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
$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 workFull timeTemporary workApprenticeshipWork at officeWork from homeHome officeMonday to FridayWeekend work$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 workMinimum wageFull timeWork experience placementLocal areaWork from home- ...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
$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 ~...SuggestedShift work- ...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
- 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 workFull timeNight shiftWeekend work
- ...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
- ...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 workFull timeLocal areaMonday to FridayFlexible hoursShift workDay shift
$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 workFull timePart timeWork at officeFlexible hoursWeekend work$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 workBi-weekly payFull timeTemporary workWork at officeLocal areaWork from homeHome office- ...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 workHourly payPart timeSeasonal workFlexible hours
- ...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 workPart timeLocal areaImmediate start
$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 workHourly payFull timeTemporary workLocal areaWork from homeWeekend work$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 workContract workFor contractors- ...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 workPart timeSeasonal work
- ...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 workPart timeSeasonal work
- ...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 workContract workImmediate start
- ...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 workTemporary workPart timeLocal areaFlexible hours
- ...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 workWork at officeLocal areaFlexible hours
$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 workFull time$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 workFull timeTemporary workApprenticeshipWork at officeWork from homeHome officeMonday to Friday$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 timeLocal areaMonday to FridayFlexible hoursShift workWeekend workDay shift$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 workFull timeWork at officeLocal areaWork from home$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 workFor contractorsPrivate practiceWork at officeLocal area$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 workHourly payLocal areaRelocation package$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- ...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
$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 workPermanent employmentFull timeImmediate start- ...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 timeLocal areaFlexible hoursShift workWeekend workDay shiftWeekday work
- ...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 timeWork at office
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