Medical Director: Remote Leadership in Quality Utilization
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Centene Management Company LLC in Arizona seeks a Board-Certified Physician to lead medical management, quality improvement, and credentialing for the business unit. The role guides utilization management, cost containment, and clinical quality initiatives, with oversight of medical reviews and payer interactions.
Active medical practice is expected; license in Arizona required. The position may require weekend/holiday work and collaboration across care teams, provider networks, and committees
#J-18808-Ljbffr Jobleads-US$248.5k - $373k
...00/yearJob Area: Medical & Clinical OperationsCompany... ....The Medical Director provides... ...Clinical Services leadership and staff to establish... ...determinations, quality improvement and... ...in various utilization management activities... ...flexibility to work remotely * from anywhere...Remote workQualityMinimum wageFull timeWork experience placementLocal area- ...roles that are 100% remote or hybrid, you must have... ...areas of the Utilization Management (UM) program... ...retrospective reviews. As a Medical Director, UM you ensure all... ...guidelines. They partner with Quality Improvement teams to... .... Provides leadership in developing and implementing...Remote workQualityContract workLocal areaFlexible hoursWeekend work
- Beacon Hill is seeking a Medical Director (MD/DO) for Raleigh,... ...focus on physical health utilization management and clinical leadership. The role collaborates... ...management teams to uphold quality, compliance, and... ...accommodating primarily remote work with a North #J-1...Remote jobQuality
- ...Health is seeking a Part-Time Medical Director to provide physician leadership for medical management and utilization review programs. You will... ...standards in a fully remote role based in the United States... ...determinations, and drive quality improvement across programs...Remote jobQualityPart time
- ...Medical Director, Utilization Management The Medical Director, Utilization Management... ...of comprehensive high-quality health care to UPMC Health Plan members. This fully remote role will be responsible for... ...Responsibilities: Provide leadership direction for provider...Remote workQualityWork at office
- ...Group, through UnitedHealthcare, seeks a Medical Director of Clinical AI Innovation and... ...training, testing, and surveillance for utilization management criteria, leveraging InterQual... ...collaborates with Medical Policy, Data Science, and UM leadership. #J-18808-Ljbffr Jobleads-USRemote job
$248.5k - $373k
...Medical Director Optum is a global organization that delivers... ...Clinical Services leadership and staff to... ...coverage determinations, quality improvement and cost... ...knowledge in various utilization management activities... ...flexibility to work remotely from anywhere within...Remote jobQualityMinimum wageFull timeWork experience placementLocal area- ...Corporation is seeking a clinical leader to assist the Chief Medical Director in directing and coordinating medical management, quality improvement, and credentialing. The role provides medical leadership for utilization management, cost containment, and quality improvement...Remote jobQuality
$275k - $325k
...growing, TOI is changing oncology for the better. Utilization Management Medical Director OncologyWork Location: REMOTE (work from home)California Nevada Arizona Oregon... ...leaders to support evidence-based high quality and cost-effective care delivery across the network...Remote workQualityWork from home- ...to provide operational leadership to a team of professionals involved in utilization management. This role... ...encompasses ensuring clinical quality and compliance while collaborating with Medical Directors and internal leaders.... ...offers a fully remote environment with comprehensive...Remote jobQuality
- WellMed Medical Management, Inc. seeks an Internal Medicine/Family Medicine physician to join our Utilization Management team as Medical Director. You will make UM determinations, monitor CMS criteria... ...multidisciplinary team committed to high-quality, cost-effective care and...Remote jobQuality
$248.5k - $373k
...,000.00/yearJob Area: Medical & Clinical OperationsCompany... ...physician to join our Utilization Management team. Optum... ...and live.The Medical Director for Utilization... ...the flexibility to work remotely * from anywhere within... ...confidentialityProvides quality assurance and...Remote workQualityMinimum wageFull timeWork experience placementWork at officeLocal areaWork from home- ...seeks an Internal/Family Medicine physician to lead utilization management. You will determine medical necessity, review cases, and drive UM protocol improvements... ...in physician meetings, with a strong focus on quality and patient care. #J-18808-Ljbffr Colorado PARemote jobQuality
- Centene Corporation is seeking a Medical Director to lead utilization management, quality improvement, and medical review activities. You will partner with Chief Medical Director to shape goals, policies, and cost-effective care for a diverse member population. The role...Remote jobQuality
- ...Medical Director Curative is seeking an enthusiastic and highly skilled... ...overseeing and performing utilization reviews, prior authorizations... ...peer discussions. This is a remote position requiring a "roll up... .... Participate in quality improvement initiatives, audits...Remote workQualityFull timeFlexible hours
$248.5k - $373k
...medicine physician to join our Utilization Management team. Optum is a... ...work and live. The Medical Director for Utilization Management will... ...organizational confidentiality Provides quality assurance and education of... ...*All employees working remotely will be required to adhere...Remote jobQualityMinimum wageFull timeWork experience placementWork at officeLocal areaWork from home- We are looking for a Medical Director, who will be the clinical... ...including clinical quality, documentation... ...huddles and provide leadership to the entire clinical... ...patient wishes and reduces utilization of unwanted... ...checklist' management, remote monitoring, etc.) used...Remote workQuality1 day per week
- ...Remote100% Remote100% Remote in the 28 states... ...Required Skills: Utilization management... ...from accredited medical school Industry Specific... ...of a Medical Director’s knowledge and clinical... ...area supported.Leadership Skills:Project... ...(Credentialing)Quality model design and...Remote workQuality
$248.5k - $373k
...00/yearJob Area: Medical & Clinical OperationsCompany... ...to work remotely * from anywhere... ...:Work to improve quality and promote evidence... ...with medical director teams focusing on... ...requires exceptional leadership skills, the... ...QualificationsHands-on utilization and/or quality...Remote workQualityMinimum wageFull timeWork experience placementWork at officeLocal area$386.5k
...500/yearJob Area: Medical & Clinical OperationsCompany... ...barriers to quality care. The work you... ...- starting with Utilization Management. The Medical Director, Clinical AI... ...UCS clinical and AI leadership team, collaborating... ...flexibility to work remotely * from anywhere...Remote workQualityMinimum wageFull timeWork experience placementLocal area$280.84k - $393.18k
...Services, the Senior Medical Director Policy & Outcomes (Sr... ...Policies and clinical leadership around member health... ...activities including quality management, grievance... ...downstream connections to utilization management,... ...schedule. (Mon & Fri - remote, Tues - Thurs onsite...Remote workQualityTemporary workLocal area- ## Medical DirectorApplylocations: Kansastime... ...**The Medical Director will serve as a clinical... ...the plan utilization management, medical... ...development, quality management, and provider... ...background, leadership skills, and the ability... ...eligible to work remotely, hybrid or onsite...Remote workQualityWork at officeImmediate startRelocation
$248.5k - $373k
...73,000.00Job Area: Medical & Clinical OperationsCompany... ...a team of medical directors, for the overall quality, effectiveness and... ..., performs Utilization Management reviews... ...flexibility to work remotely * from anywhere within... ...providersPossess leadership skills in working with...Remote workQualityMinimum wageWork experience placementLocal areaWeekend work- ...Pharmacovigilance, the Medical Director, Pharmacovigilance... ...for providing medical leadership across core pharmacovigilance... ..., medical affairs, quality, and external vendors... ....This role may be remote or based in our... ...guidelines.Experience utilizing safety databases and...Remote workQualityTemporary workWork at officeLocal areaImmediate start3 days per week
- ...Medical Director The Medical Director serves as the clinical... ...development, and quality assurance initiatives... ...CVO), health plan, or utilization management operation.... ...with organizational leadership, credentialing staff,... ...this position allows remote work, the individual...Remote workQualityContract work
- ...Medical Director Hartford, Connecticut, United States... ...innovative and high-quality care in the home and... ...need, high-risk, high-utilizing patients. Job requires... ...The role is primary remote, but residence in the... ...Previous medical leadership and teaching experience...Remote workQualityFlexible hours
- ...The Medical Director is a key clinical leader responsible... ...assignments to optimize quality metrics,... ...Responsibilities: Clinical Leadership: Provide strategic oversight... .... Innovation: Utilize advanced technology... ...off Location ~ Remote with limited travel to...Remote workQualityWork at office
$207.8k - $346.3k
...Medical Director Do you crave an intellectually stimulating... ...'ll start training remotely in a structured... ...trainers, mentors, and leadership to set you up for success... ...federal laws ~ Utilization Review Accreditation... ...National Committee for Quality Assurance standards is...Remote workQualityLocal areaWork from homeMonday to Friday$248.5k - $373k
...73,000.00Job Area: Medical & Clinical OperationsCompany... ....The Medical Director for the Oncogenetic... ...provides clinical leadership and oversight for utilization management related... ...to work remotely * from anywhere within... ...Responsibilities:Work to improve quality and promote...Remote workQualityMinimum wageWork experience placementLocal area$170 - $190 per hour
...Medical Director Huntington Beach Office - Huntington Beach, CA 92647... ...clinical oversight for MAPD utilization management, care management, appeals and grievances, quality-of-care review, delegated clinical... ...and Population Health leadership to provide physician guidance...Remote workQualityHourly payPart timeWork at office
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