Remote Medical Director - Utilization & Policy Excellence
CAI
- Remote job
CAI is seeking a Medical Director for a fully remote, full-time role to ensure utilization management aligns with top clinical standards. You will lead medical policy reviews, determine medical necessity, and guide the CMDM team.The position emphasizes physician expertise, protocol development, and cross-functional collaboration. Required are an MD/DO with board certification and active licenses in PA/NY/WV, plus 5+ years of direct patient care experience.J-18808-Ljbffr CAI
- ...Medical Director Curative is seeking an enthusiastic and... ...overseeing and performing utilization reviews, prior... ...discussions. This is a remote position requiring a... ...established medical policies, and evidence-based guidelines... ...practitioners, with excellent communication and...Remote workPolicyFull timeFlexible hours
$240k - $250k
...Medical Director Utilization Management We are looking for physicians who have... ...perspectives. This is a remote-first role that may require... ...fellowship in Internal Medicine ~ Excels in a matrix organization... ...care continuum–including policy, prior authorization,...Remote workPolicyFlexible hours$240k - $250k
...Medical Director Utilization Management We are looking for physicians who have... ...perspectives. This is a remote-first role that may require... ...fellowship in Internal Medicine. Excels in a matrix organization.... ...care continuum–including policy, prior authorization,...Remote workPolicyFlexible hours$248.5k - $373k
....00/yearJob Area: Medical & Clinical OperationsCompany... ...to join our Utilization Management team.... ...live.The Medical Director for Utilization... ...flexibility to work remotely * from anywhere within... ..., and UM policies and procedures with... ...practice clinicians who excel in caring for 900,...Remote workPolicyMinimum wageFull timeWork experience placementWork at officeLocal areaWork from home- ...seeking a licensed professional to join their staff Remotely as their new Medical Director - Utilization Management. \n About the Opportunity: \n \n... ...peer-to-peer discussions and educate physicians on policies and medical management issues. \n Support new technology...Remote jobPolicyMonday to FridayShift work
$275k - $325k
.... For more information, visit Utilization Management Medical Director Oncology Work Location: REMOTE (work from home) California Nevada... ...of utilization management policies to optimize patient outcomes.... ..., and reimbursement policies. Excellent analytical skills and the ability...Remote workPolicyWork from home$200k - $250k
# Medical Director, Utilization ManagementManaged Care & Clinical ProgramsOrlando,... ...maintain utilization management policies, guidelines, and coverage... ...management standards* Excellent clinical judgment, written... ...combination of onsite and remote days* Monday through...Remote workPolicyHourly payFull timeMonday to Friday$248.5k - $373k
...physician to join our Utilization Management team.... ...work and live. The Medical Director for Utilization Management... ...flexibility to work remotely * from anywhere... ...medicine guidelines, and UM policies and procedures with... ...practice clinicians who excel in caring for 900,000...Remote workPolicyMinimum wageFull timeWork experience placementWork at officeLocal areaWork from home$107k - $145k
...Outset, a trailblazing medical device company that is... ...OverviewThe Clinical Excellence Manager provides tactical... ...improvement to drive utilization.Review, revise, and... ...products, clinical programs, policies and procedures, and... ...Salary Range (Remote)$107,000—$145,000 USDCompany...Remote workPolicyLocal areaImmediate start- 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 jobPolicy
$250k - $350k
...is a specialized medical group dedicated to... ...care management, remote monitoring, and... ...reduce avoidable utilization, and expand access... ...Position Title: Medical Director – Intention MA... ...a culture of excellence, collaboration, and... ...organizational policies \n · Conduct periodic...Remote workPolicy- Oversee medical necessity reviews for home health, acute, post-acute, and outpatient... ...-based care and appropriate resource utilization. Apply CMS regulations, coverage... ...determinations, MCG criteria, and medical policies in a fully remote, part-time physician leadership role....Remote jobPolicyPart time
- CAI is seeking a Medical Director to ensure utilization management is performed per current clinical standards. This full-time, remote role requires leadership in medical reviews, policy adherence, and collaboration with the CMDM team. Responsibilities include case determinations...Remote jobPolicyFull time
- Bickham Services Unlimited, LLC is seeking a Medical Director, Utilization Management to lead clinical utilization reviews for... ...medical necessity determinations align with CMS, policies, and evidence-based criteria. Remote opportunity in New Jersey for a board-certified...Remote jobPolicy
- ...Staffing is seeking an experienced physician leader for a remote Medical Director, Utilization Management (Home Health, Acute & Post-Acute) role. In... ...Care Guidelines (MCG), and health plan medical policies to drive evidence-based care, ensure appropriate resource...Remote workPolicyFull timeContract workPart timeLocal areaWork from home
- Medical Director, Utilization Management Location: New Jersey - Fully Remote Work Arrangement: Remote Job Type: Contract Contract Length: 6-9 months, with potential for... ...determinations based on member benefit plans, medical policies, clinical criteria, CMS regulations, and...Remote workPolicyHourly payContract workImmediate start
- ...leadership and strategic medical direction for... .... The Medical Director is responsible... ...values, Framework for Excellence, and Fundamentals... ...quality, safety, utilization, stewardship,... ...applicable Intermountain policies and expectations.... ...applying for a remote or hybrid role,...Remote workPolicyHourly payWork at officeLocal area
$119k - $161k
Clinical Excellence Manager (California) Remote Company Overview Join us for an enriching... ...Outset, a trailblazing medical device company that is revolutionizing... ...improvement to drive utilization. Review, revise, and... ..., clinical programs, policies and procedures, and apply...Remote workPolicyContract workFor contractorsFor subcontractorWork at officeLocal areaImmediate start$130.5k - $176.4k
...Outset, a trailblazing medical device company that is... ...Manager, Clinical Excellence will lead the clinical... ...~ Participate in policies and procedure creation... ...strategies to expand the utilization of the company's medical... ...National Salary Range (Remote) $130,500—$176,400 USD...Remote workPolicyFull timeLocal areaImmediate start$213.1k - $383.58k
...care, care for the most medically and socially complex... ...communities we serve.The JobThe Utilization Management (UM) Physician Medical Director provides physician-... ...to program strategy, policy development, quality... ...yearWork Mode - Mostly Remote: Employees who reside outside...Remote workPolicyFor contractorsWork at officeLocal areaRelocation- ...Work Location : Remote (Oregon Headquarters... ...) Division: Utilization Management... ...Reports To: Nursing Director - RN Work Location... ...and organizational policies. # Oversees and... ...the YCCO Chief Medical Officer (CMO) and... ...the community. Excellent interpersonal...Remote workPolicyContract workFor contractorsCasual workWork at officeLocal areaFlexible hours
$248.5k - $373k
...00/yearJob Area: Medical & Clinical OperationsCompany... ....The Medical Director provides... ...knowledge in various utilization management... ...flexibility to work remotely * from anywhere within... ...coverage review policies, render coverage... ...reviewProven excellent oral, written, and...Remote workPolicyMinimum wageFull timeWork experience placementLocal area$248.5k - $373k
...member of a team of medical directors, for the overall quality... ..., performs Utilization Management reviews and... ...and implementation of policies, procedures and clinical... ...flexibility to work remotely * from anywhere within... ...Based Medicine (EBM) ~ Excellent computer skills and ability...Remote workPolicyMinimum wageFull timeWork experience placementLocal areaWeekend work$280.84k - $393.18k
...Health Services, the Senior Medical Director Policy & Outcomes (Sr. Medical... ...downstream connections to utilization management, population health... ...applications such as Microsoft Word, Excel, and Access. Proven... ...work schedule. (Mon & Fri - remote, Tues - Thurs onsite in...Remote workPolicyTemporary workLocal area$212.6k - $354.3k
...Medical Principal Position scope: Primarily regional... ...and consultant to utilization management, case management... ..., education, and excellent communication and negotiation... ...to other Medical Directors and other colleagues... ...evidence-based coverage policies, as well as through...Remote workPolicyWork from home$248.5k - $373k
...3,000.00Job Area: Medical & Clinical OperationsCompany... ...a team of medical directors, for the overall... ..., performs Utilization Management reviews... ...implementation of policies, procedures and... ...flexibility to work remotely * from anywhere within... ...(MS Word, Email, Excel, and Power Point)...Remote workPolicyMinimum wageWork experience placementLocal areaWeekend work- ...About The Role The Medical Director performs utilization review and medical necessity... ...assignment. *This is a Remote Role Primary Responsibilities... ..., and BHPS medical policy consistently, selecting the... ...; reporting tools such as Excel or Tableau). Work Environment...Remote workPolicyWork at officeLocal areaFlexible hours
$130 per hour
...LTSS Medical Director - Massachusetts Contract: 09/21/2026 to 10/... ...community-based services review, utilization management, and... ...implementation of local clinical policies and procedures, quality improvement... ...team-building skills. ~ Excellent interpersonal and...Remote workPolicyWeekly payFull timeContract workWork at officeLocal areaWork from home$222.75k - $267.3k
...Toland Physicians, Altais Medical Group Riverside, and Family... ...their patients. The Medical Director of Utilization and Medical Management will... ...of Utilization Management policy and procedures. This... ...program to meet your needs. ~ Excellent medical, vision, and dental...Remote workPolicyWork at officeLocal areaFlexible hours$170 per hour
...Medical Director CAI is a global services firm with over... ...have over 40 years of excellence in uniting talent and... ..., you will ensure utilization management responsibilities... ...be full-time and remote. What You'll Do... ...cases against medical policy criteria, which may include...Remote workPolicyHourly payFull timePrivate practiceWork at officeLocal areaWorldwide
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