Remote Medical Director: Utilization & Quality Leader
Centene Corporation
- Remote job
Centene Corporation is seeking a clinical professional to lead Medical Management/Health Services for 28 million members. The role drives utilization management, quality improvement, and medical review across a national organization with flexible work options. The candidate will collaborate with care management teams, providers, and committees, supporting regulatory compliance and accreditation standards while shaping physician education and network development. #J-18808-Ljbffr Centene Corporation
- Centene Corporation seeks a physician leader to direct medical management, quality improvement and credentialing for the business unit. Lead utilization management, medical reviews, and performance-improvement initiatives to enhance cost-effectiveness and care quality....Remote jobWeekend work
- 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
- 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 jobFlexible hours
- ...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
- 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
$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- SCAN is seeking an Utilization Management Physician Medical Director to lead medical necessity determinations, prior authorizations, and reviews. This physician will influence policy, provide clinical mentorship, and ensure compliant, evidence-based decision-making while...Remote job
- WellMed, part of the Optum family, seeks a Medical Director for Utilization Management to lead and optimize our... ...while fostering a collaborative, remote-friendly work environment across the... ...physicians and staff to ensure compliant, high-quality patient care. #J-18808-Ljbffr ISHERemote job
- Humana seeks a Medical Director to apply clinical expertise in reviewing complex outpatient... ...management professionals to ensure quality, compliant utilization management. The role emphasizes... ...professional development within a structured, remote-friendly environment. #J-18808-...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
- 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
- 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
- UnitedHealth Group in Minnesota seeks a Medical Director to provide physician support for... ...to ensure cost-effective, high-quality care, advances utilization management, and communicates policies... ...network and non-network physicians. Remote work from anywhere in the U.S. is...Remote job
- ...Oncology Institute is seeking a Medical Director to provide clinical expertise in... ...of oncology care with a focus on utilization management for case reviews and... ...clinical teams, and operational leaders to support evidence-based, high-quality, cost-effective care delivery across...Remote job
- ...Health is seeking a Part-Time Medical Director to provide physician... ...for medical management and utilization review programs. You will align... ...organizational standards in a fully remote role based in the United... ...necessity determinations, and drive quality improvement across programs,...Remote jobPart time
- ...Services Unlimited, LLC is seeking a Medical Director, Utilization Management to lead clinical utilization... ..., and evidence-based criteria. Remote opportunity in New Jersey for a board... ...responsible for regulatory compliance, quality initiatives, and collaboration with care...Remote job
- ...A leading virtual health company is seeking a Director of Clinical Quality to oversee its clinical quality functions in the virtual... ..., including expertise in quality improvement and utilization management. This is a remote position with a focus on maintaining high...Remote work
$248.5k - $373k
...medicine physician to join our Utilization Management team. Optum is a... ...work and live. The Medical Director for Utilization Management will... ...enjoy the flexibility to work remotely * from anywhere within the U... ...organizational confidentiality Provides quality assurance and education of...Remote workMinimum wageFull timeWork experience placementWork at officeLocal areaWork from home$150 per hour
The Utilization Review Medical Director is responsible for conducting clinical reviews of Durable Medical Equipment... ...of observed trends, potential quality concerns, or opportunities to... ...Conditions and Additional Expectations: Remote role requiring consistent...Remote workHourly payFull timeContract workTemporary workPart timeLocal area- ...Partners, a national DMEPOS network administrator, seeks a remote Utilization Review Medical Director. You will conduct clinical reviews of DMEPOS requests,... ...meet Medicare/Medicaid guidelines, and maintain high-quality documentation in a fast-paced, real-time queue. This...Remote jobFull time
- ...Alliance is seeking an RN to supervise daily Utilization Management operations for the DoD/... ...coordinates across teams to ensure timeliness, quality care, and accreditation standards.... ...utilization review criteria. This role supports remote work options and requires US citizenship...Remote jobContract work
- A leading healthcare organization is seeking a Neurologist Medical Director to ensure compliance with clinical guidelines for Medicare beneficiaries... ...hold an active medical license. This position is primarily remote, offering a full-time work schedule with comprehensive...Remote jobFull time
- LifeMD is seeking a Medical Director to provide clinical leadership across our multi-vertical telehealth platform. You will oversee physician-level accountability for care quality, safety, and compliance, partnering with product and clinical operations to scale services...
$248.5k - $373k
...medicine physician to join our Utilization Management team. Optum is a... ...work and live. The Medical Director for Utilization Management will... ...organizational confidentiality Provides quality assurance and education of... ...*All employees working remotely will be required to adhere...Remote jobMinimum wageFull timeWork experience placementWork at officeLocal areaWork from home- A healthcare organization is seeking an experienced Medical Director to lead and oversee the medical department within a residential treatment... ..., ensuring compliance with regulations, and improving quality of patient care. The ideal candidate will hold a medical license...
$100.1k - $150.2k
...currently seeking an experienced Quality Manager - Utilties/Civil... ...management oversight for underground utility construction, including... ...improvement. Serve as a remote-based quality resource with regular... ...25+ hours / week) ~ Medical and prescription drug plans that...Remote workContract workFor contractorsH1bWork at officeFlexible hours- A health communication firm is seeking a Senior Medical Director II to lead the scientific services team for assigned accounts. This position... ...skills, and a relevant graduate degree. The role allows for remote or NYC office work, aiming to support innovative healthcare...Remote jobWork at office
- ...Wellpath / Correct Care Solutions is seeking a Site Medical Director (MD/DO) in Woodland, California for 16 hours/week. The director will oversee medical care ensuring compliance with healthcare standards while providing direct patient care and supervising clinical staff...16 hoursPart timeFlexible hours
- ENOVA, part of the IQVIA Health Communications Group, is seeking a Medical Director to serve as a senior scientific leader across client accounts, therapeutic areas, and organizational initiatives. This role blends strategic vision with hands-on execution, leading Medical...Remote job
- Novo Nordisk is seeking a Medical Director based in Princeton, NJ to serve as a subject-matter expert for Diabetes and Renal products. You... ...and align with Medical Affairs, Marketing and Global teams. Remote/home-office in the US with 20-30% overnight travel is expected...Remote workHome officeNight shift
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