Remote Appeals Medical Director — Lead Care Quality
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- Remote job
UnitedHealth Group is seeking a Medical Director for Appeals and Grievances to lead clinical review and adjudication of complex cases across multiple health plans. The role offers full remote work from anywhere in the U.S.
and requires strong clinical and leadership capabilities to influence policy and care standards. You will collaborate with medical directors and network teams, provide analysis, and drive improvement in appeal outcomes while ensuring regulatory compliance.
#J-18808-Ljbffr Jobleads-US- ...UnitedHealth Group is seeking a Medical Director for Appeals and Grievances to lead clinical review and adjudication of... ...health plans. The role offers full remote work from anywhere in the U.S.... ...capabilities to influence policy and care standards. You will collaborate with...Remote jobQuality
$248.5k - $373k
...373,000.00Job Area: Medical & Clinical OperationsCompany... ...the health care experience, creating... ...removing barriers to quality care. The work you do... ...flexibility to work remotely * from anywhere... ...Responsibilities:The Appeals and Grievances Medical Director is responsible for ongoing...Remote workQualityMinimum wageWork experience placementLocal areaWork from home- ...UnitedHealth Group is seeking a senior Appeals and Grievances Medical Director to lead clinical review and adjudication for UnitedHealthcare and related... ...DO, board certification, and 5+ years clinical plus 2+ years in quality management. #J-18808-Ljbffr Jobleads-USRemote jobQualityWork from home
- ...UnitedHealth Group is hiring for a remote-friendly clinical leadership role overseeing appeals and grievances across PPO, HMO, MAPD... ...emphasizes collaboration with medical directors and network management to improve access, quality, and outcomes. The role requires...Remote jobQuality
- ...UnitedHealthcare is seeking an Appeals and Grievances Medical Director to lead clinical review and adjudication of... ...plan products. This role offers remote work from anywhere in the U.S.... ...influence benefit design and patient care quality. Responsibilities include case reviews...Remote jobQuality
- ...UnitedHealthcare is seeking a Medical Director for Appeals and Grievances to oversee clinical... ...multiple health plans. This remote role requires MD/DO licensure,... ...certification, and extensive clinical and quality management experience. You will lead high-stakes decisions, ensure...Remote jobQuality
$195.2k - $341.6k
...Overview Job Summary: The Medical Director is responsible for supporting staff by providing... ...Provide physician review for clinical appeals cases Participate in the evaluation... ...cases suspected of fraud, abuse, and quality of care concerns Participate in development...Remote jobQualityHourly payWork at officeWeekend workAfternoon shift$236.5k
...professional on our Medical Management/Health Services... ...Supervisory Medical Director at Centene provides... ...to ensure high-quality, cost-effective care for our members. This... ...participates in the appeals process, ensuring... ...approach to work with remote, hybrid, field or office...Remote workQualityFull timePart timeWork at officeFlexible hours$236.5k
...professional on our Medical Management/Health... ..., and medical quality improvement activities... ...Chief Medical Director in planning and establishing... ...-effectiveness of care and service for... ...providers, appeals team, medical and... ...approach to work with remote, hybrid, field or...Remote jobQualityFull timePart timeWork at officeFlexible hoursWeekend work- ...physician leader to conduct case reviews for appeals and grievances across multiple health... ...responses, collaboration with medical directors, and guidance on benefit interpretations... ...and advisory tasks to improve access, quality, and outcomes. Qualified candidates are...Remote jobQuality
$174.07k - $374.92k
...passionate colleagues who care deeply, innovate with... ...and prioritize safety and quality in everything we do.... ...Virginia). **This is a remote based (work at home) based... ...Responsibilities of this Medical Director role are related to Medicaid Appeals You will support the...Remote workQualityHourly payFull timeTemporary workLocal areaWork from home- ...organized Manager of Clinical Appeals to lead our clinical appeals... ...execution, ensuring quality and compliance, and... ...in clinical review, medical necessity denials, payer... ..., Medicaid Managed Care, and commercial plans. Experience managing remote and/or offshore teams...Remote workQuality
- ...mission is to make cancer care better for patients,... ...About the role The Lead Behavioral Health Care... ...bring out the highest quality work in their team.... ...patients with chronic/serious medical illness ~1+ years of... ...experience managing a remote team across multiple states...Remote workQualityFull timeFlexible hours
- ...Upward Health seeks a Medical Director to partner with cross-functional teams and senior... ...to deliver innovative, high-quality home and community-based care for high-need patients. The role requires... .... The position is primarily remote, with some on-site...Remote jobQuality
- ...UnitedHealth Group is seeking a Medical Director to provide physician support for Enterprise Clinical Services, focusing on pre-service... ...and multi-disciplinary teams to ensure cost-effective, high-quality care. Responsibilities include conducting coverage reviews, documenting...Remote jobQuality
- ...00% Remote100% Remote in the 28 states... ...accredited medical school Industry... ..., MA, FEP, and Appeals. Would cover call... ...application of a Medical Director’s knowledge and... ...the Health Care division,... ...(Credentialing)Quality model design and... ...experience.Takes a lead role in...Remote workQuality
$248.5k - $373k
...000/yearJob Area: Medical & Clinical OperationsCompany... ...that delivers care, aided by... ...flexibility to work remotely * from anywhere within... ...:Work to improve quality and promote... ...memberWork with medical director teams focusing on... ...coverage review, member appeals clinical review,...Remote workQualityMinimum wageFull timeWork experience placementWork at officeLocal area- Get It - Healthcare is seeking a dedicated Medical Director / Attending Physician to provide quality care to residents of skilled nursing facilities. This remote role requires you to visit facilities in Wellsville, NY at least twice a month, offering both flexibility and...Remote jobQuality
$386.5k
.../yearJob Area: Medical & Clinical OperationsCompany... ...the health care experience,... ...barriers to quality care. The work... .... The Medical Director, Clinical AI Innovation... ...to work remotely * from anywhere... ...production, appeals, audits, and quality... ...ability to lead through influence...Remote workQualityMinimum wageFull timeWork experience placementLocal area$174.07k - $374.92k
...passionate colleagues who care deeply, innovate... ...safety and quality in everything we do... ...opportunity for a Medical Director. Ready to take your... ...? This is a remote Work at Home position... ...in support of the appeal process, clinical... ...to work within and lead as necessary teams...Remote workQualityHourly payFull timeTemporary workLocal areaWork from home$280.84k - $393.18k
...Services, the Senior Medical Director Policy & Outcomes (... ..., executing, leading and updating guidelines... ...activities including quality management, grievance and appeals, delegation... ...Spending Account - Health Care/ChildcareCalPERS... ...schedule. (Mon & Fri - remote, Tues - Thurs...Remote workQualityTemporary workLocal area$248.5k - $373k
...3,000.00Job Area: Medical & Clinical OperationsCompany... ...that delivers care, aided by... ...Optum, the Medical Director provides leadership... ...responsible for the overall quality, effectiveness and... ...and provider appeals. In addition, the... ...to work remotely * from anywhere within...Remote workQualityMinimum wageWork experience placementWork at officeLocal area- ## Medical DirectorApplylocations: Kansastime... ...**The Medical Director will serve as a clinical... ...development, quality management, and provider... ...eligible to work remotely, hybrid or onsite... ...review, appeals processes, and claim... ...behavioral health, care management, and operations...Remote workQualityWork at officeImmediate startRelocation
- ...Medical Director Responsible for the administration of physical... ...effective medical care is received. May be... ...implementing programs to improve quality, cost, and outcomes.... ...peer-to-peer clinical appeal case reviews with... ...in healthcare. Leads, develops, directs, and...Remote workQualityWork at office
$110 - $130 per hour
...Title: Medical Director Location: Remote Duration: 6 Months with possible extension... ...Chief Medical Director to lead utilization management, quality improvement, credentialing, and appeals for high-volume inpatient and post-acute care reviews. You’ll drive medical...Remote workQuality$215k - $270k
...Medical Director (MD or DO) (NHC-1455120) Raleigh, North Carolina... ...Location: Primarily Remote (North Carolina... ...Type: Healthcare Managed Care Organization Role Overview... ...role ensures high-quality, compliant, and defensible... ..., concurrent, and appeal utilization management...Remote workQualityFull timeWork visaMonday to FridayAfternoon shift$248.5k - $373k
...3,000.00Job Area: Medical & Clinical OperationsCompany... ...that delivers care, aided by... ...together.The Medical Director for the Oncogenetic... ...to work remotely * from anywhere within... ...Responsibilities:Work to improve quality and promote... ...review, member appeals clinical review, medical...Remote workQualityMinimum wageWork experience placementLocal area$174.07k - $374.92k
...Medical Director We're building a world of health around... ...passionate colleagues who care deeply, innovate with... ...prioritize safety and quality in everything we do.... ...concurrent review, and appeal request. The Medical Director... ...in and be able to lead rounds. Required...Remote workQualityHourly payFull timeTemporary workWork from homeMonday to FridayWeekend work- ...barriers and make care truly accessible:... ...and highly skilled Medical Director to join our growing... .... This is a remote position requiring... ...contractual agreements. Lead and conduct... ...relevant regulations and appeal processes.... ...protocols. Participate in quality improvement...Remote workQualityFull timeFlexible hours
$173k - $250k
...Job Summary: The Medical Director will report to the Senior... ...Management, Member Appeals & Grievances, and Medical... ...trend management, quality, appeals and grievances... ...in You: • Full-time remote work • Competitive salaries... ...directors, primary care physicians and nurse...Remote workQualityFull timeWork at officeFlexible hours
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