Remote Medical Director, Utilization & Quality Leadership
Magellan Health Services
- Remote job
Magellan Health is seeking a Medical Director (BH, UM) for a remote position servicing Hawaii. The role requires Hawaii licensure and supports clinical leadership across Medicaid, Medicare, and Commercial lines. It involves physician oversight of an interdisciplinary team, utilization management, quality improvement, and collaboration with corporate clinical teams. The position offers full-time or part-time options with a competitive base salary and comprehensive benefits, plus potential #J-18808-Ljbffr Magellan Health
- ...Medical Review Institute of America is seeking a Medical Director (Physician Advisor) to lead clinical utilization management, peer review activities, and clinical quality management. This remote role reports to MRIoA leadership and offers a comprehensive compensation...Remote work
- ...Centene Corporation seeks a Psychiatrist to serve as Behavioral Health Medical Director in a fully remote capacity across the United States. You will guide medical management, utilization, quality improvement, and credentialing, collaborating with multidisciplinary teams...Remote work
- ...VetJobs seeks a Medical Director (BH, UM) based remotely with Hawaii licensure to lead clinical operations for... ...include developing utilization management strategies, ensuring medically... ...necessary care, and driving clinical quality and policy adherence throughout program...Remote work
- CVS Health is seeking a Medical Director to lead medical management for Medicaid populations... ...Health of Louisiana. In this remote role, you will oversee utilization management, prior authorizations,... ...teams to improve quality and outcomes. The position requires...Remote job
- ...Board-certified psychiatrist to lead and oversee utilization management, focusing on high-risk cases, medical necessity decisions, and behavioral health care management... ...to policy development. The role supports clinical quality improvement, QA investigations, and appeals, with...Remote jobWeekend work
- ...DESCRIPTION Job Summary Provides medical oversight and expertise in... ...strategy to provide quality and cost-effective member care... ...members. • Supports plan utilization management program and accompanying... ...management. • Assumes leadership relative to knowledge,...Work at officeLocal area
- ...Samaritan Health Services in Corvallis, Oregon seeks an experienced medical leader to provide medical direction across Utilization Management. The role partners with hospital leadership to align policy, quality improvement, and patient care standards, while supporting...
- ...Unlimited, LLC is seeking a Medical Director, Utilization Management to lead... ...evidence-based criteria. Remote opportunity in New Jersey... ...certified physician with strong leadership in managed care,... ...for regulatory compliance, quality initiatives, and collaboration...Remote work
- ...seeking an enthusiastic and highly skilled Medical Director to join our growing team. To qualify... .... This pivotal role will oversee utilization reviews, prior authorizations, and... ...fast-paced startup environment. This remote leadership position requires strong...Remote work
- ...Oversee medical necessity reviews for home health, acute, post-acute, and outpatient... ...care and appropriate resource utilization. Apply CMS regulations, coverage... ...MCG criteria, and medical policies in a fully remote, part-time physician leadership role. #J-18808-Ljbffr...Remote workPart time
$240k
...driven, tech-enabled utilization management company offering... ...An award-winning remote work environment Position Summary Our Medical Director, also known as a... ...standard. Maintain annual quality score per company... ...as requested by MRIoA leadership. Complete all client...Remote workFull timeTemporary workWork at officeWork from homeShift workRotating shiftWeekend work- ...Physician Pivot is seeking a Medical Director to oversee DME utilization and clinical policy across multiple states. The role is primarily virtual, with... ...and regulatory requirements. The position emphasizes leadership in utilization review, clinical governance, and...Remote work
- ...Staffing is urgently seeking a Medical Director of Utilization Management to join a... ...compliance. Location: 100% Remote Schedule: Full-Time, Monday... ...management or medical leadership role within a managed care... ...by the American Board of Quality Assurance and Utilization...Remote workFull timeMonday to Friday
$332.3k - $377.4k
...seeking an experienced Medical Director with expertise in Utilization Management (UM), Care Management... ...Strategic Leadership: Develop and implement... ...report on cost savings and quality outcomes across areas of... ...expectations. If applying for a remote or hybrid role, this...Remote workHourly payLocal areaRelocation package$320k - $340k
...partner is looking for a Lead Medical Director, Utilization Management based in the... ...is a senior physician leadership opportunity focused on ensuring... ...with clinical, quality, compliance, pharmacy, and... ...access, and outcomes. This remote-first role combines hands-...Remote workFull timeWork at officeFlexible hours$320k - $340k
...to providing high-quality, affordable, and... ...need it most. The Utilization Management team... ..., evidence-based medical necessity decisions... ...The Lead Medical Director, Utilization... ...least 5 years of leadership experience directly... ...Additionally, we embrace a remote-first culture...Remote workFull timeWork experience placementWork at officeLocal areaFlexible hours- SCAN is seeking an Utilization Management Physician Medical Director to lead medical necessity determinations, prior authorizations, and reviews. This physician... ...making while collaborating with RN reviewers and UM leadership.The role requires an active MD/DO license and board...Remote job
- ...Centene Corp. is seeking a Remote Medical Director for Inpatient Medicare to guide medical management, quality initiatives and credentialing for the unit. You will lead utilization management, cost containment and expert review of complex cases to ensure timely, compliant...Remote workFlexible hours
- ...Gotham Enterprises Ltd is seeking a Medical Director to oversee clinical operations,... ...needs. This full-time remote position requires an experienced physician with strong leadership, regulatory knowledge, and a track record in quality improvement, patient safety, and...Remote workFull time
$140 - $145 per hour
...Solutions Group is recruiting a Medical Director specializing in Surgery,... ...provide strategic clinical leadership and manage both... ...committing 75% of time to TriWest's remote operations while maintaining... ...leadership roles, particularly in Utilization Management and appeals....Remote jobHourly payLocumPrivate practice- ...Centene Corp. seeks a Medical Director (PRN) to assist the CMO in directing physician utilization management for the health plan units.... ...with a focus on improving care quality and cost-effectiveness. The position involves medical leadership for utilization management activities...Remote workPart timeRelief
- ...Gotham Enterprises Ltd. is seeking a Medical Director to oversee clinical operations and align care standards... ...identifying areas for clinical improvement while balancing medical leadership with the organization’s operational needs in a remote Denver setting. #J-18808-Ljbffr...Remote work
- Medical Director, Utilization Management Location: New Jersey - Fully Remote Work Arrangement: Remote Job Type: Contract Contract Length... ...activities. Contribute to quality improvement initiatives involving... ...physician review, or medical leadership within a managed care or...Remote workHourly payContract workImmediate start
- ...UnitedHealth Group, through Optum Serve, seeks a Medical Director to oversee clinical quality across community care networks serving Veterans. You will lead medical leadership initiatives, coordinate with internal and external partners, and guide cost-effective, evidence...Remote work
- ...A diversified healthcare organization is seeking a clinical professional to lead medical management services. Responsibilities include overseeing utilization review, coordinating quality improvement initiatives, and collaborating with various clinical teams to ensure optimal...Remote workFlexible hours
- ...Physiatrist (PM&R) to serve as Medical Director, providing clinical oversight and leadership across our post-acute and long-term... ...care network. This role blends remote medical direction with periodic... ...physiatric care standards, ensure documentation quality and #J-18808-Ljbffr...Remote work
- ...HealthCare Partners, MSO seeks a Medical Director - UM Reviewer to assure appropriate and optimized care for members. The role centers on... ...appeals determinations, serving as a clinical expert for teams in utilization management and program development. Requirements include...
- ...Kernersville Veterinary Hospital is seeking a full-time Medical Director to lead our caring veterinary team in Kernersville,... ..., dentistry, surgery, and modern imaging modalities. Leadership, mentorship, and high-quality medicine are at the core of this role. #J-18808-...Full time
- ...Job Description\n Utilization Management Medical Director Oncology\n\n\n \n \n Work Location: REMOTE (work from home)\n \n \n The Medical Director role provides clinical expertise in assessing the medical necessity, appropriateness, and efficiency of oncology care with...Remote workWork from home
- ...Leads and directs team responsible for quality management and quality performance improvement... .... • Represents the senior leadership team at internal Molina national and regional... ...process reviews, and gap analyses. • Utilizes proven quality improvement methods, such...Remote workFull timeContract workFor subcontractorWork at officeNight shift
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