Remote Medical Director: Utilization & Coverage Strategy
Texas Health Institute
- Remote job
Optum is seeking a Medical Director to provide physician support for Enterprise Clinical Services, focusing on pre-service benefit determinations and medical necessity reviews. The role collaborates with leadership to maintain clinical and operational processes, ensuring high-quality, cost-effective care for members. The position offers remote work within the United States, with responsibilities spanning clinical review, policy interpretation, and cross-functional collaboration with providers #J-18808-Ljbffr Texas Health Institute
- ...Group in Minnesota seeks a Medical Director to provide physician support... ...Services and oversee clinical coverage determinations and medical... ...high-quality care, advances utilization management, and communicates... ...and non-network physicians. Remote work from anywhere in the U....Remote job
- Optum is hiring a Medical Director to provide physician support for Enterprise Clinical Services and lead clinical coverage determinations. You will collaborate with leadership to maintain... ...and participation in clinical rounds. Remote work is available from anywhere in the...Remote job
- Optum is seeking a Medical Director to provide physician support for Enterprise Clinical Services, focusing on pre-service benefit... ...with providers, and participate in holiday and call coverage. The role supports remote work from anywhere in the U.S. #J-18808-Ljbffr...Remote job
- ...United States invites applications for a Medical Director who will provide physician support to... ...Clinical Services and oversee clinical coverage determinations. You will collaborate with... ...toward optimal care. The role offers remote work from anywhere in the U.S., with participation...Remote job
- UnitedHealth Group is seeking a Medical Director to provide physician support for Enterprise Clinical Services, focusing on clinical coverage reviews, quality improvement, and cost-effective care for members. This role collaborates with network and non-network providers...Remote job
- UnitedHealth Group is seeking a Medical Director to provide physician support for Enterprise Clinical Services, focusing on clinical coverage determinations and cost-effective care. You will collaborate with leadership to maintain medical policies and ensure quality outcomes...Remote job
- UnitedHealth Group is seeking a Medical Director to provide physician support to Enterprise Clinical Services and oversee clinical coverage reviews and medical necessity determinations... ...benefit language interpretation, with flex remote work across the U.S. This full-time...Remote jobFull timeFlexible hours
- ...and incentive compensation Coverage: Health, vision and dental... ...fortunate position of adding a Medical Director to our incredible team.... ...improved outcomes Performs utilization review and case management... ...protecting the sensitive data entrusted to us. #LI-HW1 #LI-Remote...Remote workPermanent employmentFull timeCasual work
$275k - $325k
...growing, TOI is changing oncology for the better. Utilization Management Medical Director OncologyWork Location: REMOTE (work from home)California Nevada Arizona... ...patients to clarify and discuss treatment options and coverage. Evaluate clinical and utilization data to...Remote workWork from home- ...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... ...premiums for you and 50% coverage for dependents on the base plan...Remote workFull timeFlexible hours
$248.5k - $373k
...373,000/yearJob Area: Medical & Clinical OperationsCompany... ...we deliver clinical coverage and medical claims... ...care costs.The Medical Director provides physician... ...knowledge in various utilization management activities... ...the flexibility to work remotely * from anywhere within...Remote workMinimum wageFull timeWork experience placementLocal area- ...Description Job Description Medical Director of Prior Authorization and Utilization Management - Palm Springs, California... ...can be structured as a hybrid remote role - you would not necessarily... ...bonus ~ Paid malpractice with tail coverage Requirements: MD or DO...Remote workPermanent employmentTemporary workRelocation package
- UnitedHealth Group seeks a Medical Director to lead clinical coverage reviews and benefit determinations within Enterprise Clinical Services... ...knowledge, communication, and remediation of utilization management. You can work remotely from anywhere in the United States, with...Remote job
- ...Description Job Description Medical Director of Prior Authorization and Utilization Management - Palm Springs, California... ...can be structured as a hybrid remote role - you would not necessarily... ...bonus ~ Paid malpractice with tail coverage Requirements: MD or DO...Remote workRelocation package
- ...Professional Job Description Title: Medical Director Utilization Management Job Type: 3 Months Contract Location: Remote - CA Shift: 8AM 5PM Mon Fri PST... ...make appropriate medical necessity and coverage determinations . Conduct and participate...Remote workContract workWork at officeShift work
$172.36k - $258.55k
Physician Advisor, Utilization Management (CA License Required... ...(CA License Required)remote type: Fully... ...Advisor works with Senior Medical Officers, Regional Medical... ...assistance to Quality Director. 10. Works with... ...necessary approvals of new strategies for utilization management...Remote job$248.5k - $373k
...Medical Director Optum is a global organization that delivers care,... ...expectations as we deliver clinical coverage and medical claims reviews.... ...knowledge in various utilization management activities with... ...the flexibility to work remotely from anywhere within the U....Remote jobMinimum wageFull timeWork experience placementLocal area$248.5k - $373k
...Medical Director Optum is a global organization that delivers care,... ...expectations as we deliver clinical coverage and medical claims reviews.... ...knowledge in various utilization management activities with... ...the flexibility to work remotely from anywhere within the U....Remote jobMinimum wageFull timeWork experience placementLocal area$150 per hour
The Utilization Review Medical Director is responsible for conducting clinical reviews of Durable Medical Equipment... ...and Additional Expectations: Remote role requiring consistent... ...Company-paid short term disability coverage (location restrictions may apply) ~...Remote workHourly payFull timeContract workTemporary workPart timeLocal area$209.6k - $313.38k
...Medical Director, Global Medical Strategy Otsuka is a leader and innovator in the therapeutic area, with a strong portfolio of development and marketed... ...medical, dental, vision, prescription drug coverage, company provided basic life, accidental death & dismemberment...Remote workTemporary workLocal areaFlexible hours- Title: Medical Director, Utilization Management (Commercial & MA) Start Date: 08/10/2026 End Date: 02/10... ...a possibility of an extension. Fully remote opportunity Looking for an immediate... ...criteria, Commercial medical policies, coverage guidelines, and member benefit plans....Remote workContract workWork at officeImmediate start
- Blue Cross and Blue Shield of Nebraska seeks a physician leader to direct medical management strategies, improve patient outcomes, and manage cost for the assigned region. The role oversees utilization review, prior authorizations, and collaboration with providers,...Remote job
- CareOregon, Inc. seeks a Medical Director to oversee benefit/utilization management, clinical and wellness programs for members. The role involves leadership of QA, case/disease/quality management, and collaboration with physicians to improve care and utilization outcomes...Remote jobWork from home
$230.6k - $384.4k
...Medical Director The job profile for this position is Medical Director... ...Director: Inpatient Utilization and Population Management... ...medical necessity reviews for coverage, case management, and claims... ...managed care products and strategies Ability to work within changing...Remote workLocal areaWork from home$270k - $310k
...Lucet Medical Director (Behavioral Health) At Lucet, we... ..., dental, and vision coverage 401(k) with competitive... ...reimbursement Remote work flexibility (role... ...behavioral health programs, utilization management activities... ...data and implement strategies that improve access,...Remote workWork from homeFlexible hours- ...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
- CorroHealth is seeking a Medical Director, Concurrent Review, to evaluate hospitalizations nationwide... ...provide expert recommendations. This remote position offers a predictable schedule and a path to expand knowledge in Utilization Review. Ideal candidates hold an MD/DO...Remote job
- Integra Partners is seeking a Utilization Review Medical Director to lead clinical reviews of DMEPOS requests within a high-volume UM environment. The... ...or PM&R, and experience in utilization management. Remote work during standard business hours is supported, with opportunities...Remote job
- Optum is seeking a Medical Director to provide physician support to Enterprise Clinical... ...and operational processes for coverage determinations and medical... ...network physicians and involvement in utilization management. The position offers remote work within the United States,...Remote job
- ...Medical Director ARC Group has an immediate opportunity... ...This position is 100% remote working eastern time... ...in developing Local Coverage Determinations (LCDs)... ...insurance industry, a utilization review firm, or another... ...Ability to develop strategies and processes to ensure...Remote workPermanent employmentFor contractorsWork experience placementLocal areaImmediate start
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