Remote Medical Director, Utilization Management
RXinsider
UnitedHealth Group's Enterprise Clinical Services seeks a Medical Director to provide physician support and lead clinical coverage reviews for members. You will collaborate with a multidisciplinary team to ensure cost-effective, high-quality care across national plans.
The role requires MD/DO, board certification, and 5+ years of clinical practice, with strong EBM knowledge and MS Office proficiency. This is a remote, full-time position with comprehensive benefits.
#J-18808-Ljbffr$275k - $325k
...affiliate locations of care across five states and growing, TOI is changing oncology for the better. Utilization Management Medical Director OncologyWork Location: REMOTE (work from home)California Nevada Arizona Oregon FloridaThe Medical Director role provides clinical...Remote workWork from home- ...Internal Medicine or Family Medicine physician to join the Utilization Management team. The Medical Director will support WellMed Medical Management by making UM... ...utilization trends to improve the program. Remote work is available from anywhere in the U.S. The role...Remote work
- ...To support Utilization Management operations, the full-time Utilization Review Medical Director will conduct clinical reviews of Durable Medical Equipment (DME) requests remotely, ensuring compliance with Medicare and Medicaid guidelines while maintaining productivity...Remote workFull time
$248.5k - $373k
...$373,000.00/yearJob Area: Medical & Clinical OperationsCompany... ...medicine physician to join our Utilization Management team. Optum is a clinician-... ...work and live.The Medical Director for Utilization Management... ...the flexibility to work remotely * from anywhere within the...Remote workMinimum wageFull timeWork experience placementWork at officeLocal areaWork from home- ...Health is hiring a Radiation Oncology Medical Director to oversee oncology utilization, policy implementation, and review processes in a remote, home-based role. The position supports... ..., peer-to-peer reviews, and case management. The role requires MD/DO, board certification...Remote jobWork from home
- Starling Oncology is seeking a Medical Director to provide clinical expertise in utilization management for oncology care. You will review and guide medical necessity decisions, collaborating with physicians, operations, and payers to optimize outcomes and value-based...Remote job
- UnitedHealth Group seeks a Medical Director to lead clinical coverage reviews and benefit determinations within Enterprise... ...knowledge, communication, and remediation of utilization management. You can work remotely from anywhere in the United States, with responsibilities...Remote job
- The Oncology Institute is seeking a Medical Director to provide clinical expertise in assessing medical necessity, appropriateness, and efficiency of oncology care with a focus on utilization management for case reviews and clinical decision making. In this collaborative...Remote job
$248.5k - $373k
...family medicine physician to join our Utilization Management team. Optum is a clinician-led care... ...clinicians work and live. The Medical Director for Utilization Management will support... ...fluency *All employees working remotely will be required to adhere to UnitedHealth...Remote workMinimum wageFull timeWork experience placementWork at officeLocal areaWork from home$150 per hour
The Utilization Review Medical Director is responsible for conducting clinical reviews of Durable Medical Equipment... ...to support Integra’s Utilization Management (UM) operations. Role functions... ...Conditions and Additional Expectations: Remote role requiring consistent...Remote workHourly payFull timeContract workTemporary workPart timeLocal area- Centene Corporation is seeking a clinical professional to lead Medical Management/Health Services for 28 million members. The role drives utilization management, quality improvement, and medical review across a national organization with flexible work options. The candidate...Remote jobFlexible hours
- ...family, is seeking an experienced physician to join the Utilization Management team. The Medical Director for Utilization Management will support WellMed... ...determinations and suggesting program improvements. This remote-friendly role offers the chance to influence care on...Remote work
- ...WellMed, part of Optum, seeks an experienced physician to join the Utilization Management team as Medical Director. This remote role supports WellMed Medical Management, Inc. with UM determinations and program improvements, aiming to optimize care for seniors nationwide...Remote work
- ...WellMed, part of the Optum family, is seeking a Medical Director for Utilization Management to support utilization determinations and identify trends in order to improve the UM program. The role involves developing and maintaining efficient UM processes, staying current...Remote work
$236.5k
Position Purpose:Assist the Chief Medical Director to direct and coordinate the medical management, quality improvement and... ...medical leadership of all for utilization management, cost containment, and... ...flexible approach to work with remote, hybrid, field or office work schedules...Remote workFull timePart timeWork at officeFlexible hoursWeekend work- ...WellMed, part of the Optum family, seeks a Medical Director for Utilization Management to lead and optimize our UM program. This role focuses on medical... ...program improvements while fostering a collaborative, remote-friendly work environment across the U.S. You will drive...Remote work
- ...Bickham Services Unlimited, LLC seeks a Medical Director, Utilization Management for a 6-9 month contract based in Henderson, NV, with remote work option. Immediate start favored for reviewing inpatient and post-acute care decisions for Commercial and Medicare Advantage...Remote workContract workImmediate start
- System Physician Advisor Medical Director Responsibilities and Job Description Overview:The... ...and other leadership related to case/utilization management and revenue cycle including the Lee Health... ...contracted providers involved in remote utilization review and physician...Remote workContract workFor contractorsMonday to FridayWeekend work3 days per week
$240k - $250k
...Medical Director Utilization Management We are looking for physicians who have expertise in Internal Medicine including medical and surgical clinical... ...different backgrounds and perspectives. This is a remote-first role that may require travel to Boston, MA for new...Remote workFlexible hours- ...Job Description Job Description: Manager of Clinical Utilization Management - Denial Compliance Location... ..., CA Position Type: Hybrid (85% remote, 15% onsite in Northridge, CA);... ...with physician reviewers, medical directors, and other relevant departments....Remote workPermanent employmentFull timeTemporary workFlexible hours
$275k - $300k
The Oncology Institute is seeking a Medical Director for Utilization Management Oncology to provide strategic oversight and support key clinical initiatives. This remote role involves conducting medical reviews of oncology treatment plans and ensuring compliance with evidence...Remote job- CVS Health is hiring a Medical Director (Behavioral Health) for a remote-based role with a preference for Texas-licensed psychiatrists. You will lead a utilization management team, oversee clinical quality, and shape policy and program development across mental health care...Remote job
- Integra Partners seeks an experienced Utilization Review Medical Director to lead clinical reviews of DMEPOS requests within a remote UM environment. You will ensure decisions meet Medicare/Medicaid guidelines and internal policies while maintaining timely throughput and...Remote job
- Valenz Health is seeking a Part-Time Medical Director to provide physician leadership for medical management and utilization review programs. You will align clinical decisions... ..., and organizational standards in a fully remote role based in the United States. You will collaborate...Remote jobPart time
- CVS Health is seeking a Medical Director (Behavioral Health) to lead the utilization management team remotely. You will provide psychiatric leadership, oversee high-risk cases, and ensure medical necessity decisions to deliver high-quality care for diverse health plans....Remote job
- UnitedHealth Group in Minnesota seeks a Medical Director to provide physician support for... ...effective, high-quality care, advances utilization management, and communicates policies to network and non-network physicians. Remote work from anywhere in the U.S. is supported...Remote job
$250k - $350k
...company, is a specialized medical group dedicated to providing... ...primary care, longitudinal care management, remote monitoring, and real‑time... ...quality, reduce avoidable utilization, and expand access for... ...company. Position Title Medical Director - Intention MA Location...Remote work$286.07k - $353.38k
...Place to Work since 2015.Position SummaryThe Vice President, Medical Director, Health Plan provides senior clinical leadership across... ...health plan strategy.Provide clinical leadership across utilization management, care management, population health, quality, pharmacy,...Remote workFull timeHome office- ...Medical Director Utilization Management Location: Remote Preference EST or nearby Pittsburgh PA, NY, WV Duration: 6+ Months Contract Role with possible extension. Position Overview As part of a physician team, the Medical Director ensures utilization management...Remote workContract workPrivate practice
$190k - $200k
We're seeking a board‑certified Medical Director (Internal Medicine or Family Practice) to support our team. This role is fully remote and focuses on utilization management (UM), quality review, and clinical oversight for high‑volume cases. You will work closely with...Remote workFull time
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