Remote Medical Director — Medicaid Health Plans
CVS Health Corporation
- Remote job
CVS Health Corporation, in partnership with Aetna, is seeking a Medical Director to join the centralized Medical Management team. This work-from-home role primarily supports Aetna Better Health of Louisiana while providing support to other plans as needed. You will collaborate with Medical Management staff to ensure timely, clinically sound decisions for Medicaid members and providers, including reviews, prior authorization, and peer-to-peer consultations, with rotating on-call coverage. #J-18808-Ljbffr CVS Health Corporation
- ...Primary Work Location : Remote (Oregon Headquarters).... .... Department: Health Plan Operations FLSA... ...Reports To: Nursing Director - RN Work Location Type... ...managing the healthcare for Medicaid members, covered under... ...with the YCCO Chief Medical Officer (CMO) and/or Associate...Remote workHealth InsuranceContract workFor contractorsCasual workWork at officeLocal areaFlexible hours
$173k - $250k
...WellSense Health Plan is a nonprofit health insurance company... ...and Family, and Medicaid plans. Founded more than... ...5 years ago as Boston Medical Center HealthNet Plan,... ...: The Medical Director will report to the Senior... ...performed in a typical remote interior/office work environment...Remote workHealth InsuranceWork at officeFlexible hours- ...multidisciplinary care team—including medical providers and peer... ...partners with leading health plans, employers, and... .... The Medical Director serves as a physician... ...Experience serving Medicaid and other publicly insured... ...standards. This is a fully remote role but we are...Remote workHealth InsuranceFull timeTemporary workCurrently hiringWork at officeWork visaMonday to Friday
$300k - $350k
...The Nebraska Department of Health and Human Services (DHHS) is seeking an... ...experienced physician leader to serve as Medical Director for the Division of Medicaid and Long-Term Care (MLTC). As... ...medical determinations, and strategic planning. Represent Nebraska Medicaid in...Health InsuranceFull time- System Physician Advisor Medical Director Responsibilities and... ...Overview:The Lee Health System Physician Advisor... ...(including discharge planning), and social services... ...Centers for Medicare and Medicaid Services (CMS) rules and... ...providers involved in remote utilization review and...Remote workHealth InsuranceContract workFor contractorsMonday to FridayWeekend work3 days per week
- ...management, home care resources, health information management, and... ..., Sharecare enables health plan sponsors, health systems and... ..., visit . Job Summary: The Medical Director of Population Health and Clinical... ...with Medicare Advantage or Medicaid populations preferred...Remote jobHealth Insurance
$215k - $408.5k
...clinical professional on our Medical Management/Health Services team. Centene... ...: Full time Medical Director for our Health Plan in New Hampshire Centene... ...high-quality services to Medicaid and Medicare members, as... ...flexible approach to work with remote, hybrid, field or office...Remote workHealth InsuranceFull timePart timeWork at officeFlexible hoursWeekend work- ...fulfill its mission to inspire health and make it easy.AZ Blue... ...classified as hybrid, onsite or remote. While the majority of our employees... ...professional oversight for medical management activities related... ...Committee, Medical Directors Committee, and Medical Management...Remote workHealth InsuranceFull timeWork experience placementWork at office1 day per week
- ...exceed their financial health goals. Across the... ...skilled and detail oriented Medical Director to join our team. The... .... This is a remote position. Key Responsibilities... ...participating in Medicare, Medicaid or the Children’s... ...partners with health plans across the country to...Remote jobHealth InsuranceFull timeWork at officeLocal areaMonday to FridayShift work
$120 - $135 per hour
...Here Evolent partners with health plans and providers to achieve better... ...Management team as a Field Medical Director, Cardiovascular Specialist... ...excellence. This position is 100% Remote and can be completed from... ..., including Medicare or Medicaid, and is not identified as an...Remote jobHealth InsuranceFull timePart timeWork at officeFlexible hours$280.84k - $393.18k
...Reporting to the Vice President of Health Services, the Senior Medical Director Policy & Outcomes (Sr. Medical Director... ..., as well as effective health plan performance as per DHCS, DMHC, CMS,... ...hybrid work schedule. (Mon & Fri - remote, Tues - Thurs onsite in Rancho Cucamonga...Remote workHealth InsuranceTemporary workLocal area$248.5k - $373k
...$373,000/yearJob Area: Medical & Clinical OperationsCompany... ...we're simplifying the health care experience,... ...the flexibility to work remotely * from anywhere within... ...and Grievances Medical Director is responsible for ongoing... ...grievances for various health plan and insurance products,...Remote workHealth InsuranceMinimum wageFull timeWork experience placementWork at officeLocal area$180 per hour
...REMOTE MEDICAL DIRECTOR – UTILIZATION MANAGEMENT & APPEALS $180/hour | W-2 Contract | Monday–Friday | 100% Remote | Potential Extension... ...Jacobson Group is seeking a Medical Director to support a health plan's Utilization Management and Appeals programs. This is an...Remote workHealth InsuranceContract workWork at officeMonday to Friday$284.63k
...positively impact the health of 2.5 billion people... ...SummaryAs SERM Senior Medical Director, Oncology, you will lead... ...and strategic plans.Coach and mentor medical... ...with flexibility for remote work for the remainder... ...Centers for Medicare and Medicaid Services (CMS) website...Remote workHealth InsuranceFull timeWork at officeLocal area2 days per week$270k - $310k
...behavioral and physical health solutions that connect... ...health navigation, in-home medical care, or 24/7 crisis... ...reimbursement ~ Remote work flexibility (role-... ...Functions The Medical Director (Behavioral Health) provides... ...partners with health plans, providers, and...Remote workHealth InsuranceWork from homeFlexible hours- ...About The Role The Medical Director performs utilization review and medical... ...self-funded commercial plans, and supports the Chief Medical... ...review assignment. *This is a Remote Role Primary... ...accreditation activity and client and health-plan delegation audits, including...Remote workHealth InsuranceWork at officeLocal areaFlexible hours
- ...to our clients world-wide. Job Title: Medical Director Location: Remote Duration: 6 Months Job... ...Administration/Management or Public Health • 1 year in Medical Management in a Health Insurance Plan; strong knowledge of managed care industry...Remote workHealth InsuranceTemporary workPrivate practice
- Network Health’s success is rooted in its mission to create healthy and strong Wisconsin... ...critical encounter data functions for our Medicaid TPA line of business. This position is responsible... ...837 and 834 file submissions and health plan data including provider and claims...Remote workHealth InsuranceFull timeWork at officeLocal areaWork from homeHome office
$222.75k - $267.3k
...Brown & Toland Physicians, Altais Medical Group Riverside, and Family... ...patients. The Medical Director of Utilization and Medical Management... ...line to the Chief Officer for Health and Innovation, and work... ...responsible for interfacing with health plans regarding benefits, coverage...Remote workHealth InsuranceWork at officeLocal areaFlexible hours$170 per hour
...professionals for this role. Medical Director Req number: R8700 Employment type... ...time Worksite flexibility: Remote Who we are CAI is a global services... .../Management or Public Health 1 year in Medical Management in a Health Insurance Plan; strong knowledge of managed care...Remote workHealth InsuranceHourly payFull timeApprenticeshipPrivate practiceWork at officeLocal areaWorldwide- ...Medical Director- Reproductive Psychiatry Location: Remote Reports To: Chief Operating Officer Employment... .... About FamilyWell Health FamilyWell Health... ...Medicare and Medicaid populations. FamilyWell... ...clinical voice in strategic planning, product design, and...Remote workHealth InsuranceFull timeMonday to FridayFlexible hoursWeekday work
- ...Multi-Year Contract Responsibilities: Plan, establish, execute, control, and... ...operations associated with a limited public health plan. Oversee day-to-day operations of... ...federal or public sector health programs (Medicaid, Medicare, VA, DoD, or CDC/NIOSH programs...Remote workHealth InsuranceContract workFor contractors
$240k - $250k
...Medical Director Utilization Management We are looking for physicians who... ...Medical Director for Cohere Health, this is a critical role in a... ...and perspectives. This is a remote-first role that may require... ...Assistance Program 401K retirement plan with company match; flexible...Remote workHealth InsuranceFlexible hours- ## Medical DirectorApply: Fully Remote: US - Remote: Full time: Posted Today: R35494At Allstate... ...is part of Allstate's Health Solutions business and... ...management programs. The Medical Director is a highly experienced... ..., managed care, health plan, payer, or medical management...Remote workHealth InsuranceFull timeContract workWork at officeWork from homeWork visa
$227.6k
...escalated cases electronically and using Medical Policy criteria sets to evaluate the medical... ...Administration/Management or Public Health Experience Required ~5 years... ...Medical Management in a Health Insurance Plan; strong knowledge of managed care industry...Remote workHealth InsuranceFor contractorsPrivate practiceWork at officeLocal area$248.5k - $373k
...3,000.00/yearJob Area: Medical & Clinical OperationsCompany... ...and live.The Medical Director for Utilization... ...fulfillment of advancing the health of your community with... ...the flexibility to work remotely * from anywhere within... ...the needs of the health plan members and...Remote workHealth InsuranceMinimum wageFull timeWork experience placementWork at officeLocal areaWork from home- ...prominent healthcare organization is seeking an Appeals and Grievances Medical Director to manage clinical reviews of appeals for various health plans. The role offers flexibility to work remotely. Qualified candidates should have an MD or DO, be board certified, and possess...Remote jobHealth Insurance
$286.07k - $353.38k
Join Martin's Point Health Care - an innovative, not-for-profit health care organization offering care and coverage to the... ...Place to Work" since 2015.Position SummaryThe Vice President, Medical Director, Health Plan provides senior clinical leadership across the Health Plan...Remote workHealth InsuranceFull timeHome office- The Appeals and Grievances Medical Director at UnitedHealthcare oversees ongoing clinical review... ...appeals and grievances for multiple health plans. You will apply clinical criteria,... ...interpretations. This role offers full remote work across the United States, with limited...Remote jobHealth InsuranceWork at office
- ...a UnitedHealth Group company, is seeking a Medical Director to lead appeals and grievances clinical review for multiple health plans. The role involves adjudication of cases, interacting... ...clinical practice and quality management. Remote work options within the U.S. are available....Remote jobHealth Insurance
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