Remote Appeals M.D. Pulmonologist - Medical Director
Taleo
- Remote job
UnitedHealth Group is seeking an Appeals Medical Director (Pulmonology - Remote) to oversee ongoing clinical review and adjudication of appeals and grievances across multiple health plans. You will apply clinical criteria, coordinate with medical directors, and help shape program outcomes.This senior role requires an MD or DO with active license, board certification in an ABMS/AOBMS specialty, 5+ years of clinical practice, and 2+ years in quality management.J-18808-Ljbffr Taleo
$248.5k - $373k
...$248,500 - $373,000/yearJob Area: Medical & Clinical OperationsCompany: UnitedHealth... ...'ll enjoy the flexibility to work remotely * from anywhere within the U.S. as... ....Primary Responsibilities:The Appeals and Grievances Medical Director is responsible for ongoing clinical...Remote workMinimum wageFull timeWork experience placementLocal area$236.5k
Position Purpose:Assist the Chief Medical Director to direct and coordinate the medical management... ...clinical teams, network providers, appeals team, medical and pharmacy consultants... ..., and a flexible approach to work with remote, hybrid, field or office work schedules...Remote workFull timePart timeWork at officeFlexible hoursWeekend work- ...UnitedHealthcare is seeking an Appeals and Grievances Medical Director to lead clinical review and adjudication across multiple plans. The role emphasizes... ...with medical directors and network management. Remote work within the U.S. is supported, with a focus on improving...Remote work
$180 per hour
...REMOTE MEDICAL DIRECTOR – UTILIZATION MANAGEMENT & APPEALS $180/hour | W-2 Contract | Monday–Friday | 100% Remote | Potential Extension The Jacobson Group is seeking a Medical Director to support a health plan's Utilization Management and Appeals programs. This...Remote workContract workWork at officeMonday to Friday- Humana Inc. seeks a Corporate Medical Director to lead medical interpretation and complex review determinations for appeals across Medicare, Medicaid, and Commercial lines. This fully remote leadership role requires board certification, a valid medical license, and extensive...Remote jobWork from home
- Job SummaryWe are seeking a Medical Director in Pulmonology to join our dynamic team in Cincinnati, Ohio. The Medical Director has overall... ...home flexibility. This role also has the ability to be fully remote-based with the right experience.ResponsibilitiesProvide medical...Remote workContract workWork from home
- ...Humana Inc. is seeking a Corporate Medical Director, fully remote in the USA, to provide clinical interpretation and independent decisions on complex grief and appeal cases. You will cover Medicare, Medicaid, and Commercial products and support home health, rehab, inpatient...Remote job
- A prominent healthcare organization is seeking an Appeals and Grievances Medical Director to manage clinical reviews of appeals for various health plans. The role offers flexibility to work remotely. Qualified candidates should have an MD or DO, be board certified, and...Remote job
- The Appeals and Grievances Medical Director at UnitedHealthcare oversees ongoing clinical review and adjudication of appeals and grievances for multiple... ...accurate benefit interpretations.This role offers full remote work across the United States, with limited in-office...Remote jobWork at office
- UnitedHealthcare, a UnitedHealth Group company, is seeking a Medical Director to lead appeals and grievances clinical review for multiple health plans.... ...experience in clinical practice and quality management. Remote work options within the U.S. are available. #J-18808-...Remote job
- UnitedHealth Group is seeking a Medical Director to lead appeals and grievances review for UnitedHealthcare. This role involves adjudicating cases across PPO, ASO, HMO, MAPD, and PDP products, applying clinical criteria and regulatory requirements. We value MD/DO board...Remote job
- UnitedHealth Group's UnitedHealthcare division seeks an Appeals and Grievances Medical Director to lead clinical reviews and adjudicate cases across multiple health plans. This remote position offers high impact work, cross-functional collaboration, and ongoing professional...Remote jobFlexible hours
$236.5k
...clinical professional on our Medical Management/Health Services team... ...: Assist the Chief Medical Director to direct and coordinate the... ...clinical teams, network providers, appeals team, medical and pharmacy... ...approach to work with remote, hybrid, field or office work...Remote jobFull timePart timeWork at officeFlexible hoursWeekend work- UnitedHealth Group seeks a physician leader to review appeals and guide clinical policy across health plans. The role requires an MD/DO... ...communication and project management skills are essential. Remote work is available nationwide in the U.S.; some in-office requirements...Remote jobWork at office
- ...and highly organized Manager of Clinical Appeals to lead our clinical appeals operations... ...a strong background in clinical review, medical necessity denials, payer appeal processes... ...commercial plans. ~ Experience managing remote and/or offshore teams (Philippines experience...Remote work
- ...Healthcare and Health Insurance services, seeks an accomplished Medical Appeals Coordinator Position: Medical Appeals Coordinator Location:... ...3-6 months+ temp-to-hire!!! Pay rate: $24/hr on W2 Note: REMOTE role with possibility The schedule for the training period...Remote workTemporary workLocal areaFlexible hours3 days per week1 day per week
$215k - $269k
...Medical Director - Physical Health Charllotte, NC (Primarily remote, no expectation to be in the office routinely, the selected candidate may be required to report... ...including initial reviews, concurrent reviews, appeals, and level of care determinations for inpatient...Remote workPermanent employmentFull timeWork at officeWeekend work- 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 jobFlexible hours
- ...Texas. You will conduct comprehensive clinical reviews of appeals, evaluate medical records, and provide independent clinical judgment on medical... ...thorough documentation and collaboration within a remote team, with weekday daytime hours. Ideal candidates have Medicaid...Remote jobWeekday work
$386.5k
...500 - $579,500/yearJob Area: Medical & Clinical OperationsCompany:... ...Utilization Management. The Medical Director, Clinical AI Innovation and... ...the flexibility to work remotely * from anywhere within the U.... ...teamsEnsure insights from production, appeals, audits, and quality reviews...Remote workMinimum wageFull timeWork experience placementLocal area$248.5k - $373k
...500 - $373,000/yearJob Area: Medical & Clinical OperationsCompany:... ...Review team at Optum, the Medical Director provides leadership,... ...telephonic discussions and provider appeals. In addition, the Medical... ...enjoy the flexibility to work remotely * from anywhere within the U....Remote workMinimum wageFull timeWork experience placementWork at officeLocal area$248.5k - $373k
...00.00 - $373,000.00Job Area: Medical & Clinical OperationsCompany:... ...Review team at Optum, the Medical Director provides leadership,... ...telephonic discussions and provider appeals. In addition, the Medical... ...enjoy the flexibility to work remotely * from anywhere within the U....Remote workMinimum wageWork experience placementWork at officeLocal area$248.5k - $373k
...500 - $373,000/yearJob Area: Medical & Clinical OperationsCompany:... ...Review team at Optum, the Medical Director provides leadership,... ...telephonic discussions and provider appeals. In addition, the Medical... ...enjoy the flexibility to work remotely * from anywhere within the U....Remote workMinimum wageFull timeWork experience placementWork at officeLocal area$280.84k - $393.18k
...President of Health Services, the Senior Medical Director Policy & Outcomes (Sr. Medical Director... ...quality management, grievance and appeals, delegation oversight, and population health... ...a hybrid work schedule. (Mon & Fri - remote, Tues - Thurs onsite in Rancho Cucamonga...Remote workTemporary workLocal area- ## Medical DirectorApply: Fully Remote: US - Remote: Full time: Posted Today: R35494At Allstate, great things... ...management programs. The Medical Director is a highly experienced physician responsible... ...clinical decision-making, including appeals, rescissions, grievance reviews, and...Remote workFull timeContract workWork at officeWork from homeWork visa
$174.07k - $374.92k
...health care resources. This is a remote based (work from home) role. Preferred... ...region (IL, IN, MI) In the Medical Director role you will provide oversight for medical... .../ Peer to Peer Calls / First Level Appeals / Special Projects and Committee participation...Remote workHourly payFull timeTemporary workFor contractorsLocal areaWork from home- ...About The Role The Medical Director performs utilization review and medical necessity determinations... ...review assignment. *This is a Remote Role Primary Responsibilities... ...documenting rationale that is defensible on appeal, external review, and audit. Conducts...Remote workWork at officeLocal areaFlexible hours
$110 - $130 per hour
...Title: Medical Director Location: Remote Duration: 6 Months with possible extension/Conversion FTE We’re hiring a board-certified physician... ...management, quality improvement, credentialing, and appeals for high-volume inpatient and post-acute care reviews. You...Remote work- ...talent solutions to our clients world-wide. Job Title: Medical Director Location: Remote Duration: 6 Months Job Type:... ...appropriateness. Complete initial determination of cases, review of appeals and grievances, and other reviews as assigned. Compose...Remote workTemporary workPrivate practice
$173k - $250k
...than 25 years ago as Boston Medical Center HealthNet Plan, we provide... ...Job Summary: The Medical Director will report to the Senior... ...Utilization Management, Member Appeals & Grievances, and Medical Policy... ...performed in a typical remote interior/office work environment...Remote workWork at officeFlexible hours
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Remote Appeals M.D. Pulmonologist - Medical Director. Be the first to apply!
- mental health clinical supervisor Cypress, CA
- hospital supervisor Cypress, CA
- remote medical billing manager Cypress, CA
- medical director neurology Cypress, CA
- healthcare supervisor Cypress, CA
- clinical manager Cypress, CA
- medical director remote Cypress, CA
- health manager Cypress, CA
- public health director Cypress, CA
- healthcare consulting manager Cypress, CA




