Remote Medical Director, Utilization Management
Beacon Hill
Beacon Hill is seeking a Medical Director (MD/DO) for Raleigh, North Carolina, with a strong focus on physical health utilization management and clinical leadership. The role collaborates with medical, behavioral health, and care management teams to uphold quality, compliance, and defensible decision-making. The candidate will review medical necessity criteria, participate in committees, and drive operational excellence across UM functions while accommodating primarily remote work with a North #J-18808-Ljbffr
$275k - $325k
...affiliate locations of care across five states and growing, TOI is changing oncology for the better. Utilization Management Medical Director OncologyWork Location: REMOTE (work from home)California Nevada Arizona Oregon FloridaThe Medical Director role provides clinical...Remote workWork from home$248.5k - $373k
...- $373,000.00Job Area: Medical & Clinical OperationsCompany... ...together.The Medical Director Oncology will provide utilization review determinations and... ...case and disease management teams to achieve optimal... ...the flexibility to work remotely * from anywhere within the...Remote workMinimum wageWork experience placementLocal area- ...CAI is seeking a Medical Director to oversee utilization management with adherence to top clinical standards. This full-time, remote position requires board-certified MD/DO and active state licensure in PA, NY, or WV, with 5+ years of direct patient care experience. You...Remote workFull time
- ...Judi Health is seeking a Medical Director for the Clinical Enterprise team to oversee utilization management, prior authorizations, and appeals for commercial and government programs. The role reports to the Lead Medical Director and collaborates with pharmacists and prescribers...Remote work
$240.12k - $315.16k
Hi, we're Oscar. We're hiring an Associate Medical Director to join our Utilization Management Team. Oscar is the first health insurance company built around... ...Senior Medical Director.Work Location: This is a remote position, open to candidates holding an active medical...Remote workFull timeImmediate startWork from homeHome office$248.5k - $373k
...$373,000.00/yearJob Area: Medical & Clinical OperationsCompany... ...medicine physician to join our Utilization Management team. Optum is a clinician-... ...work and live.The Medical Director for Utilization Management... ...the flexibility to work remotely * from anywhere within the...Remote workMinimum wageFull timeWork experience placementWork at officeLocal areaWork from home- ...Job Description Job Description Medical Director of Prior Authorization and Utilization Management - Palm Springs, California: Please consider becoming part... ...management This position can be structured as a hybrid remote role - you would not necessarily be required to...Remote workRelocation package
- Humana Inc. is seeking a Utilization Management Behavioral Health Professional... ...health services. This remote role supports providers and... ...internal teams in ensuring medically necessary decisions through... ...collaboration with medical directors. #J-18808-Ljbffr Humana IncRemote job
- ...Job Description Job Description Medical Director of Prior Authorization and Utilization Management - Palm Springs, California: Please consider becoming part... ...management This position can be structured as a hybrid remote role - you would not necessarily be required to...Remote workPermanent employmentTemporary workRelocation package
- ...UnitedHealth Group is seeking a Medical Director to oversee medical review services and utilization management workflows. The role involves directing policies, coordinating... ...high standards across clinical criteria. Remote work within the U.S. is supported, with potential...Remote workWeekend work
- System Physician Advisor Medical Director Responsibilities and Job Description Overview:The... ...and other leadership related to case/utilization management and revenue cycle including the Lee Health... ...contracted providers involved in remote utilization review and physician...Remote workContract workFor contractorsMonday to FridayWeekend work3 days per week
$386.5k
...579,500/yearJob Area: Medical & Clinical OperationsCompany... ...UHC Nation Medical Director Clinical Program... ...Clinical Evidence Group and manage the CPR team of 5-7... ...the flexibility to work remotely * from anywhere within... ...medical policies, utilization management processes,...Remote workMinimum wageFull timeWork experience placementLocal area$248.5k - $373k
....00 - $373,000.00Job Area: Medical & Clinical OperationsCompany... ...together.The Medical Director for the Oncogenetic Program... ...leadership and oversight for utilization management related to advanced molecular... ...enjoy the flexibility to work remotely * from anywhere within the...Remote workMinimum wageWork experience placementLocal area- ...opportunity for a Behavioral Health Medical Director supporting the TriCare/... ...of Veterans Affairs. This remote-based civilian position is... ...experience.3+ years of experience in managed care environments. Preferred... ...domains including Utilization Management, Case Management,...Remote workWeekday work
- ...enthusiastic and highly skilled Medical Director to join our growing team.... ...overseeing and performing utilization reviews, prior... ...peer discussions. This is a remote position requiring a "roll... ...Operations, to optimize utilization management processes and improve member...Remote workFull timeFlexible hours
$286.07k - $353.38k
...Place to Work since 2015.Position SummaryThe Vice President, Medical Director, Health Plan provides senior clinical leadership across... ...health plan strategy.Provide clinical leadership across utilization management, care management, population health, quality, pharmacy,...Remote workFull timeHome office- ...Medical Director Utilization Management (Payer Side Experience Required)- (Remote) Duration: 30 Weeks with possible extension Location: Pittsburgh, PA Schedule: Monday Friday | 9:00 AM 5:00 PM EST Core Hours: 40 Hours/Week Employment Type: Contract with Possibility of...Remote workFull timeContract workPart timePrivate practiceMonday to FridayFlexible hours
- ...Medical Director Utilization Management Location: Remote Preference EST or nearby Pittsburgh PA, NY, WV Duration: 6+ Months Contract Role with possible extension. Position Overview As part of a physician team, the Medical Director ensures utilization management...Remote workContract workPrivate practice
$227.6k - $385k
...Highmark Health seeks a physician for utilization management responsibilities in Albany, NY. The role involves reviewing cases in accordance with clinical standards and participating in a multidisciplinary team for case management. Essential qualifications include an...$227.6k - $385k
...Highmark Health in Salt Lake City, Utah is seeking a qualified physician to ensure adherence to clinical standards in utilization management. Responsibilities include reviewing escalated cases, participating in multidisciplinary team meetings, and developing protocols...$206.25k - $297.92k
Job title: Field Medical Director, Oncology EastLocation: Remote, US (East Coast)About the jobJoin the team transforming... ...of MSL activities. MSL managers work cross-functionally with field... ...engagement and retention strategies, utilizing clear career development...Remote workFull timeWork at office- ...Overview An Associate Medical Director will be joining a dynamic experienced clinical team... ...responsibilities include the aspects of utilization management as guided by medical policy for both... ...experience. Additional Remote work is a consideration following completion...Remote work
- ...Parkland Community Health Plan Remote PRIMARY PURPOSE Oversees medical coordination required for effective utilization and quality management of the health plan network.... ...of Texas for Managed Care Medical Directors. Board certification in the relevant...Remote workContract workWork at officeLocal area
$300k
...University of Massachusetts Chan Medical School (UMass Chan) seeks a... ...as the Facility Medical Director (FMD) for The Cape Cod and... ...areas including utilization management, risk management, support of... ...position is eligible for a hybrid/remote schedule combining regularly...Remote workDaily paidContract workLocumH1bNight shiftWeekend workDay shift- ...What you'll be doing The Regional Medical Director will perform a key role within Medical... ...institutions, community networks, and managed care communities * Present critical medical... ...fluently to any audience * Must utilize effective, professional communications...Remote workFull timeLive inWork at officeLocal areaHome office
- ...CVS Health is seeking an experienced Utilization Management Nurse Consultant for a 100% work-from-home role in the EST time zone. The position... ...hospital experience. Responsibilities include reviewing medical necessity, coordinating with providers, and ensuring timely...Remote workWork from home
- ...ProMedica is seeking a Utilization Management RN for a remote, part-time role in Ohio with a 20-hour work week. You will review admissions and transfers, apply payer rules for authorizations, and collaborate with clinicians to optimize resource use and care quality....Remote workPart timeWork from home
- ...Spectrum Healthcare Resources is seeking a Utilization Manager Registered Nurse (UMRN) to work entirely remotely from home. The nurse will review cases, educate patients on appropriate care, and manage health care costs for dependents of Active Duty and eligible retirees...Remote workWork from homeMonday to Friday
- ...Description & Requirements System Medical Director, Pre-Surgical Optimization... ...preoperative clinic utilization, reduce elective case... ...process enhancements. Provide remote and on-site clinical... .... Strong communication, management, and process improvement skills...Remote workFull timeLocal areaImmediate start
- ...A leading payment management solutions provider seeks an Offsite Invoice Payment Specialist to manage utility invoice entries in a work-from-home setup. The role requires high typing speed and self-motivation along with the ability to work independently. Candidates must...Remote workWork from home
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