Remote Medical Director & Surgeon: Claims & Coverage
Texas Health Institute
- Remote job
Optum is seeking a Medical Director to provide physician support to Enterprise Clinical Services and to lead clinical and operational processes for coverage determinations and medical necessity assessments. This role emphasizes collaboration with network and non-network physicians and involvement in utilization management. The position offers remote work within the United States, with responsibilities including documentation, peer-to-peer discussions, and daily clinical rounds to ensure #J-18808-Ljbffr Texas Health Institute
- UnitedHealth Group seeks a Medical Director to provide physician support for Enterprise Clinical Services. The role focuses on clinical review, benefit coverage determinations, and cost-effective care across networks. The position supports post-service reviews and interacts...Remote jobClaims
- UnitedHealth Group is seeking a Medical Director to provide physician support for Enterprise Clinical Services, focusing on clinical reviews, benefit coverage determinations and cost-effective care delivery. This role supports network and non-network providers and drives...Remote jobClaimsFlexible hours
- Optum is seeking a Medical Director to provide physician support for Enterprise Clinical Services, guiding coverage determinations and cost-effective care. The role emphasizes applying... ...-quality medical decisions. You can work remotely from anywhere in the U.S. This leadership...Remote jobClaims
- Optum, part of UnitedHealth Group, seeks a Medical Director to support Enterprise Clinical Services. You will conduct coverage reviews, render determinations, and collaborate... ...ensure cost-effective, high-quality care. Remote work from anywhere in the United States is available...Remote job
$248.5k - $373k
...0.00 - $373,000.00/yearJob Area: Medical & Clinical OperationsCompany: UnitedHealth... ...together.As part of the Focus Claims Review team at Optum, the Medical Director provides leadership, organization... ...ll enjoy the flexibility to work remotely * from anywhere within the U.S....Remote workClaimsMinimum wageFull timeWork experience placementLocal areaMonday to FridayFlexible hours$248.5k - $373k
...373,000/yearJob Area: Medical & Clinical OperationsCompany... ...flexibility to work remotely * from anywhere within... ...with medical director teams focusing on inpatient... ...management, clinical coverage review, member appeals... ...clinical review, medical claim review and provider...Remote workClaimsMinimum wageFull timeWork experience placementWork at officeLocal area$225k - $275k
...Overview The Client Medical Director (CMD) is a key member of the Go... ...Have in-depth knowledge of claims, claims adjudication, medical... ...disability, and life insurance coverage, 401(k) savings plans, paid... ...is selected. #LI-JB1 #LI-Remote #director #J-18808-Ljbffr...Remote workClaimsWork at officeImmediate startWork from home$248.5k - $373k
...0 - $373,000/yearJob Area: Medical & Clinical OperationsCompany... ...as we deliver clinical coverage and medical claims reviews. Our role is to empower... ...care costs.The Medical Director provides physician support... ...enjoy the flexibility to work remotely * from anywhere within the...Remote workClaimsMinimum wageFull timeWork experience placementLocal area$248.5k - $373k
...0 - $373,000/yearJob Area: Medical & Clinical OperationsCompany... ...as we deliver clinical coverage and medical claims reviews. Our role is to empower... ...care costs.The Medical Director provides physician support... ...enjoy the flexibility to work remotely * from anywhere within the...Remote workClaimsMinimum wageFull timeWork experience placementLocal area$206.01k
...Molecular Diagnostics Medicare Medical Director at Palmetto GBA oversees... ...compliance and support Medicare coverage decisions. Description... ...week) Monday-Friday working REMOTE in the United States or ONSITE... ...matters. Develops claim adjudication criteria for situations...Remote workClaimsFull timeFor contractorsWork experience placementWork at officeLocal areaMonday to Friday$173k - $250k
...circumstances. Job Summary: The Medical Director will report to the Senior... ...in You: • Full-time remote work • Competitive... ...standard criteria and determines coverage • Works with the Senior Medical... ...goals • Reviews claims involving complex, controversial...Remote workClaimsFull timeWork at officeFlexible hours$230.6k - $384.4k
...Medical Director The job profile for this position is Medical Director, which is a Band 5 Management Career Track Role.... ...Perform benefit-driven medical necessity reviews for coverage, case management, and claims resolution as needed using benefit plan information,...Remote workClaimsLocal areaWork from home- ...Medical Director ARC Group has an immediate opportunity for a Medical... ...Director! This position is 100% remote working eastern time zone... ...vital role in developing Local Coverage Determinations (LCDs) and... ...policies, reviewing medical claims, and promoting evidence-based...Remote workClaimsPermanent employmentFor contractorsWork experience placementLocal areaImmediate start
$248.5k - $373k
...0 - $373,000/yearJob Area: Medical & Clinical OperationsCompany... ...as we deliver clinical coverage and medical claims reviews. Our role is to empower... ...care costs.The Medical Director provides physician support... ...skills*All employees working remotely will be required to adhere...Remote workClaimsMinimum wageFull timeWork experience placementLocal area$223.8k - $313.1k
...our caring community The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments... ...rotational weekend/holiday coverage (approx. 5 weekends per year).... ...Travel: While this is a remote position, occasional travel to...Remote workClaimsBi-weekly payFull timeTemporary workApprenticeshipWork at officeLocal areaWork from homeHome officeMonday to FridayWeekend work- Optum, a global health care company, is seeking a Medical Director to provide physician leadership for Enterprise Clinical Services. You will guide clinical coverage determinations, collaborate with network and non-network physicians, and help drive cost-effective, high...Remote jobClaims
- Optum, a part of UnitedHealth Group, is seeking a Medical Director to provide physician support for Enterprise Clinical Services, shaping benefit coverage determinations and quality improvement initiatives. The role involves collaborating with network and non-network physicians...Remote jobClaims
- ...Associate Medical Director In support of the CMO, the Associate Medical Director is responsible... ...- 5pm Monday through Friday, weekend coverage required on rotational basis Check out... ...medical guidelines and parameters for claims review Assist in the training of NHP staff...Remote workClaimsContract workWork at officeLocal areaWork from homeHome officeMonday to FridayWeekend work
- Optum in the United States is seeking a Medical Director to provide physician support to Enterprise Clinical Services, guiding clinical and operational processes for benefit coverage determinations, quality improvement and cost effectiveness. The role emphasizes applying...Remote jobClaims
$190k - $200k
...re seeking a board‑certified Medical Director (Internal Medicine or Family... ...team. This role is fully remote and focuses on utilization management... .../controversial services and claims appeals. Support physician... ...weekend or holiday coverage on a voluntary basis. Required...Remote workClaimsFull time- ...disputed, or escalated medical review determinations across... ...under Medicare coverage policy. Actively engage... ...review, or healthcare claims processing, including familiarity... ...Contractor Medical Director or Medical Director... ...functions. This is an office/remote position. While...Remote workClaimsFull timeFor contractorsWork at officeLocal area
$248.5k - $373k
...Medical Director Optum is a global organization that delivers care, aided by technology... ...expectations as we deliver clinical coverage and medical claims reviews. Our role is to empower... ...You'll enjoy the flexibility to work remotely from anywhere within the U.S. as you...Remote jobClaimsMinimum wageFull timeWork experience placementLocal area- ...something bigger. Job Title Medical Director, Outpatient Surgery Reports... ...practicing, board-certified surgeon who provides both clinical... ...benchmarks. Participate in call coverage and peer case review as... ...malpractice complaints and claims in partnership with compliance...ClaimsLocal areaFlexible hoursAfternoon shiftEarly shift
- ...Insurance Coverage Associate | Texas | Remote Opportunity A nationally recognized insurance coverage practice is seeking an associate with 3 to... ...opinions, and litigation involving first-party and third-party claims across multiple lines of insurance. The associate will...Remote workClaims
$174.07k - $374.92k
...Summary The Radiation Oncology Medical Director supports the CVS Health... ...when necessary. This is a remote based (work from home) position... ...predetermination reviews and review of claim determinations, In the... ...medical, dental, and vision coverage, paid time off, retirement...Remote workClaimsHourly payFull timeTemporary workLocal areaWork from homeWeekend work- ...with 3-5 years of significant insurance coverage experience to join the Houston office. The... ...opinions and litigating first and third party claims concerning multiple lines of coverage and... ...required. This position is also open to remote candidates located in Texas. Cozen O’...Remote workClaimsWork at office
$238k - $357.5k
...Connecting. Growing together . The Medical Director Oncology will provide... ...enjoy the flexibility to work remotely * from anywhere within the U... ...(e.g., quality metrics, claims and health record data, utilization... ...rotational holiday and call coverage Preferred Qualification:...Remote jobClaimsFull timeWork experience placementLocal area$225.7k - $428.9k
...clinical professional on our Medical Management/Health... ...Hiring: Full time Medical Director Centene Corporation is... ...-sponsored healthcare coverage, providing access to... ...care quality. Reviews claims involving complex, controversial... ...approach to work with remote, hybrid, field or...Remote workClaimsFull timePart timeWork at officeFlexible hoursWeekend work$100k
...Insurance Comprehensive medical, dental, vision, and Rx coverage Disability Short- and long... ...support. USACS malpractice claims are less than 1/2 the... ...House Panel): Radiology (remote) CT (24/7) MRI (24/7) Adult... ...About USACS As a medical director at USACS, you will be responsible...Remote workClaimsFull timeTemporary workLive inLocal areaWeekend work$200k - $235k
...SPECIALTY (INSURANCE COVERAGE)INSURANCE COVERAGE PRACTICELocation... ...(Los Angeles, Irvine)REMOTE (everyday besides... ...errors and omissions claims involving attorneys,... ..., as well as directors and officers' coverage... ...EligibilityComprehensive Benefits Package: Medical, dental, vision,...Remote workClaimsWork at officeFlexible hours
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