Remote Medical Director, Utilization Management
Chicago Derm
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, and help shape medical necessity decisions within a managed care framework. Join Optum and contribute to improving care for a large Texas patient population while collaborating with a multidisciplinary team committed to high-quality, cost-effective care and continuous professional growth. #J-18808-Ljbffr
Vacancy posted 8 hours ago
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$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$248.5k - $373k
...$373,000/yearJob Area: Medical & Clinical OperationsCompany... ...experience, and manage health care costs.The Medical Director provides physician support... ...clinical knowledge in various utilization management activities... ...the flexibility to work remotely * from anywhere within the...Remote workMinimum wageFull timeWork experience placementLocal area- ...Judi Health is seeking a Medical Director for the Clinical Enterprise team to oversee utilization management, prior authorizations, and appeals for commercial and government programs. The role reports to the Lead Medical Director and collaborates with pharmacists and prescribers...Remote work
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Dallas, TX8 hours ago - ...WellMed, part of Optum, seeks an Internal/Family Medicine physician to lead utilization management. You will determine medical necessity, review cases, and drive UM protocol improvements within a collaborative, patient‑focused team across Texas markets. The role emphasizes...Remote work
Colorado
San Antonio, TX8 hours ago - ...Job Description Job Description Medical Director of Prior Authorization and Utilization Management - Palm Springs, California: Please consider becoming part... ...This position can be structured as a hybrid remote role - you would not necessarily be required to reside...Remote workPermanent employmentTemporary workRelocation package
Curative
Palm Springs, CAmore than 2 months ago $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$240.12k - $315.16k
Hi, we're Oscar. We're hiring an Associate Medical Director to join our Utilization Management Team. Oscar is the first health insurance company built around... ...Senior Medical Director.Work Location: This is a remote position, open to candidates holding an active medical...Remote workFull timeImmediate startWork from homeHome office- ...UnitedHealth Group, through UnitedHealthcare, seeks a Medical Director of Clinical AI Innovation and Performance. This senior physician... ...AI model training, testing, and surveillance for utilization management criteria, leveraging InterQual and custom content. You...Remote job
$248.5k - $373k
...Medical Director For Utilization ManagementWellMed, part of the Optum family of businesses, is seeking an... ...medicine physician to join our Utilization Management team. Optum is a clinician-led care... ...'ll enjoy the flexibility to work remotely from anywhere within the U.S. as you...Remote workMinimum wageFull timeWork experience placementWork at officeLocal areaWork from homeUnitedHealthcare At Home
Jacksonville, FL4 days ago$248.5k - $373k
...Medical Director Optum is a global organization that delivers care, aided... ...seamless experience, and manage health care costs. The Medical... ...knowledge in various utilization management activities with a... ...enjoy the flexibility to work remotely from anywhere within the U.S...Remote jobMinimum wageFull timeWork experience placementLocal area- 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 job
- ...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 job
- ...Health is seeking a Clinical Manager, Care Management to provide... ...of professionals involved in utilization management. This role... ...compliance while collaborating with Medical Directors and internal leaders. The... ...The position offers a fully remote environment with comprehensive...Remote job
- Luminare Health is seeking a Senior Manager, Clinical Review to lead the daily operations... ...Healthcare Management, overseeing Utilization Management and Claims Medical Management, and supporting the Utilization Review Program. Remote position; candidates must reside in...Remote job
- UnitedHealth Group is seeking a senior leader to oversee the Utilization Management program for higher levels of care in behavioral health. The... ...with a focus on patient outcomes and regulatory compliance. Remote work from anywhere in the U.S. is supported. #J-18808-Ljbffr...Remote job
- ...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
Sacbar
San Antonio, TX9 hours ago - ...Beacon Hill is seeking a Medical Director (MD/DO) for Raleigh, North Carolina, with a strong focus on physical health utilization management and clinical leadership. The role collaborates... ...functions while accommodating primarily remote work with a North #J-18808-Ljbffr...Remote work
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Raleigh, NC1 day ago - ...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, and help shape medical necessity decisions within a managed care framework...Remote work
Chicago Derm
San Antonio, TX8 hours ago - 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
$242.3k - $315k
...The Utilization Management (UM) team is made up of experienced physicians and... ...ensure Clover members receive medically appropriate, evidence-based... .... As the Medical Director, Utilization Management, you... ...Additionally, we embrace a remote-first culture that supports...Remote workFull timeWork experience placementWork at officeLocal areaFlexible hours$386.5k
...579,500/yearJob Area: Medical & Clinical OperationsCompany... ...UHC Nation Medical Director Clinical Program... ...Clinical Evidence Group and manage the CPR team of 5-7... ...the flexibility to work remotely * from anywhere within... ...medical policies, utilization management processes,...Remote workMinimum wageFull timeWork experience placementLocal area$248.5k - $373k
....00 - $373,000.00Job Area: Medical & Clinical OperationsCompany... ...together.The Medical Director for the Oncogenetic Program... ...leadership and oversight for utilization management related to advanced molecular... ...enjoy the flexibility to work remotely * from anywhere within the...Remote workMinimum wageWork experience placementLocal area- ...Medical DirectorCurative is seeking an enthusiastic... ...highly skilled Medical Director to join our growing team... ...and performing utilization reviews, prior authorizations... .... This is a remote position requiring a "... ...optimize utilization management processes and improve...Remote workFull time
CURAtive
Austin, TX4 days ago - ...opportunity for a Behavioral Health Medical Director supporting the TriCare/... ...of Veterans Affairs. This remote-based civilian position is... ...experience.3+ years of experience in managed care environments. Preferred... ...domains including Utilization Management, Case Management,...Remote workWeekday work
Spectrum Healthcare Resources
Sloan, NV9 hours ago - ...Job Title: Medical Director Location: Remote Duration: 6 Months CTH Job Description: This job, as part of a physician team, ensures that utilization management responsibilities are performed in accordance with the highest and most current clinical...Remote workPrivate practice
eTeam
United States4 days ago $160 - $170 per hour
...Medical Director Employment type: Full time Worksite flexibility: Remote Who We Are CAI is a global services firm with over 9,000 associates worldwide... ...As the Medical Director, you will ensure utilization management responsibilities are performed in accordance...Remote workHourly payFull timeApprenticeshipPrivate practiceWork at officeLocal areaWorldwideCAI
United States4 days ago$227.6k
...SUMMARY This job, as part of a physician team, ensures that utilization management responsibilities are performed in accordance with the... ...incumbent reviews escalated cases electronically and using Medical Policy criteria sets to evaluate the medical necessity and...Remote workFor contractorsPrivate practiceWork at officeLocal areaHighmark Health
United States4 days ago- ...Optum division seeks an Inpatient Care Management Medical Director to oversee acute level of care reviews... ...with nurses and staff to manage inpatient utilization at hospital, market, or national levels. The position offers remote work from anywhere in Florida,...Remote job
$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- ...AI innovation and performance within Utilization Management. You will drive interpretation of InterQual... ...-based enhancements, and partner with Medical Policy and data science teams to... ...effective coverage decisions. This remote role offers nationwide scope within the...Remote work
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