Remote Medical Director Medicare Drug Appeals
Humana
Humana Inc. is seeking a Medical Director to provide Medicare drug appeals review and medical necessity assessments. The role involves complex case analysis, cross-functional collaboration, and ensuring compliance with Medicare and Humana policies. You will work remotely with occasional travel to Humana offices for training, participate in hearings, and support CMS audits, contributing to value-based care delivery. #J-18808-Ljbffr
Vacancy posted 4 days ago
Similar jobs that could be interesting for youBased on the Remote Medical Director Medicare Drug Appeals in Columbus, OH vacancy
- ...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 $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 assignments... ...HIPAA information. Travel: While this is a remote position, occasional travel to Humana's...Remote workBi-weekly payFull timeTemporary workWork at officeLocal areaWork from homeHome officeHumana
Dover, DE2 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 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
Humana, Inc.
Nashville, TN5 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
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United States3 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...Remote workPart timeSeasonal work
Humana
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...Remote workHourly payPart timeSeasonal workFlexible hours
Humana
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). You will leverage broad clinical expertise... ...essential to deliver value-based care. This remote position offers flexible weekly hours and is...Remote workHourly payPart timeSeasonal 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...Remote jobPart time
$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... ...its affiliated brands are a drug-free workplace. Candidates...Remote workMinimum wageFull timeWork experience placementLocal areaWork from homeUnitedHealth Group
Cypress, CA13 hours ago$174.07k - $374.92k
...CVS Health Medical DirectorWe're building a world of health around every individual... ...health care resources.This is a remote based (work at home) based... ....Responsibilities of this Medical Director role are related to Medicare Appeals:Direct daily work on part C appeals...Remote workHourly payFull timeTemporary workWork from homeWeekend workOak St. Health
Windsor Locks, CT4 days ago- ...CVS Health, 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 supports a national scope, with eligibility for CVS Health's bonus and equity programs. You will...Remote work
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United States2 days ago $248.5k - $373k
...You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as... ...challenges. Primary Responsibilities: The Appeals and Grievances Medical Director is responsible for ongoing clinical... .... UnitedHealth Group is a drug - free workplace. Candidates are required...Remote workMinimum wageFull timeWork experience placementLocal areaWork from homeUnitedHealth Group
Cypress, CA2 days ago$223.8k - $313.1k
...caring community Please note that this Medical Director position is a part-time, seasonal... ...broad clinical expertise to review Medicare drug appeals (Part D and B). The Medical director... ...information. Travel: While this is a remote position, occasional travel to Humana...Remote workBi-weekly payHourly payDaily paidFull timePart timeApprenticeshipSeasonal workWork at officeLocal areaWork from homeHome officeFlexible hoursHumana
Denver, CO4 days 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
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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
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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, procedures, and performance standards. The role requires independent judgment in addressing...Remote work
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Boston, MA1 day ago - ...A prominent healthcare organization is seeking an Appeals and Grievances Medical Director to manage clinical reviews of appeals for various health plans. The role offers flexibility to work remotely. Qualified candidates should have an MD or DO, be board certified, and...Remote work
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Cypress, CA5 days ago - ...UnitedHealthcare, a part of UnitedHealth Group, is seeking a Medical Director for Appeals and Grievances. The role focuses on clinical review,... ...regulatory responses for various health plans. It offers remote work from anywhere in the U.S. and a comprehensive benefits...Remote work
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Cypress, CA5 days ago $236.5k
...DescriptionPosition Purpose:Assist the Chief Medical Director to direct and coordinate the medical... ...clinical teams, network providers, appeals team, medical and pharmacy consultants... ..., and a flexible approach to work with remote, hybrid, field or office work schedules...Remote workFull timePart timeWork at officeFlexible hoursWeekend workCentene Corporation
Abbeville, GA1 day ago$230k - $270k
...accommodation or an alternative application process. Medical Director, Pharmacovigilance & Drug Safety Pharmacovigilance & Drug Safety Regular Full-... ..., resourceful, and efficient and effectively work with remote partners on a global team Experience ~ MD or...Remote workFull timeLocal areaFlexible hoursGeron Corporation
New Jersey2 days ago$236.5k
...clinical professional on our Medical Management/Health Services team... ...: Assist the Chief Medical Director to direct and coordinate the... ...clinical teams, network providers, appeals team, medical and pharmacy... ...approach to work with remote, hybrid, field or office work...Remote workFull timePart timeWork at officeFlexible hoursWeekend workCentene Corporation
New York, NY5 days ago- ...UnitedHealth Group is seeking an Appeals Medical Director to work remotely within the United States. The role focuses on clinical review and adjudication of appeals and grievances across various health plans and products. You will oversee individual case reviews, regulatory...Remote work
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United States2 days ago - ...Alphanumeric is supporting a leading pharmaceutical company in filling a contract Medical Director – Drug Safety. This is a full-time, 1-year contract with potential extension, and 100% remote work with base in Brazil. You will lead safety evaluation and benefit-risk...Remote workFull timeContract work
Alpha Numeric
New York, NY5 days ago $174.07k - $374.92k
...quality and effective use of health care resources. **This is a remote based (work at home) based anywhere in the US.** Responsibilities of this Medical Director role are related to Medicare Appeals: * Direct daily work on part C appeals (both provider and member...Remote workHourly payFull timeTemporary workLocal areaWork from homeWeekend work- ...Humana Inc. is seeking a Medical Director to review Medicare drug appeals (Part D & B) and guide value-based care. You will analyze complex cases using Medicare... ...medical license. Travel to training or meetings may be required; remote work is possible. #J-18808-LjbffrRemote work
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New York, NY1 day ago - ...UnitedHealth Group is seeking an Appeals M.D. – Pediatrician for remote work within the U.S. The role reviews appeals/grievances, provides clinical input, and collaborates with medical directors to interpret benefits and policies. Requirements include active MD/DO license...Remote work
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Cypress, CA5 days ago - Sr. Medical Director - Drug Safety and Pharmacovigilance (Remote) job at Legend Biotech USA, Inc.. United States. Company Information Legend Biotech is a global biotechnology company dedicated to treating, and one day curing, life-threatening diseases. Headquartered in...Remote jobContract workLocal areaFlexible hours
$222.75k - $371.25k
...R&DPosition Summary Provides medical and scientific leadership in the... ...in pharmacovigilance, drug safety, or medical affairs Demonstrated... ...and team collaboration. Remote working is supported to balance... ...please visit the Centers for Medicare and Medicaid Services (CMS) website...Remote workFull timeLocal areaGSK
Waltham, MA2 days ago
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