Remote Medical Director, Utilization & Coverage
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- Remote job
UnitedHealth Group is seeking a Medical Director to provide physician support for Enterprise Clinical Services, overseeing clinical coverage determinations and collaboration with network and non-network providers. The role focuses on evidence-based review, cost-effective care, and quality improvement while enabling remote work across the United States. Responsibilities include leading coverage reviews, documenting findings, and participating in clinical rounds. #J-18808-Ljbffr Careerwebsite
- ...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
- UnitedHealth Group seeks a Medical Director to provide physician support for Enterprise Clinical Services, focusing on pre-service... ...physicians, and participating in holiday and call coverage rotations. Remote work within the U.S. is allowed. #J-18808-Ljbffr Ascension...Remote job
- ...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
$275k - $325k
...for the better. For more information, visit Utilization Management Medical Director Oncology Work Location: REMOTE (work from home) California... ...to clarify and discuss treatment options and coverage. Evaluate clinical and utilization data to...Remote workWork from home- UnitedHealth Group's Optum is seeking a Medical Director to provide physician support... ...Services, guiding clinical coverage determinations and medical... ...and non-network providers, utilization management, and cost-effective care, with a remote work option nationwide. Requirements...Remote job
$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- 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
$213.1k - $383.58k
...care, care for the most medically and socially complex... ...serve. The Job The Utilization Management (UM) Physician Medical Director provides physician-level... ...use of National Coverage Determinations, Local Coverage... ...Work Mode - Mostly Remote: Employees who reside outside...Remote workFull timeFor contractorsWork at officeLocal areaRelocation- ...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
- 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
- ...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
- ...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
- ...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
- ...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
- ...UnitedHealth Group (Optum) is seeking a Medical Director to provide physician support to Enterprise Clinical Services, shaping clinical coverage determinations, quality improvement, and cost-effective care for members. You will collaborate with network and non-network...Remote work
$240k - $250k
...Medical Director Utilization ManagementWe are looking for physicians who have expertise in Internal Medicine including medical and surgical clinical... ...of different backgrounds and perspectives.This is a remote-first role that may require travel to Boston, MA for new hire...Remote workFlexible hours- CVS 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 the enterprise oncology initiatives with emphasis on prior authorization, peer-to-...Remote jobWork from home
$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- 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 care...Remote job
- UnitedHealth Group is seeking a Medical Director to provide physician support for Enterprise Clinical Services, focusing on clinical coverage determinations and evidence-based decision-making... ...cost effectiveness.The role allows remote work from anywhere in the United...Remote job
- WellMed, part of the Optum family, seeks a Medical Director for Utilization Management to support WellMed Medical Management, Inc. by making UM determinations... ..., and proposing program improvements. This role offers remote work from anywhere in the U.S. and integration with Optum...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
- 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
- UnitedHealth Group in the U.S. seeks a Medical Director to lead physician support and clinical coverage reviews within Enterprise Clinical Services. You will apply... ...deliver cost-effective, high-quality care. This remote role lets you work from anywhere in the country,...Remote job
$248.5k - $373k
...family medicine physician to join our Utilization Management team. Optum is a clinician-... ...the way clinicians work and live. The Medical Director for Utilization Management will support... ...You'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 home$248.5k - $373k
...family medicine physician to join our Utilization Management team. Optum is a clinician-... ...way clinicians work and live. The Medical Director for Utilization Management will support... ...Spanish) fluency *All employees working remotely will be required to adhere to...Remote workMinimum wageFull timeWork experience placementWork at officeLocal areaWork from home- 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... ...knowledge and MS Office proficiency. This is a remote, full-time position with comprehensive benefits...Remote jobFull time
- Integra Partners, a national DMEPOS network administrator, seeks a remote Utilization Review Medical Director. You will conduct clinical reviews of DMEPOS requests, ensure determinations meet Medicare/Medicaid guidelines, and maintain high-quality documentation in a fast...Remote jobFull time
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