeeney, KS
    1 day ago
  • Centene Corporation seeks a physician leader to direct medical management, quality improvement and credentialing for the business unit. Lead utilization management, medical reviews, and performance-improvement initiatives to enhance cost-effectiveness and care quality.... 
    Remote job
    Weekend work

    Centene Corporation

    Kansas City, MO
    1 day ago
  •  ...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

    AzCEP

    United States
    4 days ago
  •  ...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

    CorroHealth Inc

    New York, NY
    3 days ago
  •  ...WellMed, part of the Optum family, is seeking a Medical Director for Utilization Management to support utilization determinations and identify trends in order to improve the UM program. The role involves developing and maintaining efficient UM processes, staying current... 
    Remote work

    Sacbar

    San Antonio, TX
    3 days ago
  •  ...WellMed, part of Optum, seeks an experienced physician to join the Utilization Management team as Medical Director. This remote role supports WellMed Medical Management, Inc. with UM determinations and program improvements, aiming to optimize care for seniors nationwide... 
    Remote work

    St Cloud Orthopedics

    San Antonio, TX
    4 days ago
  • CareOregon, Inc. seeks a Medical Director to oversee benefit/utilization management, clinical and wellness programs for members. The role involves leadership of QA, case/disease/quality management, and collaboration with physicians to improve care and utilization outcomes... 
    Remote job
    Work from home

    CareOregon, Inc.

    Kansas City, MO
    1 day ago
  •  ...CVS Health is seeking a Medical Director (Behavioral Health) to lead the utilization management team remotely. You will provide psychiatric leadership, oversee high-risk cases, and ensure medical necessity decisions to deliver high-quality care for diverse health plans... 
    Remote work

    CVS Health

    Wausau, WI
    1 day ago
  •  ...WellMed Medical Management, Inc. seeks an Internal Medicine/Family Medicine physician to join our Utilization Management team as Medical Director. You will make UM determinations, monitor CMS criteria, and help shape medical necessity decisions within a managed care framework... 
    Remote work

    Chicago Derm

    Brooklyn, NY
    3 days ago
  •  ...Bickham Services Unlimited, LLC seeks a Medical Director, Utilization Management for a 6-9 month contract based in Henderson, NV, with remote work option. Immediate start favored for reviewing inpatient and post-acute care decisions for Commercial and Medicare Advantage... 
    Remote work
    Contract work
    Immediate start

    Bickham Services Unlimited, LLC

    United States
    3 days ago
  • $275k - $300k

    The Oncology Institute is seeking a Medical Director for Utilization Management Oncology to provide strategic oversight and support key clinical initiatives. This remote role involves conducting medical reviews of oncology treatment plans and ensuring compliance with evidence... 
    Remote job

    jobr.pro

    Cerritos, CA
    3 days ago
  • WellMed, part of the Optum family, seeks a Medical Director for Utilization Management to support WellMed Medical Management, Inc. by making UM determinations...  ...and proposing program improvements. This role offers remote work from anywhere in the U.S. and integration with... 
    Remote job

    Tnafp

    Brooklyn, NY
    4 days ago
  • Integra Partners seeks an experienced Utilization Review Medical Director to lead clinical reviews of DMEPOS requests within a remote UM environment. You will ensure decisions meet Medicare/Medicaid guidelines and internal policies while maintaining timely throughput and... 
    Remote job

    Integra Partners

    Brooklyn, NY
    4 days ago
  • UnitedHealth Group in Minnesota seeks a Medical Director to provide physician support for...  ...effective, high-quality care, advances utilization management, and communicates policies to network and non-network physicians. Remote work from anywhere in the U.S. is supported... 
    Remote job

    Texas Health Institute

    Brooklyn, NY
    1 day ago
  • Valenz Health is seeking a Part-Time Medical Director to provide physician leadership for medical management and utilization review programs. You will align clinical decisions...  ..., and organizational standards in a fully remote role based in the United States. You will collaborate... 
    Remote job
    Part time

    Vālenz Health®

    Phoenix, AZ
    4 days ago
  • $190k - $200k

    We're seeking a board‑certified Medical Director (Internal Medicine or Family Practice) to support our team. This role is fully remote and focuses on utilization management (UM), quality review, and clinical oversight for high‑volume cases. You will work closely with... 
    Remote work
    Full time

    SPECTRAFORCE

    New York, NY
    3 days ago
  •  ...System Medical Director Physician AdvisorsThe Lee Health System Physician Advisor Medical...  ...and other leadership related to case/utilization management and revenue cycle including the Lee Health...  ...contracted providers involved in remote utilization review and physician advisory... 
    Remote work
    Contract work
    For contractors
    Monday to Friday
    Weekend work
    3 days per week

    Lee Health

    Fort Myers, FL
    4 days ago
  • $250k - $350k

     ...company, is a specialized medical group dedicated to providing...  ...primary care, longitudinal care management, remote monitoring, and real-time...  ...quality, reduce avoidable utilization, and expand access for...  ...Position Title: Medical Director Intention MA Location... 
    Remote work

    Essen Health Care

    Boston, MA
    2 days ago
  •  ...company is hiring a Physical Health Medical Director to work remotely in North Carolina. The Physical...  ...within the Physical Health Medical Management Team, providing clinical oversight,...  ...goals related to clinical quality, utilization management, and care coordination.... 
    Remote work
    Temporary work
    Work experience placement
    Work at office
    Relocation
    Flexible hours
    Weekend work
    Aberdeen, NC
    a month ago
  • Integra Partners, a national DMEPOS network administrator, seeks a remote Utilization Review Medical Director. You will conduct clinical reviews of DMEPOS requests, ensure determinations meet Medicare/Medicaid guidelines, and maintain high-quality documentation in a fast... 
    Remote job
    Full time

    Remote Genie

    Brooklyn, NY
    4 days ago
  •  ...CVS Health is seeking an experienced Utilization Management (UM) Nurse Consultant to join our remote team. This 100% work-from-home role serves members across the CST zone, ensuring safe, appropriate care and timely approvals. You will review clinical documents, collaborate... 
    Remote work
    Work from home

    Santa Barbara Cottage Hospital

    United States
    4 days ago
  • $286.07k - $353.38k

     ...Place to Work since 2015.Position SummaryThe Vice President, Medical Director, Health Plan provides senior clinical leadership across...  ...health plan strategy.Provide clinical leadership across utilization management, care management, population health, quality, pharmacy,... 
    Remote work
    Full time
    Home office

    Martin's Point Health Care

    Portland, ME
    a month ago

Do you want to receive more vacancies?

Subscribe and receive similar vacancies to Remote Medical Director, Utilization Management. Be the first to apply!