Remote Medical Director, Utilization Management
GuideWell Mutual Holding Corporation
- Remote job
GuideWell Mutual Holding Corporation is seeking a Medical Director to lead all utilization management reviews (Pre-service, Post-service, Concurrent Review and Appeals) and to collaborate with physician providers and Case Managers on complex cases. The ideal candidate holds a Florida medical license (MD/DO), BS/ABMS board certification or eligibility, and 5+ years of clinical experience, with strong communication and team collaboration in a fast-paced environment. #J-18808-Ljbffr GuideWell Mutual Holding Corporation
$275k - $325k
...and growing, Starling Oncology is changing oncology for the better. For more information, visit Utilization Management Medical Director Oncology Work Location: REMOTE (work from home) California Nevada Arizona Oregon...Remote workWork from home- SCAN is seeking an Utilization Management Physician Medical Director to lead medical necessity determinations, prior authorizations, and reviews. This physician will influence policy, provide clinical mentorship, and ensure compliant, evidence-based decision-making while...Remote job
$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... ...'ll enjoy the flexibility to work remotely * from anywhere within the U.S. as you...Remote workMinimum wageFull timeWork experience placementWork at officeLocal areaWork from home- 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
$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
...Medical Director For Utilization Management WellMed, part of the Optum family of businesses, is seeking an internal medicine or family medicine physician... ...together. You'll enjoy the flexibility to work remotely from anywhere within the U.S. as you take on some tough...Remote jobMinimum wageFull timeWork experience placementWork at officeLocal areaWork from home$217.17k - $369.93k
...Associate Medical Director Behavioral Health or Utilization Management Medical Director DOE Work from home within Oregon, Washington, Idaho or Utah Preference... ...cost trend. Other roles as assigned. #LI-Remote Pay ranges vary based on the candidate's work location...Remote workPart timeImmediate startWork from homeFlexible hours- 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
- ...Bickham Services Unlimited, LLC is seeking a Medical Director, Utilization Management to lead clinical utilization reviews for inpatient and post-acute... ...align with CMS, policies, and evidence-based criteria. Remote opportunity in New Jersey for a board-certified...Remote work
- ...listed on behalf of a partner company, who manages all applications and next steps. Our partner is looking for a Medical Director, Utilization Management (Home Health, Acute & Post-... ...as a key clinical authority within a remote utilization management environment. You...Remote workFull timePart timeLocal area
$85k - $100k
...considering Progyny! Progyny is looking for a Utilization Management Coordinator to support all utilization... ...to determine the appropriateness and medical necessity to issue authorizations for... ...note: This is not a digital nomad or remote international position; candidates...Remote workFull timeSummer workWork at officeFlexible hours3 days per week- ...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
- ...family, is seeking an experienced physician to join the Utilization Management team. The Medical Director for Utilization Management will support WellMed... ...determinations and suggesting program improvements. This remote-friendly role offers the chance to influence care on...Remote work
- ...Job Description Job Description: Manager of Clinical Utilization Management - Denial Compliance Location... ..., CA Position Type: Hybrid (85% remote, 15% onsite in Northridge, CA);... ...with physician reviewers, medical directors, and other relevant departments....Remote workPermanent employmentFull timeTemporary workFlexible hours
- ...CorroHealth is seeking a Medical Director, Concurrent Review, to evaluate hospitalizations nationwide... ...provide expert recommendations. This remote position offers a predictable schedule and a path to expand knowledge in Utilization Review. Ideal candidates hold an MD/DO...Remote work
$78.62k - $105.16k
...Pay Plan Title: NurseManager, Utilization Management Working Title: Nurse Manager, Utilization Management – Physical Health Cost Center:... ...Posting Salary Range: $78,624 - $105,158 Office Location: Remote within North Carolina POSTING DETAILS: Make an Impact...Remote workFull timeWork experience placementWork at officeLocal areaImmediate startWork from homeFlexible hours- ...TekWissen is a global workforce management provider headquartered in Ann Arbor... ...clients world-wide. Job Title: Medical Director Location: Remote Duration: 6 Months... ...of a physician team, ensures that utilization management responsibilities are performed...Remote workTemporary workPrivate practice
$240k - $250k
...Medical Director Utilization Management We are looking for physicians who have expertise in Internal Medicine including medical and surgical clinical... ...different backgrounds and perspectives. This is a remote-first role that may require travel to Boston, MA for new...Remote workFlexible hours- ...Description Position: System Medical Director, Pre-Surgical Optimization... ...strategy. Enhance the utilization of preoperative clinics, minimize... ...processes. Provide both remote and on-site clinical... ...Strong skills in communication, management, and process improvement...Remote workFull timeLocal areaImmediate start
- WellMed, part of the Optum family, seeks a Medical Director for Utilization Management to lead and optimize our UM program. This role focuses on medical... ...program improvements while fostering a collaborative, remote-friendly work environment across the U.S. You will drive...Remote job
- UnitedHealth Group is hiring a Medical Director to provide physician support for Enterprise Clinical... ...necessity decisions. The role emphasizes utilization management, evidence-based medicine and cross-functional teamwork. Remote work within the United States is...Remote job
- CVS Health is seeking a Medical Director (Behavioral Health) for a remote-based role. The provider will lead utilization management, oversee behavioral health care management, and guide clinical policy and program development. Ohio licensure and board certification are...Remote jobFull timeWeekend work
- ...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
$190k - $200k
We're seeking a board‑certified Medical Director (Internal Medicine or Family Practice) to support our team. This role is fully remote and focuses on utilization management (UM), quality review, and clinical oversight for high‑volume cases. You will work closely with...Remote workFull time$216.11k - $283.64k
...Associate Medical Director, Regulatory Management Remote Hi, we're Oscar. We're hiring an Associate Medical Director, Regulatory Management to join... ...degree or advanced certificate. Prior experience with Utilization management. This is an authentic Oscar Health job...Remote workFull timeWork at officeWork from homeHome office- ...company is hiring a Physical Health Medical Director to work remotely in North Carolina. The Physical... ...within the Physical Health Medical Management Team, providing clinical oversight,... ...goals related to clinical quality, utilization management, and care coordination....Remote workTemporary workWork experience placementWork at officeRelocationFlexible hoursWeekend work
- ...CVS Health is seeking an experienced Utilization Management (UM) Nurse Consultant to join our remote team. This 100% work-from-home role serves members across the CST zone, ensuring safe, appropriate care and timely approvals. You will review clinical documents, collaborate...Remote workWork from home
- ...A peer review organization is seeking a full-time remote Utilization Management Physician Reviewer. Ideal candidates must hold an MD, DO, or DPM degree with active board certification and unrestricted medical license in relevant states. The role involves performing detailed...Remote workFull timeWork from home
- ...Job Description Job Description We are seeking a Field Manager for utility access road construction and data mapping to become an integral part of our team! Days consisting of exploring remote access roads, managing field operations, using GIS technology, and supporting...Remote workFull timeWork at officeWork from homeFlexible hours
- ...System Physician Advisor Medical Director Responsibilities and Job Description Overview... ...and other leadership related to case/utilization management and revenue cycle including the Lee... ...contracted providers involved in remote utilization review and physician advisory...Remote workFull timeContract workFor contractorsMonday to FridayWeekend work3 days per week
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