Remote Health Plan Utilization Management Director
$190 per hourMedix™
- Remote job
Medix is seeking a Board-Certified Utilization Management Medical Director for a fully remote role spanning Pennsylvania, New York, or West Virginia. You will perform medical necessity determinations and lead peer-to-peer reviews with treating providers. This full-time position offers core hours 8:00 AM–5:00 PM ET and pay at $190–$210 per hour, with company-provided equipment. Active medical licensure in PA, NY, or WV is required or obtainable before start. #J-18808-Ljbffr Medix™
$160k
...Integra’s Utilization Management (UM) division is looking for an experienced... ...role in delivering UM to our health plan clients, growing our UM... ...Review Work with Chief Medical Director to establish, adopt, and... ...development opportunities Remote Opportunities We are actively...Remote workHealth InsuranceTemporary workLocal areaFlexible hours$112.7k - $193.2k
...one of the nation's leading health care organizations and build... ...operational oversight for all Utilization Management functions, including... ...utilization support, delegated health plan requirements, regulatory... ...non‑clinical operations. The Director is accountable for ensuring...Remote workHealth InsuranceMinimum wageFull timeContract workWork experience placementLocal area- ## Associate Dental Director, Government Programs... ...Dental Consulting and Utilization ManagementApply:... ...both in-office and remote.: Okemos, MI: Detroit... ...Consulting and Utilization Management**Number of Positions... ...to improve oral health through benefit plans, advocacy and...Remote workHealth InsuranceFull timeWork at office
$121.5k - $224.9k
About This Role The Director of Utilization Management directs the utilization management team... ...500 - $224,900/year Location: Remote, FL Brand/Division: Centene Schedule... ...Benefits Competitive pay Health insurance 401K and stock purchase plans Tuition reimbursement Paid time...Remote workHealth InsuranceFull timeWork at officeFlexible hours- ...records and information management, digital... ...strategic Senior Director, North America Benefits... ...administer cost-effective health, welfare,... ...operational budget, utilizing financial modeling... ....Lead & Empower Remote Teams: Provide direct... ...sustainable plan designs.Commanding...Remote workHealth InsuranceFull timeImmediate startFlexible hours
$220.04k - $302.54k
...Officer, the Senior Director of Healthcare... ...Spending Account - Health Care/ChildcareCalPERS... ...trend impacts, utilization shifts as well as... ...decision-makingLead Team Management & Department... ...to ensure Health Plan operations and department... ...Monday & Friday - remote, Tuesday -...Remote workHealth InsuranceTemporary workMonday to FridayShift work$210.39k - $308.46k
...Days) Overview: The Director, Actuarial –... ...Pricing & Financial Management Lead end-to-end... ...Cost of care and utilization management strategies... ...to enterprise planning, budgeting, and long... .... Sentara Health is an equal... ...are available as remote work, Sentara Health...Remote workHealth InsuranceFull timeTemporary workShift work$196k - $215k
...We're seeking a Director, Solutions Architecture to... ...Architects within Cohere Health's PaaS Delivery... ...like claims systems and utilization management infrastructure. You'... ...delivery. This is a remote-first role that may... ...in cross-functional planning and with client executive...Remote workHealth InsuranceFlexible hours$194.1k - $320.25k
...in this role: The Director, Solution Consulting will... ...and effective utilization of skill sets within the assigned region Manage day-to-day activities... ...location. We also offer health plans, including flexible spending... ...personas (flexible, remote, or required in office...Remote workHealth InsuranceWork at officeImmediate startFlexible hours$179k - $298k
...NoneWhat You Will Do:The Director, Managed Care Advisory will... ...efficiency, financial health, and patient care quality... ...careHealth Plan or Payer leadershipHealth... ...to compel them to act. Utilize proper sales operations... ...US - VA, McLean; US - Remote (Any location)Type: Full...Remote workHealth InsuranceFull timeContract workWork experience placementImmediate startFlexible hours$212.1k - $342.65k
...intelligent agreement management, Docusign... ...results-driven Senior Director of Global Account... ...with account planning, territory priorities... ...briefing utilization, customer satisfaction... ...between in-office and remote work. Access to... ...placementFull Health Benefits Plans: options...Remote workHealth InsurancePermanent employmentFull timeContract workWork at officeLocal area2 days per week- ...application process. Director, Total Rewards Management Coeur d'Alene, ID,... ...— self-funded health and welfare, a closed... ...defined benefit pension plan, 401(k) plans, and... ...competitiveness, cost trend, utilization, pay equity,... ...experience, including remote-site and northern...Remote workHealth InsuranceHourly payContract workTemporary work
- ...Centene Corp. seeks a Director of Utilization Management remote in Florida to lead the UM team, ensuring policy alignment, timely reviews, and compliant practices. The role demands expert LTC UM knowledge, Medicaid managed care experience, and strong leadership in a matrix...Remote work
$138.5k - $173.1k
...location for this role is remote. About Envestnet... ...the future of wealth management byhelpingadvisors meet... ...including wellbeing, health, retirement, and statutory... ...benefit harmonization, plan redesigns, vendor... ...outcomes. Analyzes benefits utilization, employee feedback,...Remote workHealth InsuranceLocal area$84k - $114k
...team. We are seeking a Director of Onboarding &... ...enablement curriculum and ramp plan for Customer Success Managers, Account Managers and cross... ...decisions with broader portfolio health and revenue-impacting... ...participation, content utilization, and early adoption....Remote workHealth InsuranceTemporary workVisa sponsorshipFlexible hours$160k - $180k
...Consulting; Infrastructure; Utility Services; Environmental Health Sciences; Buildings & Program Management; and Geospatial Technology. With... ...abroad, NV5 helps clients plan, design, build, test, certify... ...lifecycle material sourcing, remote logistics, and final delivery...Remote workHealth InsuranceContract workSeasonal workWork at officeLocal area- ...Centene is seeking a Director of Utilization Management in a remote-capable role based in Florida. You will lead the utilization management team to ensure policies are applied for optimal member outcomes, with emphasis on Long-Term Care UM and NCQA standards. The role...Remote workFlexible hours
$134.6k - $249k
...implement a pharmacy benefit management program. Aid the Vice... ...quality, pharmacy utilization management and... ...Key Details: This is a remote Indiana Pharmacist opportunity... ...5:00 PM Eastern. The Director, Pharmacy serves as... ...for the Indiana health plan, responsible for...Remote workHealth InsuranceContract workLive inWork at officeMonday to FridayFlexible hours- ...DescriptionProSidian is a Management and Operations... ...Advisory Services Director | Independent... ...Overtime Pay Basis Remote (within USA - W/ On... ...Gas/Power, And Utilities) Sector Experience... ...Highlights - Your health and well-being are... ...medical and dental plans, with the contributions...Remote workHealth InsuranceFull timeContract workTemporary workFor contractorsWork at officeFlexible hours
$125k - $145k
...the channel space (Director, Channel... ...responsible for developing, managing, and growing... ...portfolios. * This is a remote position that... ...evolving behavioral health offerings. Identify... ..., referrals, and utilization of Talkspace... ..., brokers, health plans, employers, or other...Remote workHealth InsuranceFull timeContract workLocal areaFlexible hours$100k - $145k
...finance, own and operate utility-scale and distributed... ...at either the Senior Manager or Associate Director level, depending on... ...documentation.Review plans for management of... ...We are also open to remote candidates. Compensation... ..., dental, vision and health insuranceWellness stipend...Remote workHealth InsuranceWork at officeLocal area3 days per week- ...that serves member health with excellence... ...contribute to strategic planning for the... ...and the Executive Directors who oversee these... ...Leadership & Operational Management ~ Cultivates and... ...committees/coalitions. Utilize computer and... ...505 Building or a remote work location:...Remote workHealth InsuranceTemporary workWork at officeLocal areaFlexible hoursWeekend workAfternoon shift
- ...that serves member health with excellence... ...contribute to strategic planning for the... ...and the Executive Directors who oversee these... ...Leadership & Operational Management ~ Cultivates and... ...committees/coalitions. Utilize computer and... ...505 Building or a remote work location:...Remote workHealth InsuranceTemporary workWork at officeLocal areaFlexible hoursWeekend workAfternoon shift
$111.84k - $146.79k
...Growth.As Associate Brand Manager, you’ll help shape how... ...integrated marketing plans to life across the consumer... ...in-store displays and utilize activation options such... ...work environment: Remote work available once a week... ...such as subsidized health care plans, maternity/paternity...Remote workHealth InsuranceFull timeTemporary workWork at officeWorldwideRelocationFlexible hours1 day per week$166.5k - $291.4k
...Assistant. As a product manager for Tool Studio, you’ll... ...complex problems by utilizing your technical depth and... ...concepts, operations, and plans. You are someone deeply... .... We also offer health plans, including flexible... ...Work personas (flexible, remote, or required in office)...Remote workHealth InsuranceWork at officeWork from homeFlexible hours- ...Director Transformers, T&D Hardware & Utility Remote, Nationwide A fast-moving infrastructure supply organization... ...procurement teams, estimators, project managers, and executive stakeholders to... ..., submittals, and material planning. Relationships across utilities...Remote workFor contractors
- ...and their families: health and financial... ...The AssociateState Director-Advocacy develops... ...within business unit plans and the overall... ...Collaborates with management to identify opportunities... ...development. Utilizes direct action... ...Mondays and Fridays as remote workdays, except...Remote workHealth InsuranceWork at officeLocal areaHome officeVisa sponsorshipWork visaMonday to Friday
$133.7k - $247.4k
...with physical/medical health needs and/or behavioral... ...within long-term care management to improve member and/... ...diagnoses, treatment plans and goals, and identify... ...Health Plan: Resource Utilization Group (RUG)... ...approach to work with remote, hybrid, field or office...Remote workHealth InsuranceFull timeContract workPart timeWork at officeFlexible hours$203k - $223k
...re seeking a Senior Director, Solution Owner to join Cohere Health's PaaS Delivery... ...Technical Program Managers to set the standard... ...leadership. This is a remote-first role that may... ...— claims systems, utilization management/prior... ..., payer, or health plan, specifically around...Remote workHealth InsuranceFull timeFlexible hours- ...continuous improvement of Care Management programs designed to ensure... ...engagement, clinical outcomes, health equity, and healthcare... ...care coordination programs. Utilize population-based analytics, predictive... ...with HEDIS improvement plans, NCQA standards, quality improvement...Health InsuranceFull timeMonday to Friday
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