Remote ENT Medical Director - Claims & Compliance
Salem Health Hospitals & Clinics
- Remote job
Optum is seeking a Medical Director to lead the Focus Claims Review team, overseeing medical services, coding reviews, and policy development. The role involves physician liaison duties, clinical summaries, and ensuring regulatory compliance across CMS/URAC/NCQA frameworks. The position offers remote work from anywhere in the United States and requires ABMS/AOA ENT board certification with facial plastic expertise and 5+ years of clinical experience. Strong communication skills essential. #J-18808-Ljbffr Salem Health Hospitals & Clinics
- ...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 workClaimsContract work
$248.5k - $373k
...a Short Stay Billing Validation (SSBV) Medical Director to join our Clinical and Coding Audit (... ...You’ll enjoy the flexibility to work remotely * from anywhere within the U.S. as you... ...determination of short-stay inpatient claims to ensure accurate billing status and alignment...Remote workClaimsMinimum wageFull timeWork experience placementLocal area$225.7k - $428.9k
...clinical professional on our Medical Management/Health Services team... ...re Hiring: Full time Medical Director Centene Corporation is a... ...health care quality. Reviews claims involving complex, controversial... ...flexible approach to work with remote, hybrid, field or office work...Remote workClaimsFull timePart timeWork at officeFlexible hoursWeekend work- UnitedHealth Group is seeking a Medical Director to lead the Focus Claims Review program. This role oversees medical services coordination, provider discussions... ..., Optum, and other providers. The position offers remote work from anywhere in the U.S. #J-18808-Ljbffr...Remote jobClaims
- UnitedHealth Group (Optum) is seeking a Medical Director to provide physician support to Enterprise Clinical Services, shaping clinical coverage determinations, quality improvement, and cost-effective care for members. You will collaborate with network and non-network...Remote jobClaims
- Optum is a global health services company seeking a Medical Director to lead the Focus Claims Review program. You will oversee claim reviews, discussions... ...aligning with regulatory standards. The role offers remote work from anywhere in the U.S. with a Monday-Friday schedule...Remote jobClaimsMonday to Friday
- UnitedHealth Group's Optum unit seeks a Medical Director to lead the Focus Claims Review program, overseeing medical services, provider discussions, and... ...quality and coordination across reviews. You can work remotely from anywhere in the U.S. The position requires an...Remote jobClaims
- ...signaling pathway. The Senior Director, Compliance will provide enterprise-wide... ...for Commercial, Marketing, Medical Affairs, Market Access, and... ...-Kickback Statute, False Claims Act, OIG guidance, Sunshine... ...City, CA on a hybrid basis. Remote candidates will be considered...Remote workClaimsFull timeWork at officeLocal areaRelocation
$110 - $130 per hour
Title: Medical Director Location: Remote Duration: 6 Months with possible extension/Conversion FTE We’re hiring a board-certified physician to support... ...reviews, and review complex/controversial services and claims appeals. Support physician committee functions and implement...Remote workClaims$248.5k - $373k
...health care organization, seeks a Medical Director for the Focus Claims Review team. You will lead medical... ...and providers to ensure quality and compliance. You must hold an MD or DO with an... ...of clinical experience. This is a remote role within the United States, with...Remote jobClaims- Optum seeks a Medical Director to provide physician support for Enterprise Clinical Services, focusing on post-service benefit determinations... ..., 5+ years of practice, and strong communication skills; remote-friendly with comprehensive benefits. #J-18808-Ljbffr Colorado...Remote jobClaims
- The Medical Director, Clinical Payment Integrity provides clinical oversight... ..., Informatics, Legal, and Compliance teams to advance payment... ...Interpret clinical documentation, claims data, coding practices, and... ...review capabilities. Fully Remote: This role is designated by...Remote workClaimsWork at office
$134.14k - $176.05k
...Hi, we're Oscar. We're hiring a Claims Compliance Associate Director to join our Claims team. Oscar is the first health insurance company built around... ...Quality and Compliance. Work Location: This is a remote position, open to candidates who reside in: Atlanta, Georgia...Remote workClaimsFull timeContract workWork at office$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... ...complex/controversial services and claims appeals. Support physician committee functions...Remote workClaimsFull time$145.5k - $205k
...Remote RTP, NC Remote- US Full time R05050 California... ...You Are The Associate Director, Corporate Compliance - Operations is an... ...industry (pharmaceutical, medical device or biotech) or, ~... ...Anti-Kickback Statute, False Claims Act, Foreign Corrupt Practice...Remote workClaimsFull timeWork at office- ...implementation of strategies that promote medical management, practice transformation,... ...applying to this position may be hybrid or remote and can live in one of the following states... ...predetermination reviews and reviews of claim determinations, providing clinical, coding...Remote workClaimsPrivate practiceLive in
$230k - $300k
...Create Alert The Executive Director - Compliance leads the US Compliance program... ...we are also open to fully remote candidates who meet the required... ...-Kickback Statute, False Claims Act, FDA promotional... ...Excellent benefit plans including medical, dental, and vision Flexible...Remote workClaimsTemporary workWork experience placementWork at officeFlexible hours- ...Job Description About The Role The Medical Director performs utilization review and medical... ...standing review assignment. *This is a Remote Role Primary Responsibilities Renders... ..., organizations, and internet sites claiming to represent Brighton Health Plan Solutions...Remote workClaimsWork at officeLocal areaFlexible hours
- ...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
$248.5k - $373k
...Medical Director Optum is a global organization that delivers care, aided by technology to... ...deliver clinical coverage and medical claims reviews. Our role is to empower providers... ...You'll enjoy the flexibility to work remotely from anywhere within the U.S. as you take...Remote jobClaimsMinimum wageFull timeWork experience placementLocal area$174.07k - $374.92k
...Position Summary The Radiation Oncology Medical Director supports the CVS Health Specialty oncology... ...management when necessary. This is a remote based (work from home) position One may... ...predetermination reviews and review of claim determinations, In the Medical Director...Remote workClaimsHourly payFull timeTemporary workLocal areaWork from homeWeekend work$248.5k - $373k
...Medical Director Optum is a global organization that delivers care, aided by technology to... ...deliver clinical coverage and medical claims reviews. Our role is to empower providers... ...You'll enjoy the flexibility to work remotely from anywhere within the U.S. as you take...Remote jobClaimsMinimum wageFull timeWork experience placementLocal area$248.5k - $373k
...Medical Director Optum is a global organization that delivers care, aided by technology to... ...deliver clinical coverage and medical claims reviews. Our role is to empower providers... ...You'll enjoy the flexibility to work remotely from anywhere within the U.S. as you take...Remote jobClaimsMinimum wageFull timeWork experience placementLocal area$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$248.5k - $373k
...Medical Director Optum is a global organization that delivers care, aided... .... As part of the Focus Claims Review team at Optum, the... ...enjoy the flexibility to work remotely from anywhere within the U.S... ...regarding URAC, NCQA, Regulatory Compliance, Confidentiality, Conflict...Remote jobClaimsMinimum wageWork experience placementLocal area- ...Medical Director - Remote ARC Group has an immediate opportunity for a Medical Director! This position is 100% remote... ...Coverage Determinations (LCDs) and ensuring compliance with Medicare policies, reviewing medical claims, and promoting evidence-based healthcare. Essential...Remote workClaimsPermanent employmentFor contractorsWork experience placementLocal areaImmediate start
$210k - $260k
...s program by determining the medical appropriateness of services by... ...to the Managing Medical Director for Cohere Health, this is a... ...with Cohere's support Fully remote opportunity with about 5% travel... ...authorization data with post‑service claims validation, we’re creating a...Remote jobClaimsFlexible hours- ..., depending on number of MDR’s. The Medical Director serves as a physician leader responsible... ...plans for which Independence serves as claims administrator, and on the terms and... ...Cross credentialing process Fully Remote: This role is designated by...Remote workClaimsWork at officeWeekend work
$231.9k
Join to apply for the Remote Medical Director - California role at RemoteWorker US 1 day ago Be among the first 25 applicants Join to apply for... ...would improve utilization and health care quality. Reviews claims involving complex, controversial, or unusual or new...Remote jobClaimsFull timeWork at officeFlexible hoursWeekend work$157k - $205.5k
Associate Director, Ethics and Compliance Join to apply for the Associate Director, Ethics... .... Esperion is a fully remote based company with a corporate... ...-Kickback Statute, False Claims Act, Food and Drug... ...Associate Director/Director of Medical Engagement (AD/Dir) Ann Arbor...Remote workClaimsFull timeWork at officeShift workWeekend workAfternoon shift
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