Remote Medical Director: Appeals & Grievances Leader
Jobleads-US
- Remote job
UnitedHealthcare is seeking a clinician to review appeals and grievances across PPO, HMO, MAPD and PDP products. The role involves regulatory responses and collaboration with medical directors and network staff.
We offer remote work from anywhere in the U.S. The successful candidate will bring MD/DO credentials, 5+ years’ clinical practice, and strong leadership, communication, and project-management skills to help improve care access and outcomes.
#J-18808-Ljbffr Jobleads-US$248.5k - $373k
...$248,500.00 - $373,000.00Job Area: Medical & Clinical OperationsCompany: UnitedHealth... ...'ll enjoy the flexibility to work remotely * from anywhere within the U.S. as... .... Primary Responsibilities:The Appeals and Grievances Medical Director is responsible for ongoing clinical...Remote workMinimum 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 companies. The role offers work-from-home flexibility across the United States. You will perform case reviews for...Remote jobWork from home
- ...Kern Family Health Care is seeking a Medical Director for Appeals, Grievances & Disputes in Bakersfield, California. This role involves leadership, operational execution, and ensuring compliance with all regulations regarding grievances and appeals. The ideal candidate...Suggested
- ...UnitedHealthcare is seeking an Appeals and Grievances Medical Director to lead clinical review and adjudication of appeals and grievances across multiple health plan products. This role offers remote work from anywhere in the U.S. and a chance to influence benefit...Remote job
- Health Wealth Safe is seeking an Appeals and Grievances Medical Director to review medical appeals and grievances across health plan products, ensuring... ...professional growth with comprehensive benefits and flexible remote work. #J-18808-Ljbffr Health Wealth SafeRemote jobFlexible hours
$102.18k
...Supervisor, Appeals and Grievances Clinical Operations RN Job Category: Clinical... ...; escalates to appropriate leader/team when necessary.... ...weekends, holidays, a hybrid remote schedule, occasional flexibility... ...Reimbursement Retirement Plans Medical, Dental and Vision Wellness...Remote workFull timeShift workWeekend work$27 - $31 per hour
Pyramid Consulting, Inc. is seeking an Appeals & Grievances Case Manager for a California assignment in Los Angeles. This is a 06+ months contract with potential for extension, and is listed as remote in the LA area. The role requires extensive appeals experience within...Remote jobHourly payContract work$245k - $260k
PCHP Medical Director Clinical Leader Location: Mockingbird Towers 4th FLR, Dallas, TX Remote PRIMARY PURPOSE Oversees medical coordination required... ...pre‑service and post‑service appeals request for medical necessity and resolves grievances related to medical quality of...Remote workPermanent employmentFull timeContract workPart timeLocumPrivate practiceWork at officeVisa sponsorshipRelocation packageMonday to FridayFlexible hours- ...UnitedHealth Group is hiring for a remote-friendly clinical leadership role overseeing appeals and grievances across PPO, HMO, MAPD, and PDP products. The position emphasizes collaboration with medical directors and network management to improve access, quality, and outcomes...Remote job
- Health Marketing in the United States seeks an Appeals and Grievances Medical Director to oversee clinical review and adjudication of appeals and grievances for health plans and insurance products. Remote work options are available. You will perform individual case reviews...Remote job
- ...UnitedHealth Group is seeking a physician leader to conduct case reviews for appeals and grievances across multiple health plans. The role involves regulatory responses, collaboration with medical directors, and guidance on benefit interpretations. You will participate...Remote job
$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... ...initiatives Collaborate with market/product leaders to help define market strategy...Remote jobHourly payWork at officeWeekend workAfternoon shift- ...for a high-level clinical specialist to review appeals and manage quality programs. This role offers remote work from anywhere in the U.S. and opportunities... ...regulatory responses, and communications with medical directors. Required credentials include an active MD/DO license...Remote work
$174.07k - $374.92k
...& West Virginia). **This is a remote based (work at home) based anywhere... ...US.** Responsibilities of this Medical Director role are related to Medicaid Appeals You will support the Medical... ...and consultation to the Medicaid grievance and appeals team You will chair...Remote workHourly payFull timeTemporary workLocal areaWork from home$236.5k
...clinical professional on our Medical Management/Health Services team... ...Purpose Supervisory Medical Director at Centene provides medical... ...actively participates in the appeals process, ensuring that appeals... ...flexible approach to work with remote, hybrid, field or office work...Remote workFull timePart timeWork at officeFlexible hours$236.5k
...clinical professional on our Medical Management/Health Services team... .... Assists Chief Medical Director in planning and establishing... ...clinical teams, network providers, appeals team, medical and pharmacy... ...flexible approach to work with remote, hybrid, field or office work...Remote jobFull timePart timeWork at officeFlexible hoursWeekend work$280k - $310k
A distinguished behavioral health organization seeks a Medical Director to lead psychiatric consultation and clinical innovation within the... ...extensive clinical experience and proven leadership skills. A fully remote position with a competitive salary range of $280,000 to $310,...Remote work- VNS Health is seeking a remote Clinical Education Manager to plan, implement, and evaluate education programs for staff across... ...Bachelor’s and often a Master’s in Nursing, plus five years in Grievance and Appeals or similar clinical education settings. #J-18808-Ljbffr VNS...Remote job
- A healthcare service provider is seeking an Appeals and Grievances Clinical Specialist to manage member complaints and clinical case resolutions. This is a 100% remote role requiring an RN, LPN, or Dental Hygienist license. Responsibilities include developing cases, researching...Remote work
- Medpace is seeking a Medical Director in Neurology to provide medical leadership for clinical trials in Cincinnati, Ohio. This role encompasses... ...hybrid work from home flexibility and potential for full remote work based on experience. Travel may be required up to 20%. #J...Remote jobWork from home
- ...To support a growing remote team, the full-time Appeals and Grievance Specialist will manage and resolve complaints, grievances, and appeals from members and providers while ensuring compliance with applicable requirements. Key responsibilities Manage and resolve complaints...Remote workFull time
- ...Upward Health seeks a Medical Director to partner with cross-functional teams and senior leaders to deliver innovative and high-quality care in the home and community for... ..., high-risk patients. The role is primarily remote, but residence in Rhode Island is required, with...Remote job
- ...Copa Health is seeking multiple Medical Directors to lead psychiatric services in East and West Valley programs, while maintaining an active... ...evidence-based, recovery-oriented care, available for a hybrid/remote work arrangement to support organizational initiatives. #J-...Remote work
- 6120-Janssen Scientific Affairs, LLC is seeking a Medical Director, Rheumatology Therapeutic Area, to lead clinical study programs and collaborate... .... The position offers a hybrid work schedule, with three days in the office and two days remote. #J-18808-Ljbffr Jobleads-USRemote workWork at office
- ...Puzzle Healthcare seeks a Physiatrist (PM&R) to serve as Medical Director, providing clinical oversight and leadership across our post-acute and long-term care network. This remote-first role includes periodic on-site support for complex rehabilitation procedures. As...Remote job
- ...Direct Jobs is seeking a Medical Director in Oncology to expand world-class cancer care into rural communities across the United States. This leadership role focuses on guiding oncology services at community hospitals and improving access to life-saving treatments for...Remote jobFlexible hours
- A staffing solutions company is seeking a Grievance & Appeals Coordinator for a fully remote position in Detroit, MI. This role involves processing appeals, grievances, and inquiries while maintaining accurate documentation and effective communication. The ideal candidate...Remote jobContract work
- ...Appeals And Grievances Lead 3 Key Consulting is recruiting an Appeals and Grievances Lead for a... ...DMHC, and DHCS regulations. Must know Medical Terminology. Must have excellent written... ...but not limited to members, peers, leaders, physicians, executives, and regulatory...Flexible hoursWeekend work
- A national healthcare organization is seeking a medical professional to lead and coordinate medical management efforts. Responsibilities include utilization management, medical quality improvement, and collaboration with clinical teams to optimize patient care. The ideal...Remote jobFull timeFlexible hours
$45.9k - $78.6k
..., and assignment of member complaints, grievances, appeals, and regulatory inquiries. This role ensures... ...with appropriate partners or leaders to support awareness and timely resolution... ...rewards package that includes competitive medical, dental, vision, PTO, Holidays, paid...Full timeWork experience placementWork at office3 days per week
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