Remote ENT Medical Director - Claims & Compliance
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- Remote job
UnitedHealth Group's Optum is seeking a Medical Director to lead the Focus Claims Review program, ensuring high-quality medical review services and regulatory compliance. MD or DO with ABMS/AOA ENT board certification and 5+ years of clinical experience are required; MS Office skills are expected. This role offers remote work from anywhere in the U.S. and a comprehensive benefits package. #J-18808-Ljbffr Socket.dev
$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) with expertise in...Remote workClaimsMinimum wageFull timeWork experience placementWork at officeLocal area- ...role in ensuring regulatory compliance and labeling accuracy across... ...access to quality, affordable medication and data insights while promoting... ...the accuracy of label claims for new artwork creation and... ...and industry-first dedicated remote distribution capabilities provide...Remote workClaimsFull timeContract work
$80 per hour
...Mercor is seeking a Medical Billing Manager to oversee medical billing operations. This remote position offers $80/hour. The ideal candidate will have 5... ...platforms. Responsibilities include managing claims workflows, ensuring compliance with CMS guidelines, and evaluating AI-...Remote workClaims- ...Medical Director OpportunityTop Healthcare Company is hiring a North Carolina Licensed Physician... ...North Carolina Physician License. 100% Remote role! Contract for one year to start!... ...or update various moderate to complex claims payments and payment errors for any business...Remote workClaimsContract work
$248.5k - $373k
...500 - $373,000/yearJob Area: Medical & Clinical OperationsCompany:... ...enjoy the flexibility to work remotely * from anywhere within the U.... ...each memberWork with medical director teams focusing on inpatient... ...appeals clinical review, medical claim review and provider appeals...Remote workClaimsMinimum wageFull timeWork experience placementWork at officeLocal area$248.5k - $373k
...500 - $373,000/yearJob Area: Medical & Clinical OperationsCompany:... ...Billing Validation (SSBV) Medical Director to join our Clinical and... ...enjoy the flexibility to work remotely * from anywhere within the U.... ...of short-stay inpatient claims to ensure accurate billing status...Remote workClaimsMinimum wageFull timeWork experience placementLocal area$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$225k - $275k
...Overview The Client Medical Director (CMD) is a key member of the Go To Market team. Along... ...Solutions teams. Have in-depth knowledge of claims, claims adjudication, medical policy... ...candidate is selected. #LI-JB1 #LI-Remote #director #J-18808-Ljbffr...Remote workClaimsWork at officeImmediate startWork from home$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$200k - $240k
...LinkedIn and Facebook. The Director of Compliance provides compliance guidance... ...Compliance works closely with Medical, Commercial, Regulatory... ...the possibility of being a remote role. Primary Responsibilities... ...Anti-Kickback Statute, False Claims Act, data privacy, and transparency...Remote workClaimsLocal area$150k - $160k
...Position Summary The Director of Compliance is a leadership role within... ...and comprehensive academic medical center compliance program, ensuring... ...on-site, hybrid, or fully remote work arrangements based on... ...-Kickback Statute, False Claims Act). Must be inquisitive...Remote workClaimsTemporary workLocal area$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$248.5k - $373k
...- $373,000.00Job 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 wageWork 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$187.28k - $312.13k
Position SummaryA Medical Affairs Medical Director has strong clinical and scientific... ...including recommending medical claims.ResponsibilitiesThis role... ...with a mix of on-site and remote work. Exact on-site days... ...necessary to ensure GSK’s compliance to all federal and state...Remote workClaimsFull timeLocal area$231.8k - $301.8k
...partner is looking for a Senior Director, North America Compliance based in the United States... ...-Kickback Statute, False Claims Act, federal and state... .... ~ Comprehensive medical, dental, and vision insurance... ...benefits . ~ Remote work opportunity within the...Remote workClaimsFull timeFor contractorsWork at office$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$223.8k - $313.1k
Medical Director physician job in Texas : Become a part of our caring community... ...and reviews health claims. The Medical Director work assignments... ...Travel: While this is a remote position, occasional travel... ...take affirmative action, in compliance with Section 503 of the...Remote workClaimsBi-weekly payTemporary workApprenticeshipWork at officeLocal areaWork from homeHome officeWork visaMonday to FridayWeekend work- Optum, part of UnitedHealth Group, seeks a Medical Director to lead the Focus Claims Review team and oversee medical services and policy development for... ...medical licensure, and extensive clinical experience. Remote work from anywhere in the U.S. is available with a comprehensive...Remote jobClaims
$215k - $408.5k
...clinical professional on our Medical Management/Health Services team... ...re Hiring: Full time Medical Director for our Health Plan in New... ...care quality. \n Reviews claims involving complex, controversial... ...approach to work with remote, hybrid, field or office work...Remote workClaimsFull timePart timeWork at officeFlexible hoursWeekend work$130k - $175k
...people love working at A&M. Director, Government Contractor Investigations & Compliance The Team At A&M you will have... .... You will manage disputes, claims, and litigation support while also... ...quarterly, as needed · Fully remote position Your journey at A&M...Remote workClaimsContract workPart timeFor contractorsFor subcontractorFlexible hours- ...Medical DirectorThe Medical Director serves as the clinical leader and chairperson of the... ...initiatives. This role ensures compliance with NCQA accreditation... ...credentialing and claims-related matters.This position... ...While this position allows remote work, the individual must...Remote workClaimsContract work
- Optum is seeking a Medical Director to provide physician support for Enterprise Clinical Services, overseeing clinical coverage determinations and utilization management. You will collaborate with leadership to maintain processes for benefit coverage, quality improvement...Remote jobClaims
- Optum is seeking a Medical Director to provide leadership for the Focus Claims Review program. You will oversee medical services... ...claim reviews. The role offers remote work from anywhere in the U.S. with a strong emphasis on compliance, collaboration with physicians, and...Remote jobClaims
- ...Medical Director Opportunity At Karoo Health Karoo Health is a cardiovascular... ...company connects clinical, claims, pharmacy, and patient data... ...pathways. Help maintain compliance with applicable clinical,... ..., transitions of care, remote patient management, or chronic...Remote workClaims
- Optum is seeking a Medical Director to lead claims review, provide clinical oversight, and ensure quality across medical... ...for medical programs and services. Remote work offered across the U.S. with focus on regulatory compliance, clinical criteria, and collaboration with...Remote jobClaims
- ...part of UnitedHealth Group, seeks a Medical Director to lead the claims review program and oversee medical services... ...criteria and policy development. Remote work is available nationwide within... ...leadership in medical review, compliance with regulatory standards, and collaboration...Remote jobClaims
$174.07k - $374.92k
...of health care resources. **This is a remote based (work at home) based anywhere in the... ..., has an exciting opportunity for a Medical Director (Spine) that can be remote based, work from... ...predetermination reviews ad reviews of claim determinations, providing clinical, coding...Remote workClaimsHourly payFull timeTemporary workLocal areaWork from home$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... ...skills*All employees working remotely will be required to adhere to...Remote workClaimsMinimum wageFull timeWork experience placementLocal area- ...in Brighton, MA office; 1 day remote from home FLSA Status: Exempt Position Summary The Medical Director oversees all medical and... ...of patient care, regulatory compliance, and innovation. This role is... ...pharmacy, and service operations (claims). The Medical Director also collaborates...Remote workClaimsContract workWork at officeLocal area
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