Remote Inpatient Utilization Review Medical Director
$223.8k - $313.1kJobleads-US
- Remote job
A leading healthcare company is seeking a Medical Director to perform expert clinical reviews and ensure high-quality decision-making. The role involves collaboration, communication with providers, and adherence to regulatory standards in a remote setting with occasional travel. A competitive salary range of $223,800 - $313,100 per year is offered, supported by comprehensive benefits including medical, dental, and a retirement savings plan. #J-18808-Ljbffr Jobleads-US
$223.8k - $313.1k
A leading healthcare company in New Jersey seeks a Medical Director to perform clinical reviews of inpatient medical records and assess medical necessity. Candidates... ...within a supportive team environment. This is a remote role with standard hours and occasional travel,...Remote job$223.8k - $313.1k
...caring community The Medical Director relies on medical background and reviews health claims. The... ...advancing the quality of inpatient care through clinical... ...those experienced in Utilization Review are encouraged... ...Travel: While this is a remote position, occasional travel...Remote workBi-weekly payFull timeTemporary workApprenticeshipWork at officeLocal areaWork from homeHome officeMonday to FridayWeekend work- ...and e-referral case review and authorization of services utilizing established mental... ...substance abuse medical necessity criteria... ...management review of inpatient, residential,... ...cases to the Medical Director for review of... ...full-time, fully remote (work from home) and...Remote workFull timeWork from homeShift workWeekend workAfternoon shift
- ...Medical Director, Utilization Management The Medical Management team ensures that Blue Shield is on the cutting edge of medical, medication, and... ...In this role you will deliver and collaborate on clinical review activities, which includes management of the physician processes...SuggestedFull timePart timeWork at officeLocal areaWork from homeHome office2 days per week
- ...Medical Director Utilization Management Location: Remote Preference EST or nearby Pittsburgh PA, NY, WV Duration: 6+ Months Contract Role with possible extension... ...most current clinical standards. The incumbent reviews escalated cases electronically using Medical...Remote workContract workPrivate practice
- ...Medical Director Utilization Management (Payer Side Experience Required)- (Remote) Duration: 30 Weeks with possible extension Location: Pittsburgh, PA Schedule: Monday Friday... ...responsible for conducting medical necessity reviews, appeals, and escalated case evaluations...Remote workFull timeContract workPart timePrivate practiceMonday to FridayFlexible hours
$248.5k - $373k
...5838 Job category: Medical & Clinical Operations... ...physician to join our Utilization Management team. Optum... ...live. The Medical Director for Utilization Management... ...flexibility to work remotely * from anywhere within... ...Participates in case review and medical necessity...Remote workMinimum wageFull timeWork experience placementWork at officeLocal areaWork from home- ...and benefits, including medical, dental, vision, long-... ...-life balance. ~ Remote setting ROLE DESCRIPTION... ...This individual will utilize clinical knowledge and... ...treatment or inpatient confinement. This individual... ...to a second level reviewer. This individual interfaces...Remote workTemporary workWork at officeWork from homeMonday to FridayFlexible hours
$240k - $250k
...Medical Director Utilization Management We are looking for physicians who have expertise in Internal... ...medical appropriateness of services by reviewing clinical information and applying... ...backgrounds and perspectives. This is a remote-first role that may require travel to...Remote workFlexible hours- ...Health is seeking a Full-Time Utilization Management Physician Reviewer to ensure accurate coverage determinations for inpatient and outpatient services.... .... Candidates must have a medical degree, at least one year... ...US. This position offers remote work options and competitive...Remote workFull time
- ...great opportunity for a local remote position. Schedule PRN... ...commercial, behavioral health, inpatient, etc). Requirements: ~2... ...patients. ~2 years of utilization review (UR) experience reviewing hospital admissions for medical necessity. ~ Must live within...Remote workReliefLocal areaWork from homeMonday to FridayFlexible hoursShift work
- ...Plan Solutions is seeking an Utilization Management Nurse to perform medical necessity and benefit reviews remotely. The role requires current... ...with experience in inpatient/outpatient reviews. The successful... ...determinations for medical director oversight, ensuring regulatory...Remote work
- ...substance abuse case management through utilization reviews and care coordination. While not a... ...care at the right time. This is a fully remote position with a Monday-Friday schedule... ...care Coordinate transitions between inpatient and outpatient settings Collaborate...Remote workMonday to Friday
$248.5k - $373k
...Billing Validation (SSBV) Medical Director to join our Clinical... ...conducting facility inpatient payment integrity... ...-functional clinical reviews of nurses and do not... ...flexibility to work remotely * from anywhere within... ...InterQual or MCG) in utilization review or payment integrity...Remote workMinimum wageFull timeWork experience placementLocal area- ...Management Location: 100% Remote Schedule: M-F 9:00am... ...Works with the Utilization Management team primarily responsible for inpatient medical necessity/utilization review and other utilization management... ...cases to Client medical directors regularly, as necessary....Remote workContract work
$110 - $130 per hour
...Title: Medical Director Location: Remote Duration: 6 Months with possible extension... ...to support the Medicare Inpatient Pod. This role partners... ...Medical Director to lead utilization management, quality... ...inpatient and post-acute care reviews. You’ll drive medical necessity...Remote work$223.8k - $313.1k
...caring community The Medical Director relies on... ...Guidance on following and reviewing Home Health, SNF, DME... ...Intermediate to advanced skills utilizing Microsoft Office and... ...Experience in an inpatient and/or outpatient... ...Information Workstyle: Remote work at home Hours...Remote workFull timeTemporary workApprenticeshipWork at officeLocal areaWork from homeHome officeMonday to Friday- Gainwell Technologies LLC is looking for a Utilization Review Nurse to work remotely in Maine. You will conduct reviews for medical necessity and appropriateness of services,... ...Maine RN license and at least 3 years of inpatient clinical experience. Additional benefits include...Remote jobFlexible hours
- ...Patient Chart Reviewer In this position you will be reviewing patient charts to determine... ...surgical cases should be boarded as inpatient instead of outpatient. You will also... ...clinical experience preferred. Previous utilization management or case management...Remote jobFull timeMonday to Friday
- ...REMOTE PHYSICIAN REVIEWER REMOTE MEDICAL DIRECTOR The Medical Director's work includes reviewing of all... ...compliant medical necessity reviews for inpatient services Maintain... ...evolving workflows, tools, and utilization management practices Required...Remote work
- ...The Medical Director is a key clinical leader responsible for... ...coding accuracy across inpatient care. This role... ...Analytics & Strategy: Review performance metrics, identify... ...outcomes. Innovation: Utilize advanced technology... ...Paid time off Location Remote with limited travel to...Remote workWork at office
$223.8k - $313.1k
Medical Director physician job in Louisiana : Become a part... ...guidelines based on utilization patterns and client demographics... ...experience in an inpatient environment and/or... ...a medical management review organization, such as... ...: While this is a remote position, occasional...Remote workTemporary workApprenticeshipWork at officeWork from homeHome officeWork visa- ...Centre (RCC), the TOP Medical Director – LAC RCC is... ...of all TRICARE Prime Remote regional clinical operations... ...and all CONUS‑based inpatient management for TOP beneficiaries... ...), case audit and review service recovery,... ...quality meetings, utilization review escalations. Provide...Remote workFull timeContract workWork experience placementLocumWork at officeWorldwideRelocationOverseasMonday to FridayDay shiftAfternoon shiftWeekday work
- ...QM objectives Responsibilities: • Reviews documentation and evaluates Potential Quality... ...of experience as an RN • 1+ years of inpatient hospital experience • Registered Nurse... ...• Must have prior authorization utilization experience • Able to work in multiple...Remote work
$212k
...benefits packaging including Medical, Dental & Vision... ...Committees, Utilization Management Committees,... ...management, complex case reviews and clinical rounds.... ...residency, including both inpatient and outpatient mental... ...Harrisburg Workplace Remote Employment Type Full...Remote workFull timeLocal areaFlexible hours$275k - $325k
...growing, TOI is changing oncology for the better. Utilization Management Medical Director Oncology Work Location: REMOTE (work from home) California Nevada Arizona... ...on direct utilization management for case review and clinical decision making. In this collaborative...Remote workWork from home- ...Description: Manager of Clinical Utilization Management - Denial... ...Position Type: Hybrid (85% remote, 15% onsite in Northridge, CA... ...managing daily tasks, performance reviews, and any necessary... ...collaboration with physician reviewers, medical directors, and other relevant...Remote workPermanent employmentFull timeTemporary workFlexible hours
- Currently seeking a Utilization Management RN .... ...below: Position is remote - candidate must... ...three (3) years of Medical/Surgical experience... ...medical record review to determine medical... ...medical necessity for inpatient admissions,... ...criteria to the Medical Director for further...Remote workImmediate startDay shift
- Humana seeks a Utilization Management Behavioral Health Professional to support coordination... ...determine appropriate care and working remotely with a flexible schedule. The position... ...and experience in managed care, inpatient care, or similar settings. #J-18808-Ljbffr...Remote jobFlexible hours
- ...Medical Director Of Case Management And Utilization Review Location: Miramar, Florida At Memorial, we are dedicated to improving the health, well-being and, most of all, quality of life for the people entrusted to our care. An unwavering commitment to our service...Work experience placementShift work
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Remote Inpatient Utilization Review Medical Director. Be the first to apply!
- senior clinical data manager Richmond, VA
- senior director clinical operations Richmond, VA
- regional director of clinical operations Richmond, VA
- medical director Richmond, VA
- remote medical coding supervisor Richmond, VA
- health services director Richmond, VA
- senior director clinical development Richmond, VA
- occupational health manager Richmond, VA
- director behavioral health Richmond, VA
- behavioral health supervisor Richmond, VA

