Remote Appeals Medical Director - Lead Clinical Decisions
Jobleads-US
- Remote job
UnitedHealthcare is hiring a Medical Director for Appeals and Grievances, responsible for clinical review and adjudication across multiple health plans. The role supports remote work from anywhere in the U.S. and requires collaboration with regional and plan medical directors, as well as regulatory bodies.
The position emphasizes clinical leadership, policy interpretation, and cross-functional teamwork to improve access and outcomes in a complex health system.
#J-18808-Ljbffr Jobleads-US- ...UnitedHealthcare is hiring a Medical Director for Appeals and Grievances, responsible for clinical review and adjudication across multiple health plans. The role supports remote work from anywhere in the U.S. and requires collaboration with regional and plan medical directors...Remote job
$248.5k - $373k
...- $373,000.00Job Area: Medical & Clinical OperationsCompany: UnitedHealth... ...the flexibility to work remotely * from anywhere within... ...Responsibilities:The Appeals and Grievances Medical Director is responsible for... ...directors regarding appeals decision rationales, and benefit...Remote workMinimum wageWork experience placementLocal areaWork from home- ...is seeking a clinician to review appeals and grievances across PPO, HMO,... ...responses and collaboration with medical directors and network staff. We offer remote work from anywhere in the U.S.... ...bring MD/DO credentials, 5+ years’ clinical practice, and strong leadership,...Remote job
- ...together Work at home! The Appeals and Grievances Medical Director is responsible for ongoing clinical review and adjudication of... ...enjoy the flexibility to work remotely from anywhere within the U.S.... ...directors regarding appeals decision rationales, and benefit interpretations...Remote jobWork from home
- ...UnitedHealthcare is seeking a Medical Director for Appeals and Grievances to oversee clinical review and adjudication... ...multiple health plans. This remote role requires MD/DO licensure... ...management experience. You will lead high-stakes decisions, ensure regulatory...Remote job
$195.2k - $341.6k
...Overview Job Summary: The Medical Director is responsible for... ...staff by providing training, clinical consultation, and clinical case... ...physician review for clinical appeals cases Participate in the... ...sensitivity to cultural diversity Decision making/problem solving...Remote jobHourly payWork at officeWeekend workAfternoon shift- ...UnitedHealth Group is seeking a senior Appeals and Grievances Medical Director to lead clinical review and adjudication for UnitedHealthcare and related companies. The role offers work-from-home flexibility across the United States. You will perform case reviews for...Remote jobWork from home
$174.07k - $374.92k
...recognizes physicians for their clinical quality and effective use of health... ...& West Virginia). **This is a remote based (work at home) based anywhere... ...US.** Responsibilities of this Medical Director role are related to Medicaid Appeals You will support the Medical...Remote workHourly payFull timeTemporary workLocal areaWork from home- ...UnitedHealthcare is seeking an Appeals and Grievances Medical Director to lead clinical review and adjudication of appeals and grievances across multiple health plan products. This role offers remote work from anywhere in the U.S. and a chance to influence benefit...Remote job
- ...UnitedHealth Group is hiring for a remote-friendly clinical leadership role overseeing appeals and grievances across PPO, HMO, MAPD, and PDP products. The position emphasizes collaboration with medical directors and network management to improve access, quality, and outcomes...Remote job
- ...UnitedHealthcare is seeking an experienced Medical Director for Appeals and Grievances, with leadership in clinical review and adjudication across PPO, HMO, MAPD, and PDP products. This remote role supports diverse health plans and requires expert regulatory responses...Remote job
- ...UnitedHealth Group in the United States seeks a Medical Director to oversee appeals and grievances, reviewing cases and applying medical policies. This remote role adapts to a nationwide footprint, handling diverse health plans and regulatory requirements. You will...Remote jobFlexible hours
$328k
...DescriptionGeneral Summary:The Executive Medical Director, Global Medical Lead (GML), Pain is a critical... ..., in collaboration with Clinical Development, HEOR, RWE,... ...solutions and make decisions that maximize medical and... ...as: 1. Hybrid: work remotely up to two days per week;...Remote workFull timeSummer workFlexible hours2 days per week- A leading healthcare solutions firm seeks a Payment Integrity Supervisor to oversee daily... ...assurance measures and resolving provider appeals. The ideal candidate will also ensure compliance... ...on improving service delivery. This remote position requires strong experience in...Remote workDaily paid
- ...certified or board-eligible child psychiatrists to become the Medical Director for the Missouri Child Psychiatry Access Program (MO-CPAP).... ...time role supports tele-psychiatry services across outpatient clinics and school-based programs, with opportunities for inpatient,...Remote jobFull time
$228.1k - $325.85k
...diseases with high unmet medical need. Learn more at... ...and iADCs). The Asset Lead has overall and primary... ...deliverables and day-to-day decision making for the asset(s)... ...nomination through clinical development, global/local... ...based in Northbrook, IL. Remote work from anywhere in...Remote workWork at officeLocal areaWork from homeWorldwide$143.32k - $273.93k
.... USAA roles may offer remote or hybrid flexibility for... ...Member Value Decision Science team, playing a... ...Decision Science Analyst Lead, you will be at the forefront... ...discretion of the USAA Board of Directors. The above description... ...include comprehensive medical, dental and vision...Remote workWork at officeRelocation packageFlexible hours- ...physician leader to conduct case reviews for appeals and grievances across multiple health... ...responses, collaboration with medical directors, and guidance on benefit interpretations... ...certification, and at least five years of clinical practice plus two years #J-18808-Ljbffr...Remote job
$133k - $195k
Role Description We're hiring a Lead Decision Scientist to be strategic partners embedded with... ...compensation package includes a wide range of medical, dental, vision, financial, and other... ...reimbursement support for a productive remote environment. ~Free Life360 Platinum...Remote workFull timeSummer workFlexible hours$386.5k
...00/yearJob Area: Medical & Clinical OperationsCompany... ...Management. The Medical Director, Clinical AI... ...coverage decisions, support safe and... ...flexibility to work remotely * from anywhere within... ...from production, appeals, audits, and... ...scaleProven ability to lead through influence...Remote workMinimum wageFull timeWork experience placementLocal area$248.5k - $373k
...73,000/yearJob Area: Medical & Clinical OperationsCompany: UnitedHealth... ...flexibility to work remotely * from anywhere... ...with medical director teams focusing on inpatient... ...review, member appeals clinical review, medical... ...confidence to make autonomous decisions and an ability to...Remote workMinimum wageFull timeWork experience placementWork at officeLocal area$280.84k - $393.18k
...Services, the Senior Medical Director Policy & Outcomes... ...Policies and clinical leadership around... ...developing, executing, leading and updating... ..., grievance and appeals, delegation oversight... ....Ensure medical decisions are rendered by... .... (Mon & Fri - remote, Tues - Thurs onsite...Remote workTemporary workLocal area$56.6k - $84.84k
...makes data-driven decisions, embraces continuous... .... The Intake Lead provides advanced... ..., grievances, appeals, and regulatory inquiries... ...(e.g., Pharmacy, Clinical, Operations,... ...This position is a Remote role. To be eligible... ...includes competitive medical, dental, vision,...Remote workFull timeWork experience placement$118.3k - $207.4k
...Wolters Kluwer Health, the UpToDate suite supports millions of clinical decisions every day. As AI changes how clinicians search for,... ...your work and personal life, including but not limited to: Medical, Dental, & Vision Plans, 401(k), FSA/HSA, Commuter Benefits,...Full timeWork at office$128.9k - $226.05k
...and care teams engage with UpToDate's clinical decision support products.At Wolters Kluwer Health... ...changes affect adoption and value. As Lead Product Analyst, CDS Adoption & Engagement... ...life, including but not limited to: Medical, Dental, & Vision Plans, 401(k), FSA/HSA...Full timeWork at office$133k - $195k
...ones they love. Our category-leading mobile app, Tile tracking devices... ...more than 500 (and growing!) remote-first employees. For more... ...Life360 touches every product decision, every experiment, and every... ...package includes a wide range of medical, dental, vision, financial,...Remote workFull timeSummer workFlexible hours- ...Kern Family Health Care is seeking a Medical Director for Appeals, Grievances & Disputes in Bakersfield, California. This role involves leadership, operational execution, and ensuring compliance with all regulations regarding grievances and appeals. The ideal candidate...
- ...Centene is seeking a Medical Doctor or Doctor of Osteopathy to lead clinical management on our Medical Management/Health Services team in Missouri. The role involves medical leadership for utilization management, quality improvement, and cost containment across complex...Remote job
$248.5k - $373k
...$373,000.00Job Area: Medical & Clinical OperationsCompany: UnitedHealth... ...together.The Medical Director for the Oncogenetic... ...evidence-based decision-making, compliance... ...flexibility to work remotely * from anywhere within... ...coverage review, member appeals clinical review,...Remote workMinimum wageWork experience placementLocal area- ...experienced and highly organized Manager of Clinical Appeals to lead our clinical appeals operations across... ...strong background in clinical review, medical necessity denials, payer appeal... ...commercial plans. Experience managing remote and/or offshore teams (Philippines experience...Remote work
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