Remote Medical Director, Utilization & Quality Oversight
$190k - $200kSPECTRAFORCE
A healthcare management company is seeking a fully remote Medical Director to support their team in utilization management and clinical oversight for high-volume cases. The ideal candidate will have an MD or DO with board certification in Internal Medicine or Family Practice, along with 4–7 years of clinical experience. Responsibilities include providing medical leadership, conducting case reviews, and collaborating on quality improvement initiatives. Salary ranges from $190,000 to $200,000, reflecting the role's seniority. #J-18808-Ljbffr
- ...CenCal Health is seeking a Medical Director to oversee clinical management and ensure quality care for its members. Reporting... ...position involves clinical oversight in utilization management and care... ...principles. This role is hybrid or remote, and requires local residency...Remote workLocal areaRelocation
$110 - $130 per hour
A healthcare staffing company is seeking a Medical Director to lead utilization management and quality improvement for Medicare inpatient care. This remote role requires board-certified physicians with active medical licenses in FL and TX. Key responsibilities include...Remote work- Humana Inc. is seeking a Medical Director National OP Medicare located in Washington, D.C. This... ...compliance with regulatory standards, and utilizing extensive medical judgment and... ...of post-residency experience. This is a remote position with competitive pay and benefits...Remote work
- Humana Inc in Columbus, Ohio is seeking a Medical Director for National OP Medicare to leverage... ...expertise for service authorization and utilization management. This role requires strong... ...in a structured environment and may involve remote work. #J-18808-Ljbffr Humana IncRemote work
$225.7k - $428.9k
...Centene Corp. is looking for a Full-time Medical Director to lead medical management initiatives in South Carolina. This role offers remote work flexibility, ensuring effective... ...management experience and knowledge of quality accreditation standards. Benefits include...Remote workFull time$275k - $300k
...oncology for the better. Utilization Management Medical Director Oncology Work Location: REMOTE (work from home) California... ...medical and strategic oversight of utilization management while... ...recommendations that balance quality, outcomes, and cost-effectiveness...Remote workWork from home- Molina Healthcare is seeking a medical professional to provide oversight and ensure quality care in Los Angeles, California. The role requires expertise in utilization management practices and a strong understanding of medical necessity and regulatory compliance. The ideal...
- ...Now Hiring: Medical Director – Utilization Management 100% Remote | Must work PST hours Medicare Advantage | Inpatient... ...compliant care decisions that support quality outcomes, cost efficiency, and... ...standards, audits, and delegated oversight Identify utilization trends and contribute...Remote workImmediate start
$192.6k - $260.6k
...Director, Clinical Quality Risk & Portfolio Oversight Overview The Director, Clinical Quality Risk & Portfolio... ...effectiveness. This position is open to remote working. Key Responsibilities... ...comprehensive benefits including medical, dental, and vision coverage,...Remote workFull timeTemporary workLocal areaFlexible hoursShift work$275k
...Remote Medical Director, Hematology/Oncology (Utilization Management & Clinical Strategy) Full-Time | Remote (Post-Onboarding... ...resource, providing expert oversight for oncology-related medical necessity... ...strategies to enhance care quality while reducing external review dependency...Remote workFull timeRelocation packageMonday to Friday$223.8k - $313.1k
Humana Inc. seeks a Medical Director for National OP Medicare to leverage medical expertise in authorization decisions. This role involves... ...over five years of clinical experience. This position offers remote work flexibility and a comprehensive benefits package, along...Remote work$240.12k - $315.16k
...Oscar is hiring an Associate Medical Director to join the Utilization Management Team. This... ...management and adherence to quality standards. You will... ...Work Location This is a remote position, open to candidates... ...their performance. Provide oversight to ensure the team meets...Remote workImmediate startWork from home$223.8k - $313.1k
...caring community The Medical Director National OP Medicare... ...requirements in daily utilization management and coverage... ...to support quality, coordination, and appropriate... .... Provide oversight or input, as applicable... ...Travel: While this is a remote position, occasional...Remote jobBi-weekly payFull timeTemporary workApprenticeshipWork from homeHome office- ...operational supervision of clinical staff conducting utilization reviews and specialty review activities. This fully remote position requires a strong background in health... ...and communication skills. This role supports quality management initiatives aimed at improving...Remote work
$275k - $325k
...Medical Director - Utilization Management Astrana is seeking a California-licensed... ...(UM) to provide clinical oversight and strategic leadership... ...ensure members receive high-quality, medically appropriate,... ...This position is fully remote, with some travel to SoCal...Remote work- ...oversee clinical staff conducting utilization reviews. This fully remote position requires strong leadership... ...context and a proactive approach to quality management. Key responsibilities include... .... Outstanding benefits include medical insurance, paid time off, and a...Remote work
- Obran Cooperative is seeking a Medical Director to provide clinical oversight for California-based Home Healthcare Agencies. This part-time role requires a... ...regulatory compliance and clinical governance. The position is remote with a commitment of 8-10 hours per month, offering a...Remote workPrice workPart time
$248.5k - $373k
...Corporation is seeking a Chief Medical Officer for UnitedHealthcare... ...leadership role focuses on quality improvement and enhancing member... ...functional partners to align utilization management strategies with... ...experience. This position offers remote flexibility within Wisconsin...Remote work$140k - $175k
...About the Role The Director of Clinical Quality serves as Equip's primary owner... ...while providing direct oversight of the Utilization Management (UM) program.... ...directly to the VP of Medical Operations & Quality and... ...compliance staff) in a remote or telehealth setting. Proven...Remote workWork at officeLocal areaWork from homeHome officeFlexible hours- ...A diversified healthcare organization is seeking a clinical professional to lead medical management services. Responsibilities include overseeing utilization review, coordinating quality improvement initiatives, and collaborating with various clinical teams to ensure optimal...Remote workFlexible hours
- Humana Inc. located in Austin, Texas is looking for a Medical Director to manage utilization oversight. Responsible for clinical review of services and... ...physicians. Join a leading healthcare organization dedicated to quality patient care. #J-18808-Ljbffr Humana Inc
- ...The Clinical QA Supervisor is responsible for the oversight of the review of Physician reports and accompanying medical records to ensure that the report is complete,... ...your future. Apple equipment and a media stipend are provided for remote workspace. #J-18808-Ljbffr...Remote workTemporary work
- ...Crains Cleveland is seeking a qualified candidate in Tallahassee, Florida to assist the Medical Director in physician leadership and quality oversight for medical projects. The role involves managing Physician Reviewers, overseeing quality assurance, and providing an...Remote work
$186.2k - $363.09k
...healthcare organization in California seeks a Medical Director to oversee the appropriateness and... ...provided to members, enhancing quality and efficiency. The ideal candidate has... .... Responsibilities include evaluating utilization management practices, developing medical...- ...-time. This role is remote-friendly, but we are... ...office. Role: Director of Clinical Quality and Outcomes We are... ...traditional clinical oversight. It is about turning... ...rates, goal mastery, utilization, treatment fidelity,... ...understanding of medical necessity, audits, and...Remote workFull timeWork at officeFlexible hoursShift work
$259.56k - $363.39k
...Partnership HealthPlan of California in Redding is seeking a qualified Medical Doctor or Doctor of Osteopathy to oversee the quality of care and ensure appropriate utilization of services. The role includes reviewing Treatment Authorization Requests and engaging with...$238k - $357.5k
...Stryker Corporation is seeking a Medical Director Oncology to provide utilization review determinations and support case management for optimal clinical outcomes. This role offers flexibility to work remotely from anywhere in the U.S. The ideal candidate will have an...Remote work$79.8k - $126k
...Judi Health is seeking a Medical Director (Texas Licensed) for a remote position. The role will involve overseeing clinical support for Capital Rx's utilization management programs and making clinical determinations for patient care. Qualified candidates must have an active...Remote work$255k - $285k
...Transcarent, Inc. is seeking a Medical Director for Population Health and Clinical Oversight, responsible for leadership in population health strategy and oversight of clinical programs. This remote role demands strong leadership and expertise in population health management...Remote work- ...A healthcare organization is seeking a Medical Director for Utilization Management to ensure compliant care decisions for Medicare Advantage members. This remote position requires expertise in clinical decision-making, particularly with MCG guidelines and utilization...Remote work
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