Remote Medical Director - Medicare Appeals (Part-Time)
Humana
The Medical Director at Humana relies on broad clinical expertise to review Medicare drug appeals (Part D and B). The role is part-time, seasonal with flexible weekly hours and compensated hourly, working to support value-based care within Medicare and Humana policy. Collaboration with clinicians and staff is essential to ensure optimal member outcomes. Requirements include an MD or DO, an unrestricted license, board certification, and strong communication and analytic skills. #J-18808-Ljbffr
Vacancy posted 1 day ago
Similar jobs that could be interesting for youBased on the Remote Medical Director - Medicare Appeals (Part-Time) in Boise, ID vacancy
- ...The Medical Director at Humana relies on broad clinical expertise to review Medicare drug appeals (Part D and B). The role is part-time, seasonal with flexible weekly hours and compensated hourly, working to support value-based care within Medicare and Humana policy....Part timeRemote workHourly paySeasonal workFlexible hours
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United States1 day ago - ...Humana, Inc. is seeking a part-time, seasonal Medical Director to review Medicare drug appeals (Part D and B) with broad clinical expertise. The role involves collaboration with clinicians to deliver value-based care within regulatory guidelines. A current unrestricted...Part timeRemote workHourly paySeasonal workFlexible hours
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United States2 days ago - ...Humana, Inc. is seeking a Medical Director for a part-time, seasonal role focused on reviewing Medicare drug appeals (Part D and B). The position involves licensed physicians with... ...policy and CMS guidelines. The role is remote with travel to Humana offices as needed. It...Part timeRemote workSeasonal work
Humana
United States1 day ago - ...Humana, Inc. seeks a Medical Director for a part-time, seasonal, remote role to review Medicare drug appeals (Part D and B) and support value-based care within regulatory guidelines. The role collaborates with clinicians to optimize member outcomes and ensure compliance...Part timeRemote workSeasonal work
Humana
Honolulu, HI5 days ago - ...Humana, Inc. is seeking a Medical Director for a part-time, seasonal role to review Medicare drug appeals (Part D and B). The position requires an MD or DO, a current medical... ...Medicine, Emergency Medicine, or PM&R. This remote role may involve some travel for training and...Part timeRemote workSeasonal work
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Richmond, VA1 day ago - ...Humana, Inc. is seeking a Medical Director for a part-time seasonal role focused on reviewing Medicare drug appeals (Part D and B). You will leverage broad clinical expertise... ...essential to deliver value-based care. This remote position offers flexible weekly hours and is...Part timeRemote workHourly paySeasonal workFlexible hours
Humana
United States5 days ago - Humana, Inc. in the United States is seeking a part-time Medical Director to review Medicare drug appeals (Part D and B) and provide expert clinical oversight within policy and regulatory guidelines. You will collaborate with clinicians and staff to support value-based...Part timeRemote job
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...Purpose:Assist the Chief Medical Director to direct and... ...medical services, ensuring timely and quality decision making... ..., network providers, appeals team, medical and... ...approach to work with remote, hybrid, field or office... ...including full-time or part-time status. Total...Part timeRemote workFull timeWork at officeWork from homeFlexible hoursWeekend workCentene Corporation
Lincoln, WA1 day ago$236.5k
...professional on our Medical Management/Health... ...the Chief Medical Director to direct and... ...services, ensuring timely and quality decision... ...network providers, appeals team, medical and... ...approach to work with remote, hybrid, field or... ...full-time or part-time status. Total...Part timeRemote workFull timeWork at officeFlexible hoursWeekend workCentene Corporation
New York, NY5 days ago$223.8k - $313.1k
...Become a part of our caring community Please note that this Medical Director position is a part-time, seasonal position, with variable/flexible... ...expertise to review Medicare drug appeals (Part D and B). The Medical... ...: While this is a remote position, occasional travel...Part timeRemote workBi-weekly payHourly payDaily paidFull timeApprenticeshipSeasonal workWork at officeLocal areaWork from homeHome officeFlexible hoursHumana
Denver, CO1 day ago- ...Medical Director (BH, UM) - Honolulu, HIThis is a remote position requiring active Hawaii licensure. Both full-time and part-time candidates will be considered.This position... ...business (Medicaid, Medicare, and Commercial) and... ...the integrity of the appeals process, both...Part timeRemote workFull timeContract workInternshipImmediate startFlexible hours
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Honolulu, HI2 days ago $174.07k - $374.92k
...CVS Health Medical DirectorWe're building a world... ...do. Join us and be part of something bigger... ...one community at a time.Aetna, a CVS Health... ....This is a remote based (work at home... ...Responsibilities of this Medical Director role are related to Medicare Appeals:Direct daily work...Remote workHourly payFull timeTemporary workWork from homeWeekend workOak St. Health
Windsor Locks, CT4 days ago$223.8k - $313.1k
...Become a part of our caring community The Medical Director relies on broad clinical expertise to review Medicare drug appeals (Part D & B). The Medical director works... ...: While this is a remote position, occasional travel... ...base pay for full time (40 hours per week) employment...Remote workBi-weekly payFull timeTemporary workWork at officeLocal areaWork from homeHome officeHumana
Lansing, MI2 days ago- ...through its Aetna subsidiary, seeks an experienced Medical Director to lead Medicare Appeals. This remote role can be based anywhere in the United States and... ...and equity programs. You will direct daily work on Part C appeals, supervise appeal nurses, participate in the...Remote work
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United States2 days ago - ...Humana Inc. is seeking a Medical Director to review Medicare drug appeals (Part D and B) and ensure medical necessity aligns with Humana policies. The role involves complex case analysis, inter-department collaboration, and potential involvement in CMS audits and hearings...Remote work
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Albany, NY3 days ago - ...Humana Inc. is seeking a Medical Director to provide expert clinical review of Medicare drug appeals (Part D & B) and support value-based care within Humana policies and Medicare rules. You will analyze moderately to complex cases, collaborate with prescribers, and participate...Remote work
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Nashville, TN5 days ago - ...Humana, Inc. seeks a Medical Director to review Medicare drug appeals (Part D & B) with broad clinical expertise. The role involves case-by-case analysis of Medicare rules, Humana policies, and medical necessity to support value-based care. You will collaborate with clinicians...Remote work
Humana
Bismarck, ND4 days ago - ...Humana Inc. is seeking a Medical Director to provide Medicare drug appeals review and medical necessity assessments. The role involves complex case analysis... ...with Medicare and Humana policies. You will work remotely with occasional travel to Humana offices for training...Remote work
Humana
Columbus, OH4 days ago - ...Humana Inc. is seeking a Medical Director to provide clinical leadership in reviewing Medicare drug appeals (Part D & B) and to ensure decisions align with Medicare rules, Humana policy, and medical necessity. The role involves computer-based reviews, peer discussions...Remote work
Humana
United States3 days ago - ...Humana Inc. is seeking an experienced Medical Director to oversee review of Medicare drug appeals (Part D & B) and support value-based care in a remote capacity. You will analyze complex to moderately complex cases, collaborate with clinicians, participate in hearings,...Remote work
Humana
Boise, ID3 days ago - ...Description Location: Fully Remote | Candidates must be available to work Eastern Time (EST) business hours. Hours: Part-time hours Description: The Medical Director, Appeals is responsible for... ...clinical decisions within a Medicare Advantage environment....Part timeRemote workLocal areaImmediate start
$301.6k - $312k
...Medical Director As the Medical Director you will provide clinical oversight and signed authorization of... ...closely with the departments that manage external appeal and independent review operations. This is a part-time remote position (All work must be performed within...Part timeRemote workHourly payContract workFor contractors$224k - $364k
...FL, United States (Remote) Job Description The Medical Director will work closely... ...Concurrent Review and Appeals. Key... ...resources to render timely decisions on medical... ...as commercial or Medicare medical policy •... ...Benefits for intern, part-time and seasonal...Part timeRemote workTemporary workWork experience placementInternshipSeasonal workFlorida Blue Group
Florida4 days ago- ...Elevance Health is seeking a Medical Director for Florida Medicare on a part-time basis. The role supports utilization management and medical necessity reviews for inpatient and outpatient care, with weekend on-call rotations as part of UM requirements. The position offers...Part timeRemote workWeekend work
Elevance Health, Inc.
Tallahassee, FL3 days ago $248.5k - $373k
...- $373,000/yearJob Area: Medical & Clinical OperationsCompany... .... Work at home!The Appeals and Grievances Medical Director is responsible for ongoing... ...enjoy the flexibility to work remotely * from anywhere within the... ...00 annually based on full-time employment. We comply with...Remote workMinimum wageFull timeWork experience placementLocal areaWork from homeUnitedHealth Group
Cypress, CA20 hours ago$215.01k - $408.49k
...priority. Provides medical leadership for... ...Performs case reviews and appeals for all health... ...specialty familiar with Medicare patients.... ...reimbursement, paid time off plus holidays,... ...approach to work with remote, hybrid, field or office... ...full-time or part-time status. Total...Part timeRemote workHourly payFull timeReliefWork at officeFlexible hours- ...Humana, Inc. is seeking a Medical Director for a part-time, seasonal, remote role in the United States. The candidate will review Medicare drug appeals (Part D and B) using Medicare rules, Humana policies, and clinical literature to ensure appropriate coverage decisions...Part timeRemote workSeasonal work
Humana
Cheyenne, WY1 day ago - ...UnitedHealthcare is seeking an Appeals and Grievances Medical Director to oversee clinical review and adjudication of appeals across health plan products. Remote work allowed from anywhere in the U.S. You will lead regulatory responses, coordinate with medical directors...Remote work
Optum
United States2 days ago - ...’s UnitedHealthcare division seeks an Appeals Medical Director specializing in Radiology. You will ensure... ...outcomes across the country, with remote collaboration among physicians, nurses... ...offering growth within the organization and exposure to Medicare and #J-18808-LjbffrRemote work
UnitedHealth Group
United States2 days ago - ...Humana, Inc. is seeking a Corporate Medical Director to provide clinical interpretation and reviews of medical records for appeals decisions, applying established review policies... ...functional teams, focusing on improving consistency, turnaround times, and #J-18808-Ljbffr...Remote work
Humana
Boston, MA1 day ago
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