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
- ...GuideWell Mutual Holding Corporation is seeking a Medical Director to lead all utilization management reviews (Pre-service, Post-service, Concurrent Review and Appeals) and to collaborate with physician providers and Case Managers on complex cases. The ideal candidate...Remote work
- ...Humana Inc is seeking a Medical Director to lead inpatient medical necessity reviews and utilization management with a focus on quality and physician collaboration. The role... ...and support Humana’s care standards. This remote position requires MD or DO, board...Remote work
- ...CAI is seeking a Medical Director for a remote, full-time role to oversee utilization management in accordance with current clinical standards. The candidate will perform electronic reviews, determine medical necessity, and guide case determinations with a focus on adherence...Remote workFull time
$248.5k - $373k
...$373,000.00/yearJob Area: Medical & Clinical OperationsCompany... ...medicine physician to join our Utilization Management team. Optum is a clinician-... ...work and live.The Medical Director for Utilization Management... ...the flexibility to work remotely * from anywhere within the...Remote workMinimum wageFull timeWork experience placementWork at officeLocal areaWork from home$222.75k - $267.3k
Altais is seeking a Medical Director of Utilization and Medical Management to drive Utilization Management policy and lead interdisciplinary teams in California. You will co-chair committees, collaborate with physician leaders, and ensure high-quality, cost-conscious patient...Remote job$275k - $315k
...Job Description Title: Medical Director of Utilization Management \n \n Summary: Step into a strategic leadership position as the Clinical Lead... ...75,000 - 315,000 / year \n High-impact leadership role with a hybrid schedule (3 days remote / 2 days onsite)\n...Remote workWork at officeMonday to FridayShift work2 days per week- HJ Staffing is urgently seeking a Medical Director of Utilization Management to join a leading Medicare Advantage Health Plan. This physician leader will... ...optimal outcomes and regulatory compliance. Location: 100% Remote Schedule: Full-Time, Monday - Friday (Must work PST...Remote workFull timeMonday to Friday
$248.5k - $373k
...2345838 **Job category:** Medical & Clinical Operations WellMed... ...physician to join our Utilization Management team. Optum is a clinician-... ...work and live. The Medical Director for Utilization Management... ...enjoy the flexibility to work remotely * from anywhere within the...Remote workMinimum wageFull timeWork experience placementWork at officeLocal areaWork from home$213.1k - $308.3k
...primary care, care for the most medically and socially complex populations,... ...communities we serve. The Job The Utilization Management (UM) Physician Medical Director provides physician-level clinical... ...,301 per year Work Mode - Mostly Remote: Employees who reside outside the...Remote workFor contractorsWork at officeLocal areaRelocation- ...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...Remote work
- 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
- ...supervision of clinical staff performing utilization reviews and specialty reviews using... ...criteria. You will mentor reviewers, ensure medical necessity decisions are accurate, and maintain... .... This role supports a flexible remote work model with occasional on-site collaboration...Remote workFlexible hours
- KVC Health Systems, Inc. in Kansas City, MO is seeking a dedicated Utilization Review Manager (URM) to obtain and review clinical and medical service authorizations, supporting high-quality behavioral healthcare for children and families. You will liaise with treatment...Remote job
- CVS Health is seeking an Utilization Management Clinical Consultant to apply clinical expertise in coordinating care and ensuring appropriate benefits across care levels. This role leverages evidence-based guidelines, triage, crisis support, and collaboration with providers...Remote jobFull timeWork from home
- University of Miami Health System seeks a Full-time, remote Utilization Case Manager to conduct ongoing reviews for clinical utilization and determine continued authorization. The role coordinates with the Nurse Case Manager and healthcare team to support timely patient...Remote jobFull time
- ...Primary Work Location : Remote (Oregon Headquarters). This position... ...(Salaried) Division: Utilization Management Physical Strength: Light (L) Reports To: Nursing Director - RN Work Location Type:... ...Collaborates with the YCCO Chief Medical Officer (CMO) and/or...Remote workContract workFor contractorsCasual workWork at officeLocal areaFlexible hours
$236.5k
Position Purpose:Assist the Chief Medical Director to direct and coordinate the medical management, quality improvement and... ...medical leadership of all for utilization management, cost containment, and... ...flexible approach to work with remote, hybrid, field or office work schedules...Remote workFull timePart timeWork at officeFlexible hoursWeekend work- ...CorroHealth is seeking a Medical Director, Concurrent Review, to evaluate hospitalizations nationwide... ...provide expert recommendations. This remote position offers a predictable schedule and a path to expand knowledge in Utilization Review. Ideal candidates hold an MD/DO...Remote work
- ...TekWissen is a global workforce management provider headquartered in Ann Arbor... ...clients world-wide. Job Title: Medical Director Location: Remote Duration: 6 Months... ...of a physician team, ensures that utilization management responsibilities are performed...Remote workTemporary workPrivate practice
- WellMed Medical Management, Inc. is seeking a Medical Director for Utilization Management to support the UM program and optimize medical necessity determinations across plans.You'll work remotely from anywhere in the United States, require an MD/DO/MBBS with board certification...Remote work
$227.6k
...Job Title Utilization Management Physician Job Description This job, as part of a physician team, ensures that utilization management... ...incumbent reviews escalated cases electronically and using Medical Policy criteria sets to evaluate the medical necessity and...Remote workFor contractorsPrivate practiceWork at officeLocal area$240k - $250k
...Medical Director Utilization Management We are looking for physicians who have expertise in Internal Medicine including medical and surgical clinical... ...different backgrounds and perspectives. This is a remote-first role that may require travel to Boston, MA for new...Remote workFlexible hours- System Physician Advisor Medical Director Responsibilities and Job Description Overview:The... ...and other leadership related to case/utilization management and revenue cycle including the Lee Health... ...contracted providers involved in remote utilization review and physician...Remote workContract workFor contractorsMonday to FridayWeekend work3 days per week
- ...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
- ...Job Description Job Description: Manager of Clinical Utilization Management - Denial Compliance Location... ..., CA Position Type: Hybrid (85% remote, 15% onsite in Northridge, CA);... ...with physician reviewers, medical directors, and other relevant departments....Remote workPermanent employmentFull timeTemporary workFlexible hours
$170 per hour
...Medical Director Req number: R8700 Employment type: Full time Worksite flexibility: Remote Who we are CAI is a global services firm with over 9,000 associates... ...Medical Director, you will ensure utilization management responsibilities are performed in...Remote workHourly payFull timeApprenticeshipPrivate practiceWork at officeLocal areaWorldwide- ...will lead the operational areas of the Utilization Management (UM) program including prospective,... ...concurrent, and retrospective reviews. As a Medical Director, UM you ensure all patient care... .... Work Arrangement ~ Fully remote; must be willing to work rotational weekend...Remote workContract workLocal areaFlexible hoursWeekend 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
$262.15k - $393.22k
...changing lives but saving them. Together.The Regional Medical Director, Non-Acute Utilization Management (RMD Non-Acute UM) is a market-facing physician... ...is a local-market position requiring a combination of remote work, home-based clinical visits, and regular in-person...Remote workFull timeWork at officeLocal areaWork from home$26.01 - $56.14 per hour
...family and one community at a time. Behavioral Health Utilization Management Clinician Remote | Louisiana Preferred | Sunday - Thursday Schedule Are... ...behavioral health services and treatment plans to determine medical necessity and appropriateness of care Apply evidence-...Remote workHourly payFull timeTemporary workLocal area
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