Medical Director, Utilization Management (Home Health, Acute & Post-Acute) (Fully Remote)
Jobgether SRL
Oversee medical necessity reviews for home health, acute, post-acute, and outpatient services for Medicare Advantage populations. Collaborate with treating physicians, nursing teams, and external agencies to promote evidence-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. #J-18808-Ljbffr
- ...Medical Director, Utilization Management (Home Health, Acute & Post-Acute)HJ Staffing is seeking an experienced physician leader for a remote Medical Director, Utilization Management (Home Health, Acute... ...improve health outcomes.Location: Fully Remote (Must be available...Remote workWork from homeContract workPart timeLocal area
- ...Remote Medical Director, Utilization ManagementImpresiv Health is seeking an experienced physician leader for a remote Medical Director, Utilization Management (Home Health, Acute & Post-Acute) role. In this position, you will serve as the primary clinical authority for...Remote workWork from homeLocal areaImmediate start
$262.15k - $393.22k
Alignment Health is breaking the mold in conventional... ....The Regional Medical Director, Non-Acute Utilization Management (RMD Non-Acute UM)... ...reduced avoidable post-acute placement,... ...determinations, DME, home health, advanced imaging... ...a combination of remote work, home-based...Remote workWork from homeFull timeWork at officeLocal area$223.8k - $313.1k
...community The Medical Director uses their... ...arise from post-acute care... ...training programs; utilize ongoing team... ...full-time, remote position with... ...on quality management, utilization... ...Delivery Systems, health insurance,... ...This is a fully remote... ...Work at Home Requirements...Remote workWork from homeFull timeTemporary workApprenticeshipLive inWork at officeHome officeMonday to Friday- ...Humana Inc. is seeking a Medical Director to authorize services, determine level of... ...care, and site of service within a remote, nationwide role. The position emphasizes... ..., CMS guidelines, and efficient utilization management in post-acute care settings. Qualified...Remote workFull time
$262.15k - $393.22k
...Alignment Health is breaking the mold in conventional... ...Raleigh or Charlotte*** Remote Regional Medical Director, Non-Acute Utilization Management (RMD Non-Acute UM) is a... ..., reduced avoidable post-acute placement,... ...necessity determinations, DME, home health, advanced...Remote workWork at officeLocal area$179.5k - $307.73k
Elevance Health is seeking an Associate Medical Director for Post Acute Care within Carelon Medical Benefits Management. The role supports medical management staff to ensure timely and... ...with a focus on post-acute care and utilization management. The position requires an...Remote jobRelocation package$248.5k - $373k
...yearJob Area: Medical & Clinical... ...to join our Utilization Management team. Optum... ...The Medical Director for Utilization... ...work and at home. Experience... ...the health of your community... ...flexibility to work remotely * from... ...plansConducts post service... ...experience with acute admissions2+...Remote workWork from homeMinimum wageFull timeWork experience placementWork at officeLocal area- ...Humana Inc. seeks a Medical Director to authorize services in acute inpatient rehab, guided by national guidelines... ...standards. The role emphasizes utilization management, compliance, and collaboration... ...regions. The position is fully remote in the U.S. with a standard 40-...Remote work
$179.5k - $307.73k
...Clinical Operations Associate Medical Director Carelon Medical Benefits Management Post Acute Care Benefit Utilization Management Schedule: 11... ...member of the Elevance Health family of companies, is a healthcare... ...Company. The Company is fully committed to ensuring equal...Full timeWork experience placementWork at officeLocal areaRelocation packageShift workWeekend work- Medical Director, Utilization Management Location: New Jersey - Fully Remote Work Arrangement: Remote Job Type: Contract Contract Length... ...focus on inpatient and post-acute care reviews. This position... ...including SNF, IRF, LTACH, and home health. Evaluate the appropriateness...Remote workHourly payContract workImmediate start
- ...Humana Inc. invites a qualified Utilization Management Registered Nurse to... ...documentation and communications for medical services and benefit... ...Management within the One Home/Home Solutions Utilization... ...Management team dedicated to post-acute care services. Required qualifications...Remote work
- Elevance Health seeks an Associate Medical Director, Post Acute Care to provide clinical leadership across post-acute settings... ...care. You will review and guide utilization decisions, support transitions... ...care, and collaborate with case management, network, and quality teams to...Full time
- ...Post-Acute Regional Medical Director - Northeastern Region of Pennsylvania (Part-time/PRN)Adfinitas... ...is responsible for leading and managing the Adfinitas Health program and providers at our partner... ...contact requirements.Manage utilization and scheduling of team's PTO....Part timeFor contractorsReliefAll shifts
- ...seeking a Registered Nurse with utilization management experience to review ED... ...InterQual/MCG criteria for medical necessity. You will discuss... ...candidates have 3+ years in acute care nursing and 2+ years in... ...proficiency in EMR and MS Office. Remote work arrangements are...Remote job
- ...Abode Care Partners seeks a Regional Medical Director to lead clinical strategy across post-acute settings, including SNFs and home-based care. The role balances active clinical... ...pathways, provider performance, and utilization management in a distributed, multi-site...
- ...Staffing is seeking an experienced physician leader for a remote Medical Director, Utilization Management role. You will serve as the primary clinical authority for home health authorizations and support acute, post-acute, appeals, and reviews for Medicare Advantage...Remote work
- ...Humana Inc. is seeking a Medical Director to authorize services, determine level of care, and site of service per CMS and Humana policies... ...regulatory standards, with a focus on DSNP. The position is fully remote, 40 hours weekly, and may be performed from any location...Remote work
- ...urgently seeking a Medical Director of Utilization Management to join a leading Medicare Advantage Health Plan. This physician... ...integrity of inpatient and post-acute care reviews,... ...compliance. Location: 100% Remote Schedule: Full-Time,... ..., IRF, LTACH, and Home Health). Criteria...Remote workFull timeMonday to Friday
$223.8k - $313.1k
...client, we are seeking a Medical Director - Acute Rehab to join the... ...adherence to timelines in a remote setting. Location:... ...programs and utilize ongoing team support... ...patient care experience post-residency or fellowship... ...experience in quality management and utilization...Remote workTemporary workVisa sponsorship$83.3k - $166.6k
...United States | Remote, California... ...live more fully at all... ...diagnostics, medical devices,... ...improve people’s health. We’re... ...monitor and manage heart failure... .... The Acute Product Consultant... ...and drive utilization of the... ...the post-purchase training... ...effectively from a home office base...Remote workWork from homeWorldwideHome office- ...Clinical Program Manager will be the operational owner for Post Acute programming across... ...Reporting to the Senior Director for Programs and... .... This position utilizes their Case... ..., availability of health and welfare benefit... ...health care benefits (medical, dental, vision),...Minimum wageFull timeTemporary workLocal areaShift work
- ...Humana Inc. is seeking a Medical Director to oversee utilization management, determine service appropriateness, and ensure compliance with national guidelines... ...teams across inpatient, outpatient, and post-acute settings. Ideal candidates have 5+ years of direct clinical...Remote work
- ...Acute Care Clinical ManagerGreat Falls, MT No Remote Sep 25, 2026 Acute Care Clinical Manager Job Type: Full-Time | On-Site Department: Leadership Clinical / Medical-Surgical & Emergency Services Location: Great Falls, Montana We have partnered closely with a prominent...Remote workFull time
- ...CAI is a global services firm seeking a Medical Director to ensure utilization management meets the highest clinical standards. The position is full-time and remote, enabling work from home while contributing to critical case reviews and policy development. The role...Remote workWork from homeFull time
- ...CMR Recruiting seeks a Medical Director for a Skilled Nursing Facility in Alliance, OH. The role combines onsite medical leadership with... ...certification in a related field, and experience in geriatrics or post-acute care. Competitive pay and strong benefits accompany the...Full timePart timeFlexible hours
- ...University of Minnesota’s Department of Rehabilitation Medicine seeks a full-time Medical Director for the Acute Rehabilitation Center (ARC) within a premier academic medical center. Lead clinical care, drive education, and advance research in physiatry. The role focuses...Full time
- ...Legacy Care in Charlottesville, VA is seeking a compassionate physician to serve as Medical Director and attending physician for our post-acute care practice. You will provide onsite care to medically complex adults in skilled nursing and long-term care settings while...For contractorsFlexible hoursWeekday work
$127.2k - $190.8k
...alleviate pain, restore health, and extend life.... ...innovative medical technologies that... ...in the Life The Acute Care and Monitoring... ...This position is remote to enhance our competitive... ...adoption and utilization ~ Leverage... ...markets Experience managing large projects or...Remote workFull timeH1bWork at officeLocal areaImmediate startWorldwideFlexible hours- ...Masimo is seeking a Hospital Account Manager to sell its Acute Care portfolio and build strategic clinical... ...and the Mississippi Gulf Coast with remote working flexibility. You will... ...hospital-based sales experience with medical devices, strong presentation and communication...Remote work
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