Remote Utilization Management Medical Director
SCAN
- Remote job
SCAN is seeking an Utilization Management Physician Medical Director to lead medical necessity determinations, prior authorizations, and reviews. This physician will influence policy, provide clinical mentorship, and ensure compliant, evidence-based decision-making while collaborating with RN reviewers and UM leadership. The role requires an active MD/DO license and board certification, 5+ years of clinical practice, and 2–3 years in utilization management. #J-18808-Ljbffr SCAN
- ...To support Utilization Management operations, the full-time Utilization Review Medical Director will conduct clinical reviews of Durable Medical Equipment (DME) requests remotely, ensuring compliance with Medicare and Medicaid guidelines while maintaining productivity...Remote workFull time
- ...Health is hiring a Radiation Oncology Medical Director to oversee oncology utilization, policy implementation, and review processes in a remote, home-based role. The position supports... ..., peer-to-peer reviews, and case management. The role requires MD/DO, board certification...Remote jobWork from home
- Starling Oncology is seeking a Medical Director to provide clinical expertise in utilization management for oncology care. You will review and guide medical necessity decisions, collaborating with physicians, operations, and payers to optimize outcomes and value-based...Remote job
- Humana seeks a Medical Director to apply clinical expertise in reviewing complex... ...-functional teams, and care management professionals to ensure quality, compliant utilization management. The role... ...development within a structured, remote-friendly environment. #J-1880...Remote job
- The Oncology Institute is seeking a Medical Director to provide clinical expertise in assessing medical necessity, appropriateness, and efficiency of oncology care with a focus on utilization management for case reviews and clinical decision making. In this collaborative...Remote job
$248.5k - $373k
...family medicine physician to join our Utilization Management team. Optum is a clinician-led care... ...way clinicians work and live. The Medical Director for Utilization Management will support... ...'ll enjoy the flexibility to work remotely * from anywhere within the U.S. as you...Remote workMinimum wageFull timeWork experience placementWork at officeLocal areaWork from home$150 per hour
The Utilization Review Medical Director is responsible for conducting clinical reviews of Durable Medical Equipment... ...to support Integra’s Utilization Management (UM) operations. Role functions... ...Conditions and Additional Expectations: Remote role requiring consistent...Remote workHourly payFull timeContract workTemporary workPart timeLocal area$248.5k - $373k
...family medicine physician to join our Utilization Management team. Optum is a clinician-led care... ...way clinicians work and live. The Medical Director for Utilization Management will support... ...) fluency *All employees working remotely will be required to adhere to...Remote jobMinimum wageFull timeWork experience placementWork at officeLocal areaWork from home- Centene Corporation is seeking a clinical professional to lead Medical Management/Health Services for 28 million members. The role drives utilization management, quality improvement, and medical review across a national organization with flexible work options. The candidate...Remote jobFlexible hours
- Centene Corporation seeks a physician leader to direct medical management, quality improvement and credentialing for the business unit. Lead utilization management, medical reviews, and performance-improvement initiatives to enhance cost-effectiveness and care quality....Remote jobWeekend work
$275k - $325k
...and growing, Starling Oncology is changing oncology for the better. For more information, visit Utilization Management Medical Director Oncology Work Location: REMOTE (work from home) California Nevada Arizona Oregon...Remote workWork from home- A healthcare management organization is seeking a Remote Medical Director to lead the review of medical records and provide expert decision-making. This role demands a blend of clinical experience, leadership, and the ability to guide a team while ensuring compliance with...Remote jobContract workWeekend work
- Bickham Services Unlimited, LLC is seeking a Medical Director, Utilization Management to lead clinical utilization reviews for inpatient and post-acute... ...align with CMS, policies, and evidence-based criteria. Remote opportunity in New Jersey for a board-certified physician...Remote job
$75.3k - $135.4k
...Supervises the behavioral health (BH) utilization review clinicians to ensure... ...activities of BH utilization management team. Key details : Centene is hiring a remote Supervisor, Behavioral Health... ...preferred. Understanding of medical necessity criteria for a broad...Remote workFull timePart timeWork at officeLocal areaFlexible hours- ...family, is seeking an experienced physician to join the Utilization Management team. The Medical Director for Utilization Management will support WellMed... ...determinations and suggesting program improvements. This remote-friendly role offers the chance to influence care on...Remote work
- CareOregon, Inc. seeks a Medical Director to oversee benefit/utilization management, clinical and wellness programs for members. The role involves leadership of QA, case/disease/quality management, and collaboration with physicians to improve care and utilization outcomes...Remote jobWork from home
- ...Medical Director ID 2026-25149 Category Physician... ...of Veterans Affairs. This remote-based civilian position is an... ...~3+ years of experience in managed care environments. Preferred... ...domains including Utilization Management, Case Management,...Remote workWeekday work
- ...company is hiring a Physical Health Medical Director to work remotely in North Carolina. The Physical... ...within the Physical Health Medical Management Team, providing clinical oversight,... ...goals related to clinical quality, utilization management, and care coordination....Remote workTemporary workWork experience placementWork at officeRelocationFlexible hoursWeekend work
$275k - $300k
The Oncology Institute is seeking a Medical Director for Utilization Management Oncology to provide strategic oversight and support key clinical initiatives. This remote role involves conducting medical reviews of oncology treatment plans and ensuring compliance with evidence...Remote job- WellMed, part of the Optum family, seeks a Medical Director for Utilization Management to lead and optimize our UM program. This role focuses on medical... ...program improvements while fostering a collaborative, remote-friendly work environment across the U.S. You will drive...Remote job
- Integra Partners seeks an experienced Utilization Review Medical Director to lead clinical reviews of DMEPOS requests within a remote UM environment. You will ensure decisions meet Medicare/Medicaid guidelines and internal policies while maintaining timely throughput and...Remote job
- WellMed, part of the Optum family, seeks a Medical Director for Utilization Management to support WellMed Medical Management, Inc. by making UM determinations... ...and proposing program improvements. This role offers remote work from anywhere in the U.S. and integration with...Remote job
- Valenz Health is seeking a Part-Time Medical Director to provide physician leadership for medical management and utilization review programs. You will align clinical decisions... ..., and organizational standards in a fully remote role based in the United States. You will collaborate...Remote jobPart time
- UnitedHealth Group in Minnesota seeks a Medical Director to provide physician support for... ...effective, high-quality care, advances utilization management, and communicates policies to network and non-network physicians. Remote work from anywhere in the U.S. is supported...Remote job
- CVS Health is seeking a Medical Director (Behavioral Health) for a remote-based role. The provider will lead utilization management, oversee behavioral health care management, and guide clinical policy and program development. Ohio licensure and board certification are...Remote jobFull timeWeekend work
$250k - $350k
...company, is a specialized medical group dedicated to providing... ...primary care, longitudinal care management, remote monitoring, and real‑time... ...quality, reduce avoidable utilization, and expand access for... ...company. Position Title Medical Director - Intention MA Location...Remote work- CVS Health is seeking a Medical Director (Behavioral Health) to lead the utilization management team remotely. You will provide psychiatric leadership, oversee high-risk cases, and ensure medical necessity decisions to deliver high-quality care for diverse health plans....Remote job
- ...System Physician Advisor Medical Director Responsibilities and Job Description... ...and other leadership related to case/utilization management and revenue cycle including the Lee Health... ...with contracted providers involved in remote utilization review and physician advisory...Remote workContract workFor contractorsMonday to FridayWeekend work3 days per week
$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 review, and clinical oversight for high‑volume cases. You will work closely with...Remote workFull time$223.8k - $313.1k
...caring community As the Medical Director, you will be the designated... ...needs. This is a fully remote role. You will report to the... ...evaluate collaboration capacity, utilization, and effectiveness to... ...participate in quality, risk management, and patient safety...Remote workFull timeTemporary workApprenticeshipWork at officeWork from homeHome office
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Remote Utilization Management Medical Director. Be the first to apply!
- medical project manager Los Angeles, CA
- bcba clinical director Los Angeles, CA
- clinical operations supervisor Los Angeles, CA
- health economics manager Los Angeles, CA
- clinical supervisor lmft lcsw Los Angeles, CA
- remote medical coding supervisor Los Angeles, CA
- occupational health manager Los Angeles, CA
- entry level clinical data manager Los Angeles, CA
- lead clinical data manager Los Angeles, CA
- director of health and wellness Los Angeles, CA


