Remote Medical Director, Appeals & Quality Programs
Centene Corporation
A diversified healthcare organization is seeking a clinical professional to lead medical management services. Responsibilities include overseeing utilization review, coordinating quality improvement initiatives, and collaborating with various clinical teams to ensure optimal patient outcomes. The ideal candidate must be a licensed Medical Doctor or Doctor of Osteopathy, preferably with expertise in managing diverse populations. This role offers competitive pay, a comprehensive benefits package, and flexible work arrangements. #J-18808-Ljbffr
- ...Centene Corp. is seeking a Remote Medical Director, Appeals to lead medical management, utilization review, and quality improvement for our national program. You will provide medical leadership across utilization management, cost containment, and clinical quality initiatives...Remote work
$248.5k - $373k
...73,000.00Job Area: Medical & Clinical OperationsCompany... ...barriers to quality care. The work you... ...to work remotely * from anywhere within... ...Responsibilities:The Appeals and Grievances Medical Director is responsible for... ...and the sharing of program results.Provide clinical...Remote workMinimum wageWork experience placementLocal areaWork from home$236.5k
...professional on our Medical Management/Health... ...Medical Director at Centene provides... ...expertise to ensure high-quality, cost-effective care... ...in the appeals process, ensuring... ...sanctions from government programs requiredPay Range:... ...approach to work with remote, hybrid, field or...Remote workFull timePart timeWork at officeFlexible hours$248.5k - $373k
...373,000.00Job Area: Medical & Clinical OperationsCompany... ....The Medical Director for the Oncogenetic Program provides clinical... ...flexibility to work remotely * from anywhere within... ...Responsibilities:Work to improve quality and promote evidence... ...review, member appeals clinical review,...Remote workMinimum wageWork experience placementLocal area$286.07k - $353.38k
...SummaryThe Vice President, Medical Director, Health Plan provides senior... ...Health Plan, with a focus on quality, affordability, compliance,... ...payment policy, and clinical program development.Lead cross-functional... ..., including clinical appeals and grievances, using sound...Remote workFull timeHome office$386.5k
...0 - $579,500/yearJob Area: Medical & Clinical OperationsCompany... ...and removing barriers to quality care. The work you do here... ...together.The UHC Nation Medical Director Clinical Program Governance, Evaluation and... ...the flexibility to work remotely * from anywhere within the...Remote workMinimum wageFull timeWork experience placementLocal area$220k - $330k
...first — developing innovative medical technologies that improve... ...role as a Medical Affairs, Program Director, you will partner with the Enterprise... ...we do. This position is remote to enhance our competitive... ....Develop and deliver high quality, innovative written and verbal...Remote workFull timeH1bWork at officeLocal areaImmediate startWorldwideFlexible hours$134.6k - $230.8k
...230,800/yearJob Area: Medical & Clinical OperationsCompany... ...removing barriers to quality care. The work you do... ...together.The Clinical Program Director of Health Technology... ...device (SaMD), remote patient monitoring, and... ...of the programAnalyze appeal trends, overturn rates...Remote workMinimum wageFull timeWork experience placementLocal areaFlexible hours- ...PharmaceuticalsSelling Points Drive clinical quality excellence in a hybrid executive role.... ...across teams to enhance clinical program standards.Job DescriptionOverviewLead the... ...effective corrective action plans.Supervise remote vendor audits, ensuring thorough follow-up...Remote work
- ...leading virtual health company is seeking a Director of Clinical Quality to oversee its clinical quality functions in the virtual eating disorder program. The role involves driving operational... ...and utilization management. This is a remote position with a focus on maintaining...Remote work
$140k - $175k
...About the Role The Director of Clinical Quality serves as Equip's primary owner of... ...'s virtual eating disorder program. This role drives operational... ...directly to the VP of Medical Operations & Quality and serves... ...or compliance staff) in a remote or telehealth setting. Proven...Remote workWork at officeLocal areaWork from homeHome officeFlexible hours$177k - $278.08k
...the best of my knowledge.Job DescriptionAbout the roleThe Director, Clinical Program Quality & Excellence (CPQE) serves as a strategic quality leader... ...QualificationsBachelor's degree in a scientific, medical, healthcare, or related discipline requiredMinimum 10 years...Minimum wageTemporary workLocal areaWorldwide$50k
...access and adhere to critical medications. Backed by proven industry expertise... ...prior authorizations / denial appeals, determining financial qualifications for assistance programs and assisting patients or... ...and English are a plus. Remote work eligibility is subject to...Remote workTemporary workWork at officeImmediate startWork from homeMonday to FridayShift work$248.5k - $373k
...3,000.00Job Area: Medical & Clinical OperationsCompany... ..., the Medical Director provides... ...the claims review program. They are responsible... ...responsible for the overall quality, effectiveness and... ...and provider appeals. In addition, the... ...to work remotely * from anywhere within...Remote workMinimum wageWork experience placementWork at officeLocal area$200.4k - $343.5k
...- $343,500/yearJob Area: Medical & Clinical OperationsCompany... ...and removing barriers to quality care. The work you do... ...together.The National Medical Director of Radiology and Imaging Programs is responsible for... ...the flexibility to work remotely * from anywhere within the...Remote workMinimum wageFull timeWork experience placementWork at officeLocal area$125k - $150k
...Description This is a 100% fully remote role within the United... ...We are seeking a Senior Director, Admissions Testing Programs to lead the strategy,... ...position. This role will appeal to individuals who: ~Enjoy... ...approve releases to ensure quality, alignment, and readiness....Remote workFull timeWork at office$280.84k - $393.18k
...Health Services, the Senior Medical Director Policy & Outcomes (Sr.... ...activities including quality management, grievance and appeals, delegation oversight, and... ...IEHP’s Quality Program goals including, but not... ...schedule. (Mon & Fri - remote, Tues - Thurs onsite in...Remote workTemporary workLocal area$200.4k - $343.5k
...$343,500/yearJob Area: Medical & Clinical OperationsCompany... ...removing barriers to quality care. The work you do here... ....The National Medical Director of Orthopedic and Musculoskeletal Programs is responsible for leading... ...the flexibility to work remotely * from anywhere within...Remote workMinimum wageFull timeWork experience placementWork at officeLocal area- JOB DESCRIPTION Job Summary Provides subject matter expertise and leadership for Medicare Stars quality improvement (QI) programs and activities. Provides subject matter expertise in planning and implementing QI initiatives and education programs to support improved Medicare...Remote workWork at office
- OverviewWe are seeking a Coding Quality Program Manager to join our team at UnityPoint Health! This position is responsible for actively supporting... ...-making groups.Hours: Monday-Friday 8am-4:30pmLocation: Remote - applicants must reside within the UnityPoint Health...Remote workDaily paidFull timeTemporary workMonday to FridayShift work
$90k - $110k
...excellent opportunity for a Sr. Program Manager, Health Science... ...goals. Demonstrate knowledge of Quality Improvement skills related to... ...to achieve guideline directed medical therapy for heart failure... ...with Disabilities #AHAIND3, #LI-Remote Job SummaryRequisition ID: 2...Remote workFull timeWork at officeLocal areaWork from homeNight shift$120.1k - $208.15k
...:WHAT WE'RE DOINGLockheed Martin has a Quality Program Manager (QPM) role available within the... ...this and future openings.Ability to Work Remotely: Part-time Remote Telework: The... ...when extending an offer.Benefits offered: Medical, Dental, Vision, Life Insurance, Short-...Remote workFull timeContract workTemporary workPart timeWork experience placementWork at officeFlexible hoursNight shift- ...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
$170k - $210k
...Opportunity:Tetra Tech is adding an experienced National Program Manager, Air Quality to lead and expand our national air quality program while... ...national leader in air quality consulting.Location: Flexible (Remote/Hybrid; Travel Required)Why Tetra Tech:At Tetra Tech, we...Remote workContract workFor contractorsWork experience placementWork at officeLocal areaWorldwideFlexible hours$104.5k - $184.12k
...innovation and integrity. THE WORKThe Quality Program Manager (QPM) will lead the Quality team... ...this and future openings.Ability to Work Remotely: Part-time Remote Telework: The... ...when extending an offer.Benefits offered: Medical, Dental, Vision, Life Insurance, Short-...Remote workFull timeContract workTemporary workPart timeWork experience placementWork at officeLocal areaFlexible hours- We are hiring for a Quality Program Manager position at Providence Kodiak Island Medical Center in Kodiak, AK!Position is full time... ...the direction of the Regional Director of Quality Regulatory Services... ...is based in Kodiak, some remote work is possible, travel within...Remote workMinimum wageFull timeLocal areaMonday to FridayShift workDay shift
$139.64k - $183.18k
...may take place by phone. For remote roles, and at our discretion... ....We’re looking for a Senior Quality Program Manager within our... ...passport.You’ll report to the Director, Continuous Improvement and... ...employees are eligible to enroll in Medical, Dental, and VisionAdditional...Remote workFull timeWork at officeWorldwideFlexible hoursShift work$248.5k - $373k
...**Job category:** Medical & Clinical Operations... ..., the Medical Director provides leadership... ...the claims review program. They are responsible... ...for the overall quality, effectiveness and... ...and provider appeals. In addition, the... ...Friday. This can be remote work from home anywhere...Remote workMinimum wageFull timeWork experience placementLocal areaWork from homeMonday to Friday$100k - $150k
Team: Quality & Security & ComplianceCity: PleasantonState: CA Veeva Systems is a mission... ....The RoleThe Quality Operations Program Manager role ensures the integrity, compliance... ...as variable bonus and/or stock bonus.#LI-Remote#LI-AssociateVeeva’s headquarters is located...Remote workWork at officeLocal areaWork from home3 days per week- ...leading the National Test Regionalization program, a key strategic initiative designed to... ...- National Test RegionalizationThis is a Remote opportunity however the incumbent must reside... ...of the benefits offered may include:· Medical/Prescription Drugs· Dental· Vision· Flexible...Remote workFull timeTemporary workPart timeWork experience placementFlexible hours
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