Remote Utilization Management Medical Director
ISHE
- Remote job
UnitedHealth Group seeks a Medical Director to lead clinical coverage reviews and benefit determinations within Enterprise Clinical Services. You will collaborate with leadership to implement processes, educate providers, and ensure cost-effective, high-quality care for members. The role emphasizes clinical knowledge, communication, and remediation of utilization management. You can work remotely from anywhere in the United States, with responsibilities spanning holidays and on-call rotation as #J-18808-Ljbffr ISHE
$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/yearJob Area: Medical & Clinical OperationsCompany... ...experience, and manage health care costs.The Medical Director provides physician support... ...clinical knowledge in various utilization management activities... ...the flexibility to work remotely * from anywhere within the...Remote workMinimum wageFull timeWork experience placementLocal area- ...To support Utilization Management operations, the full-time Utilization Review Medical Director will conduct clinical reviews of Durable Medical Equipment (DME) requests remotely, ensuring compliance with Medicare and Medicaid guidelines while maintaining productivity...Remote workFull time
- ...WellMed, part of Optum, seeks an Internal/Family Medicine physician to lead utilization management. You will determine medical necessity, review cases, and drive UM protocol improvements within a collaborative, patient‑focused team across Texas markets. The role emphasizes...Remote work
- ...Job Description Job Description Medical Director of Prior Authorization and Utilization Management - Palm Springs, California: Please consider becoming part... ...This position can be structured as a hybrid remote role - you would not necessarily be required to reside...Remote workPermanent employmentTemporary workRelocation package
$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- ...Health is hiring a Radiation Oncology Medical Director to oversee oncology utilization, policy implementation, and review processes in a remote, home-based role. The position supports... ..., peer-to-peer reviews, and case management. The role requires MD/DO, board certification...Remote jobWork from home
- ...Job Description Job Description Medical Director of Prior Authorization and Utilization Management - Palm Springs, California: Please consider becoming part... ...This position can be structured as a hybrid remote role - you would not necessarily be required to reside...Remote workRelocation package
- Sacbar is seeking a Medical Director of Prior Authorization and Utilization Management in Palm Springs, CA. The role focuses on prior authorization, concurrent review... ...utilization management with a flexible hybrid remote arrangement. The position offers a competitive salary...Remote workRelocation packageFlexible hours
- The Oncology Institute is seeking a Medical Director to provide clinical expertise in assessing medical necessity, appropriateness, and efficiency of oncology care with a focus on utilization management for case reviews and clinical decision making. In this collaborative...Remote job
- UnitedHealth Group, through UnitedHealthcare, seeks a Medical Director of Clinical AI Innovation and Performance. This senior physician... ...AI model training, testing, and surveillance for utilization management criteria, leveraging InterQual and custom content. You will...Remote job
$150 per hour
The Utilization Review Medical Director is responsible for conducting clinical reviews of Durable Medical Equipment... ...to support Integra’s Utilization Management (UM) operations. Role functions... ...Conditions and Additional Expectations: Remote role requiring consistent...Remote workHourly payFull timeContract workTemporary workPart timeLocal area$248.5k - $373k
...family medicine physician to join our Utilization Management team. Optum is a clinician-led care... ...way clinicians work and live. The Medical Director for Utilization Management will support... ...) fluency *All employees working remotely will be required to adhere to UnitedHealth...Remote workMinimum wageFull timeWork experience placementWork at officeLocal areaWork from home$248.5k - $373k
...Medical Director Optum is a global organization that delivers care, aided... ...seamless experience, and manage health care costs. The Medical... ...knowledge in various utilization management activities with a... ...enjoy the flexibility to work remotely from anywhere within the U.S...Remote jobMinimum wageFull timeWork experience placementLocal area$172.36k - $258.55k
Physician Advisor, Utilization Management (CA License Required) page is loaded##... ...(CA License Required)remote type: Fully Remotelocations... ...Advisor works with Senior Medical Officers, Regional Medical... ...provide assistance to Quality Director. 10. Works with Extensivists...Remote job$248.5k - $373k
...Medical Director Optum is a global organization that delivers care, aided... ...seamless experience, and manage health care costs. The Medical... ...knowledge in various utilization management activities with a... ...enjoy the flexibility to work remotely from anywhere within the U.S...Remote jobMinimum wageFull timeWork experience placementLocal area- Centene Corporation is seeking a Medical Director to lead utilization management, quality improvement, and medical review activities. You will partner with Chief Medical Director to shape goals, policies, and cost-effective care for a diverse member population. The role...Remote job
- Centene Corporation is seeking a clinical leader to assist the Chief Medical Director in directing medical management, quality improvement and credentialing for the business unit. You will lead utilization management, drive cost containment and ensure high-quality care...Remote job
- ...United States seeks a clinical professional to lead Medical Management/Health Services, driving utilization review, cost containment, and medical quality... ...supporting policy planning and education across networks. Remote, hybrid, or office work options are available. #J-...Remote jobWork at office
- ...Corporation is seeking a clinical leader to assist the Chief Medical Director in directing and coordinating medical management, quality improvement, and credentialing. The role provides medical leadership for utilization management, cost containment, and quality improvement...Remote job
- Centene Corporation is seeking a clinical professional to lead Medical Management/Health Services for 28 million members. The role drives utilization management, quality improvement, and medical review across a national organization with flexible work options. The candidate...Remote jobFlexible hours
- Centene Corporation seeks a physician leader to direct medical management, quality improvement and credentialing for the business unit. Lead utilization management, medical reviews, and performance-improvement initiatives to enhance cost-effectiveness and care quality....Remote jobWeekend work
- UnitedHealth Group is seeking a Medical Director to provide physician leadership and manage clinical coverage reviews for Enterprise Clinical Services. This role... ...and support benefits interpretation across plans. Remote work from anywhere in the U.S. #J-18808-Ljbffr...Remote job
- ...Health is seeking a Clinical Manager, Care Management to provide... ...of professionals involved in utilization management. This role... ...compliance while collaborating with Medical Directors and internal leaders. The... ...The position offers a fully remote environment with comprehensive...Remote job
- A healthcare management organization is seeking a Remote Medical Director to lead the review of medical records and provide expert decision-making. This role demands a blend of clinical experience, leadership, and the ability to guide a team while ensuring compliance with...Remote jobContract workWeekend work
- Centene Management Company LLC is seeking a remote Utilization Management leader to oversee BH UM clinicians and ensure appropriate care for members. The role involves guiding UM practices, tracking performance, and aligning with regulatory standards. Requires nursing...Remote jobFlexible hours
$102.9k - $190.5k
Position Purpose Manages the behavioral health (BH) utilization review clinicians to ensure appropriate care to members... ...utilization management. This is a remote opportunity supporting BH UM.... ...preferred. Advanced understanding of medical necessity criteria for a broad...Remote workWork at officeFlexible hours- ...the fortunate position of adding a Medical Director to our incredible team. This... ...provide improved outcomes Performs utilization review and case management support on complex members... ...and to protecting the sensitive data entrusted to us. #LI-HW1 #LI-Remote...Remote workPermanent employmentFull timeCasual work
- ...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... ...functions while accommodating primarily remote work with a North #J-18808-LjbffrRemote work
- ...WellMed, part of the Optum family, is seeking a Medical Director for Utilization Management to support utilization determinations and identify trends in order to improve the UM program. The role involves developing and maintaining efficient UM processes, staying current...Remote work
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