Sign up to access all features of our service.
  • Job search
  • Favorites
  • Create a CV
    New
  • Salaries
  • Subscriptions

Remote Medical Director, Appeals & Grievances (MD/DO)

UnitedHealth Group

UnitedHealthcare, a part of UnitedHealth Group, is seeking a Medical Director for Appeals and Grievances. The role focuses on clinical review, adjudication, and regulatory responses for various health plans. It offers remote work from anywhere in the U.S. and a comprehensive benefits package. The position requires MD or DO, board certification, extensive clinical practice, and quality management experience, with strong communication and project management skills. #J-18808-Ljbffr

Vacancy posted 4 days ago
Similar jobs that could be interesting for youBased on the Remote Medical Director, Appeals & Grievances (MD/DO) in Cypress, CA vacancy
  • $246.1k - $344.2k

     ...community The Corporate Medical Director relies on medical...  ...medical records for appeals decisions. The...  ...clinical reviews of grievance and appeal cases for...  ...Required Qualifications ~ MD or DO degree ~ Current, unrestricted...  ...Work Style: Fully remote living in the... 
    Remote work
    Full time
    Temporary work
    Apprenticeship
    Work at office
    Work from home
    Home office
    Monday to Friday
    Weekend work

    Humana

    Remote
    3 days ago
  • $248.5k - $373k

     ...- $373,000/yearJob Area: Medical & Clinical OperationsCompany...  .... Work at home!The Appeals and Grievances Medical Director is responsible for ongoing...  ...the flexibility to work remotely * from anywhere within the...  ....Required Qualifications:MD or DO with an active, unrestricted... 
    Remote work
    Minimum wage
    Full time
    Work experience placement
    Local area
    Work from home

    UnitedHealth Group

    Cypress, CA
    11 hours ago
  •  ...UnitedHealthcare is seeking an Appeals and Grievances Medical Director to oversee clinical review and adjudication of appeals across health plan products. Remote work allowed from anywhere in the U.S. You will lead regulatory responses, coordinate with medical directors... 
    Remote work

    Optum

    United States
    1 day ago
  • $257.05k - $340.59k

     ...expects to pay starting compensation for the position of Medical Director, Appeals, Grievances & Disputes in the range of $257,050 – $340,591.50...  ...goals of the organization. Employment Standards ~ MD or DO with an active, unrestricted license in California ~... 
    Suggested
    Shift work

    Kern Health Systems

    Bakersfield, CA
    23 hours ago
  •  ...prominent healthcare organization is seeking an Appeals and Grievances Medical Director to manage clinical reviews of appeals for...  ...plans. The role offers flexibility to work remotely. Qualified candidates should have an MD or DO, be board certified, and possess 5+ years... 
    Remote work

    UnitedHealthcare

    Cypress, CA
    4 days ago
  • Hospice Medical Director - Central Region Join to apply for the Hospice Medical Director - Central...  ...school of medicine or osteopathy. (MD or DO degree). Completion of an approved American...  ...Care Management - Care Transitions - Remote anywhere in US Medical Operations... 
    Remote work
    Full time
    Night shift
    Weekend work

    Inova Health

    Fairfax, VA
    2 days ago
  •  ...Humana, Inc. is seeking a Corporate Medical Director to provide clinical interpretation and reviews of medical records for appeals decisions, applying established review policies, procedures, and performance standards. The role requires independent judgment in addressing... 
    Remote work

    Humana

    Boston, MA
    23 hours ago
  •  ...Hybrid Regional Medical Director (MD/DO) - Southeast Missouri Position Type Full-Time Job Shift Day Education Level Professional Degree Category...  ...Monday - Friday ~ Day shift ~2 days on-site ~3 days remote ~ NO CALL REQUIRED We offer competitive compensation... 
    Remote work
    Full time
    Local area
    Monday to Friday
    Flexible hours
    Shift work
    Day shift

    Centurion

    Tipton, MO
    4 days ago
  • $236.5k

     ...Purpose: Assist the Chief Medical Director to direct and coordinate the...  ...teams, network providers, appeals team, medical and pharmacy...  ...Current state license as a MD or DO without restrictions, limitations...  ...approach to work with remote, hybrid, field or office work... 
    Remote work
    Full time
    Part time
    Work at office
    Flexible hours
    Weekend work

    Centene Corporation

    Auburn, WA
    4 days ago
  • $223.8k - $313.1k

     ...of our caring community The Medical Director relies on broad clinical expertise...  ...to review Medicare drug appeals (Part D & B). The Medical...  ...impact Required Qualifications: MD or DO degree 5+ years of direct...  ...information. Travel: While this is a remote position, occasional travel... 
    Remote work
    Bi-weekly pay
    Full time
    Temporary work
    Work at office
    Local area
    Work from home
    Home office

    Humana

    Frankfort, KY
    3 days ago
  •  ...The Medical Director at Humana relies on broad clinical expertise to review Medicare drug appeals (Part D and B). The role is part-time, seasonal with flexible weekly hours and...  ...member outcomes. Requirements include an MD or DO, an unrestricted license, board certification... 
    Remote work
    Hourly pay
    Part time
    Seasonal work
    Flexible hours

    Humana

    United States
    23 hours ago
  •  ...Description Location: Fully Remote | Candidates must be...  ...Description: The Medical Director, Appeals is responsible for...  ...Management, Appeals and Grievances, nursing teams,...  ...documented. What You Will Do: Conduct physician-...  ...You Will Bring: MD or DO degree from an accredited... 
    Remote work
    Part time
    Local area
    Immediate start

    Impresiv Health

    Saint Paul, MN
    13 days ago
  • $174.07k - $374.92k

     ...resources. **This is a remote based (work at home)...  ...Responsibilities of this Medical Director role are related to Medicare Appeals: * Direct daily work...  ...Industry * Medical License (MD) or (DO) * An Active state...  ...- Medicare Complaints, Grievance & Appeals experience.... 
    Remote work
    Hourly pay
    Full time
    Temporary work
    Local area
    Work from home
    Weekend work

    CVS Health

    Connecticut
    14 days ago
  • $30 - $35 per hour

     ...Mid-Senior Level professional for a contract role to manage grievances and appeals. Candidates should have 6+ years in customer service with strong...  ...pay range of $30.00/hr - $35.00/hr based on qualifications. Remote work is available for candidates within 100 miles of... 
    Remote work
    Contract work
    For contractors

    artechllc.com

    Portland, OR
    2 days ago
  •  ...Humana, Inc. is seeking a Medical Director for a part-time, seasonal role to review Medicare drug appeals (Part D and B). The position requires an MD or DO, a current medical license, and board certification...  ...Medicine, or PM&R. This remote role may involve some travel for... 
    Remote work
    Part time
    Seasonal work

    Humana

    Richmond, VA
    23 hours ago
  •  ...Humana, Inc. seeks a Medical Director for a part-time, seasonal, remote role to review Medicare drug appeals (Part D and B) and support value-based care within regulatory guidelines...  ...Humana procedures. The position requires an MD/DO, an unrestricted license, board... 
    Remote work
    Part time
    Seasonal work

    Humana

    Honolulu, HI
    4 days ago
  •  ...Health Plan Case Manager – Appeals & Grievances (California)Immediate need for a talented Health Plan...  ...and is located in California (Remote).Job ID: 26-29770 Pay Range: $27 - $30/...  ...communication skillsExperience reviewing medical records and clinical documentationOur client... 
    Remote work
    Contract work
    Immediate start

    Pyramid Consulting

    Santa Monica, CA
    2 days ago
  •  ...Part-Time option available Medical Directorship Geriatric Assessments - Local Onsite & Remote Tele Options available Must...  ...active SC license Seeking an MD/DO to provide gero assessments,...  ...#MD #DO #Physician #Medical Director #Supervision #Assessments #Nurse... 
    Remote work
    Temporary work
    Part time
    Local area
    Flexible hours

    LifeSource, Inc.

    Pickens, SC
    25 days ago
  •  ...About The Role The Medical Director performs utilization...  ...assignment. ~ This is a Remote Role Primary...  ...is defensible on appeal, external review, and...  ...member and provider grievances and reviews complaint...  ...Education and Experience MD or DO degree with active,... 
    Remote work
    Work at office
    Local area
    Flexible hours

    MagnaCare

    United States
    7 hours ago
  • $225k - $280k

     ...Mental health, physical health, medications, and day-to-day realities all...  ...About the Role Location: Remote – US based Sailor’s...  ...Healthcare Advocacy - Clinical Director, you will lead this physician...  ...will shape what our physicians do, how they do it, and how we scale... 
    Remote work
    Full time

    Sailor Health

    Remote
    13 days ago
  • $223.8k - $313.1k

     ...our caring community The Medical Director relies on medical background...  ...clinical documentation, grievance and appeals processes, and outpatient...  .... Required Qualifications MD or DO degree 5+ years of direct...  ...committees. Work Style Fully Remote Occasional travel to Humana... 
    Remote work
    Full time
    Temporary work
    Apprenticeship
    Work at office
    Work from home
    Home office
    Monday to Friday

    Humana

    New York, NY
    3 days ago
  • $301k

     ....00 Salary Job Shift: Day Job Category: Medical Physician & Advanced Practice Provider $...  ...currently seeking a full-time Site Medical Director to join our team at West Tennessee State...  ...as requested. Qualifications MD or DO Active, unrestricted TN license... 
    Full time
    Local area
    Monday to Friday
    Flexible hours
    Shift work
    Weekend work
    Day shift

    Centurion Health

    Henning, TN
    3 days ago
  • $262.15k - $393.22k

     ...saving them. Together.The remote Regional Medical Director, Non-Acute Utilization Management...  ...authorization, denial, appeal, and overturn trends;...  ...participate in audits, appeals, grievance reviews, and regulatory...  .... Education: Required: MD or DO degree from an accredited... 
    Remote work
    Full time
    Work at office
    Local area
    Work from home

    Alignment Healthcare

    Fresno, CA
    2 days ago
  • $227.6k

     ...cases electronically and using Medical Policy criteria sets to evaluate...  ...determination of cases, review of appeals and grievances, and other reviews as assigned....  ...Required ~ Medical Doctor (MD) or Doctor of Osteopathic Medicine (DO) Substitutions ~ None... 
    Remote work
    For contractors
    Private practice
    Work at office
    Local area

    Highmark Health

    United States
    4 days ago
  • $332.3k - $377.4k

     ...is seeking an experienced Medical Director with expertise in Utilization...  ..., medical claims reviews, appeals, and grievances and ensure timely and...  ...Medicine. Requires current MD or DO licensure within the State...  .... If applying for a remote or hybrid role, this includes... 
    Remote work
    Hourly pay
    Local area
    Relocation package

    Intermountain Healthcare

    Murray, UT
    23 hours ago
  • $107.7k - $199.3k

     ...Centene Corp. is seeking a Director of Grievance & Appeals to oversee the member appeals and grievance processes from a Florida-based, remote location. The role emphasizes efficient operations, regulatory compliance, and continual improvement across cross-functional teams... 
    Remote work

    Centene Corporation

    United States
    4 days ago
  •  ...UnitedHealth Group is seeking an Appeals Medical Director to work remotely within the United States. The role focuses on clinical review and adjudication of appeals and grievances across various health plans and products. You will oversee individual case reviews, regulatory... 
    Remote work

    UnitedHealth Group

    United States
    1 day ago
  • $400k

     ...referrals, and ModMed EHR with remote and AI scribe options....  ...Candidate Requirements MD or DO degree from an accredited institution...  ...Ophthalmology. Eligible for medical licensure in Nevada....  ...Reno and Carson City offer an appealing mix of metro convenience and... 
    Remote work
    Permanent employment
    Full time
    Immediate start

    Curative

    Reno, NV
    1 day ago
  •  ...Medical Director (MD/DO) - Nashville, Tennessee TN, Nashville - DeBerry Special Needs Facility - Nashville, TN 37209 Overview Position Type Full-Time Job Shift Day Education Level Professional Degree Category Medical Physician & Advanced Practice Provider Description... 
    Full time
    Local area
    Flexible hours
    Shift work
    Weekend work
    Day shift
    Weekday work

    Centurion

    Nashville, TN
    1 day ago
  •  ...Your Role The Medical Management team ensures that Blue Shield of California (BSC) is on the cutting edge...  ...based health care system in California. The Medical Director, Utilization Management - Appeals and Grievances is a key member of BSC's Clinical Appeals and Grievance... 
    Full time
    Work at office

    Blue Shield of CA

    Oakland, CA
    23 hours ago

Do you want to receive more vacancies?

Subscribe and receive similar vacancies to Remote Medical Director, Appeals & Grievances (MD/DO). Be the first to apply!