Remote Medical Director Medicare Compliance
$223.8k - $313.1kHumana Inc
- Remote job
A leading health services provider seeks a Medical Director to evaluate healthcare services for Medicare and Medicaid members. This role requires strong clinical expertise and compliance with national guidelines. The ideal candidate will have 10+ years of patient care experience, an MD or DO degree, and applicable board certification. The position is remote, offers a competitive salary range of $223,800 - $313,100 per year, and includes participation in a bonus incentive plan. Exceptional communication skills and Microsoft Office proficiency are essential. #J-18808-Ljbffr Humana Inc
- A healthcare company seeks a remote Medical Director to review clinical cases for Medicare and Medicaid members, ensuring compliance with guidelines and regulations. The ideal candidate has an MD/DO degree, board certification, and extensive clinical experience. Responsibilities...Remote job
- ...healthcare services provider in Atlanta is seeking a Medical Director to oversee compliance with healthcare services for Medicare and Medicaid members. The role requires an MD... ...salary and the flexibility to work remotely, along with a comprehensive benefits package....Remote job
$223.8k - $313.1k
...organization is seeking an experienced Medical Director to review clinical cases and... ...necessity of services for Medicare and Medicaid members. This remote position requires an MD or DO degree... ...post-residency. The role emphasizes compliance with regulatory standards and offers...Remote job$223.8k - $313.1k
...services company is seeking a Medical Director to enhance healthcare... ...alignment with CMS guidelines for Medicare and Medicaid.... ...cases for medical necessity and compliance, supporting organizational excellence... ...analytical skills. This is a remote position requiring occasional...Remote jobWork at office$223.8k - $313.1k
...healthcare provider is seeking a Medical Director to oversee the clinical... ...healthcare services related to Medicare and Medicaid. This role... ...reviewing clinical cases, ensuring compliance with policies, and... ...direct clinical experience. This remote position offers a competitive...Remote job$223.8k - $313.1k
...services organization seeks a Medical Director to oversee the evaluation of healthcare services for Medicare and Medicaid members. The role involves ensuring compliance with national guidelines, conducting... ...of clinical experience. This remote position requires adaptability...Remote job$223.8k - $313.1k
A healthcare organization is seeking a Medical Director to oversee clinical cases for Medicare and Medicaid members, ensuring compliance with necessary regulations. The role requires... ...team environment. This is a remote position with a salary range of $223,800...Remote job- ...health insurance provider in New York is seeking a Medical Director to ensure compliance with CMS Medicare guidance and evaluate healthcare services for Medicare... ...years of clinical experience. This position offers remote work and comprehensive benefits including medical,...Remote job
- A leading health insurance provider is seeking a Medical Director to join their remote team. The role involves evaluating Medicare and Medicaid services for compliance with clinical standards and CMS guidelines. Responsibilities include reviewing clinical cases, ensuring...Remote job
- ...consulting firm in Washington is seeking a part-time Associate Medical Director to assist clients by reviewing complex cases and providing... ...may require up to 10 hours of work a month, offering flexibility and remote working capabilities. #J-18808-Ljbffr Dane Street, LLCRemote workPart time
$240.12k - $315.16k
...Description Hi, we're Oscar. We're hiring a Medical Director to join our Clinical Affairs team.... ...the Clinical Policy, Regulatory, and Compliance functions within the Office of Clinical... ...list of states is subject to change. #LI-Remote Pay Transparency: The base pay for...Remote workFull timeWork at office$102.16k - $199.22k
Job Description Leads and directs team responsible for compliance activities. Seeks to ensure the organization adheres to regulatory requirements... ...in a health plan or government programs setting (Medicaid, Medicare, Marketplace). Certificate in Healthcare Compliance (CHC), or...Remote jobWork experience placementWork at office$223.8k - $313.1k
...of our caring community The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing... ...a framework of regulatory compliance. This secures compliance with all... ...Additional Information Workstyle: remote work at home Hours: Must be...Remote workFull timeTemporary workApprenticeshipWork at officeWork from homeHome officeMonday to Friday- A leading healthcare organization is seeking a Medical Director to oversee compliance with Medicare guidelines and ensure proper healthcare service evaluations... ...in call rotations. The role offers flexibility for remote work and competitive compensation, along with...Remote job
- A healthcare organization is seeking a Medical Director for Utilization Management to ensure compliant care decisions for Medicare Advantage members. This remote position requires expertise in clinical decision-making, particularly with MCG guidelines and utilization review...Remote work
$215k - $408.5k
...clinical professional on our Medical Management/Health Services team... ...re Hiring: Full time Medical Director for our Oklahoma Health Plan!... ...services to Medicaid and Medicare members, as well as to individuals... ...approach to work with remote, hybrid, field or office work...Remote workFull timePart timeWork at officeFlexible hoursWeekend work- Humana Inc. is seeking a Medical Director National OP Medicare located in Washington, D.C. This role focuses... ...authorization for services, ensuring compliance with regulatory standards, and... ...post-residency experience. This is a remote position with competitive pay and benefits...Remote work
- Humana Inc in Columbus, Ohio is seeking a Medical Director for National OP Medicare to leverage medical expertise for service authorization and utilization... .... The position operates in a structured environment and may involve remote work. #J-18808-Ljbffr Humana IncRemote work
- ...major healthcare insurer is seeking a Medical Director in Ohio. This remote role requires an MD or DO degree and a strong background in Medicare and Medicaid. Responsibilities include reviewing clinical cases, ensuring compliance, and improving medical management operations...Remote job
- ...health services organization is seeking a Medical Director to ensure compliance with healthcare standards and evaluate medical necessity for Medicare and Medicaid services. Required... ...clinical experience. The role supports remote work and requires participation in call...Remote job
- A healthcare solutions firm is seeking a Medical Director to lead medical decision-making and ensure compliance with Medicare policies. The role requires an MD or DO and extensive... ...initiatives. This position includes remote work opportunities in various states. Join a...Remote job
- ...About OVME OVME is a national medical aesthetics company operating... ...on regulatory and clinical compliance for the first time in OVME's... ...The role reports to the Sr. Director of Clinical Talent Management... ...sheet. This role is also remote but could include travel....Remote jobTemporary work
$223.8k - $313.1k
Humana Inc. seeks a Medical Director for National OP Medicare to leverage medical expertise in authorization decisions... ...driven decisions within regulatory compliance. The ideal candidate should have an... ...experience. This position offers remote work flexibility and a...Remote work$223.8k - $313.1k
Humana Inc is seeking a Behavioral Health Medical Director to oversee strategy and operations in... ...care. The role allows for a fully remote schedule and requires an MD or DO degree... ...physicians, focusing on quality care and compliance. A competitive salary range from $223,8...Remote job- ...Clinical Compliance Manager Job Category: Clinical... ...2026 Full-Time Remote Corporate Headquarters... ...Reporting to the Senior Director of Compliance, this... ...years of experience in Medicare Managed Care, with preferred... ...Benefits - Medical, dental, and vision insurance...Remote workFull timeWork at officeFlexible hours
$184.11k - $396.55k
...Job Purpose and Summary: The Sr. Clinical Solutions Medical Director, Population Health, Medicare position will serve as the liaison between data analytics... ...required Must meet COVID-19 requirements This is a remote/work from home position within the United States Education...Remote workHourly payFull timeTemporary workWork experience placementLocal areaWork from home$223.8k - $313.1k
...a part of our caring community The Medical Director National OP Medicare relies on medical background and reviews... ...with a context of regulatory compliance. Work is assisted by diverse resources... ...Travel: While this is a remote position, occasional travel to Humana...Remote workBi-weekly payFull timeTemporary workApprenticeshipWork from homeHome office$160k - $170k
...Senior Manager, Clinical Compliance Fully Remote • Irvine, CA 92618 Overview Salary Range $160,000.00 - $170,000.00 Salary Position Type... ..., clinical operations, or clinical quality assurance; medical device experience strongly preferred. ~ Minimum 3 years...Remote workFull timeContract workWork at officeHome office$223.8k - $313.1k
...of our caring community The Medical Director relies on medical background... ...management or inpatient review (Medicare Advantage, Managed Medicaid,... .... Travel: While this is a remote position, occasional travel... ...take affirmative action, in compliance with Section 503 of the...Remote workBi-weekly payFull timeTemporary workApprenticeshipWork at officeLocal areaWork from homeHome officeMonday to FridayWeekend work- Now Hiring: Medical Director - Utilization Management 100% Remote | Must work PST hours Medicare Advantage | Inpatient & Post-Acute Focus We’re looking for an experienced... ...consistent, cost‑effective care Support CMS compliance, NCQA standards, audits, and delegated...Remote workImmediate start
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