Remote Medical Director, Medicare Utilization & Quality
Centene Corporation
- 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 across networks. The role requires a MD/DO with active board certification and ongoing medical practice, plus experience in accreditation standards and culturally diverse populations. #J-18808-Ljbffr Centene Corporation
- ...national DMEPOS network administrator, seeks a remote Utilization Review Medical Director. You will conduct clinical reviews of DMEPOS requests, ensure determinations meet Medicare/Medicaid guidelines, and maintain high-quality documentation in a fast-paced, real-time...Remote jobQualityFull time
- ...States seeks a clinical professional to lead Medical Management/Health Services, driving utilization review, cost containment, and medical quality improvement for 28 million members. This... ...planning and education across networks. Remote, hybrid, or office work options are...Remote jobQualityWork at office
$275k - $325k
...growing, TOI is changing oncology for the better. Utilization Management Medical Director OncologyWork Location: REMOTE (work from home)California Nevada Arizona Oregon... ...leaders to support evidence-based high quality and cost-effective care delivery across the network...Remote workQualityWork from home- ...Beacon Hill is seeking a Medical Director (MD/DO) for Raleigh, North Carolina... ...focus on physical health utilization management and clinical... ...management teams to uphold quality, compliance, and defensible... ...while accommodating primarily remote work with a North #J-18808...Remote workQuality
$248.5k - $373k
...373,000/yearJob Area: Medical & Clinical OperationsCompany... ...costs.The Medical Director provides physician... ...coverage determinations, quality improvement and cost... ...knowledge in various utilization management activities... ...the flexibility to work remotely * from anywhere within...Remote workQualityMinimum wageFull timeWork experience placementLocal area- ...seeks an Internal/Family Medicine physician to lead utilization management. You will determine medical necessity, review cases, and drive UM protocol improvements... ...active participation in physician meetings, with a strong focus on quality and patient care. #J-18808-Ljbffr...Remote workQuality
- ...WellMed Medical Management, Inc. seeks an Internal Medicine/Family Medicine physician to join our Utilization Management team as Medical Director. You will make UM determinations, monitor CMS criteria... ...multidisciplinary team committed to high-quality, cost-effective care and...Remote workQuality
- ...Description Job Description Medical Director of Prior Authorization and Utilization Management - Palm Springs, California... ...providing the highest quality care to our residents in the Coachella... ...position can be structured as a hybrid remote role - you would not necessarily...Remote workQualityPermanent employmentTemporary workRelocation package
- CareOregon, Inc. seeks a Medical Director to oversee benefit/utilization management, clinical and wellness programs for members. The role involves leadership of QA, case/disease/quality management, and collaboration with physicians to improve care and utilization outcomes...Remote jobQualityWork from home
$240k - $250k
...Medical Director Utilization Management We are looking for physicians who have expertise in Internal... ...backgrounds and perspectives. This is a remote-first role that may require travel to... ...in medical care to improve the quality of patient outcomes. Provide timely...Remote workQualityFlexible hours$248.5k - $373k
...,000.00/yearJob Area: Medical & Clinical OperationsCompany... ...physician to join our Utilization Management team. Optum... ...and live.The Medical Director for Utilization... ...the flexibility to work remotely * from anywhere within... ...confidentialityProvides quality assurance and...Remote workQualityMinimum wageFull timeWork experience placementWork at officeLocal areaWork from home- UnitedHealth Group seeks a Medical Director to lead clinical coverage reviews and benefit... ...and ensure cost-effective, high-quality care for members. The role... ...communication, and remediation of utilization management. You can work remotely from anywhere in the United States...Remote jobQuality
- ...Health is seeking a Part-Time Medical Director to provide physician... ...for medical management and utilization review programs. You will align... ...organizational standards in a fully remote role based in the United... ...necessity determinations, and drive quality improvement across programs,...Remote jobQualityPart time
- UnitedHealth Group in Minnesota seeks a Medical Director to provide physician support for... ...to ensure cost-effective, high-quality care, advances utilization management, and communicates policies... ...network and non-network physicians. Remote work from anywhere in the U.S. is...Remote jobQuality
- The Oncology Institute is seeking a Medical Director to provide clinical expertise in assessing... ...of oncology care with a focus on utilization management for case reviews and clinical... ...leaders to support evidence-based, high-quality, cost-effective care delivery across...Remote jobQuality
- ...Description Job Description Medical Director of Prior Authorization and Utilization Management - Palm Springs, California... ...providing the highest quality care to our residents in the Coachella... ...position can be structured as a hybrid remote role - you would not necessarily...Remote workQualityRelocation package
- ...Medical Director Curative is seeking an enthusiastic and highly skilled... ...overseeing and performing utilization reviews, prior authorizations... ...peer discussions. This is a remote position requiring a "roll up... .... Participate in quality improvement initiatives, audits...Remote workQualityFull timeFlexible hours
- 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 jobQuality
$172.36k - $258.55k
Physician Advisor, Utilization Management (CA... ...License Required)remote type: Fully Remotelocations... ...works with Senior Medical Officers, Regional... ...also ensuring the quality of care provided.... ...compliance with Medicare/CMS: NCD, LCD and... ...to Quality Director. 10. Works with Extensivists...Remote jobQuality$150 per hour
The Utilization Review Medical Director is responsible for conducting clinical reviews of... ...made in accordance with Medicare and Medicaid guidelines, health... ...trends, potential quality concerns, or opportunities... ...Additional Expectations: Remote role requiring consistent...Remote workQualityHourly payFull timeContract workTemporary workPart timeLocal area$248.5k - $373k
...Medical Director Optum is a global organization that delivers care, aided... ...coverage determinations, quality improvement and cost effectiveness... ...knowledge in various utilization management activities with a... ...enjoy the flexibility to work remotely from anywhere within the U.S...Remote jobQualityMinimum wageFull timeWork experience placementLocal area$248.5k - $373k
...Medical Director Optum is a global organization that delivers care, aided... ...coverage determinations, quality improvement and cost effectiveness... ...knowledge in various utilization management activities with a... ...enjoy the flexibility to work remotely from anywhere within the U.S...Remote jobQualityMinimum wageFull timeWork experience placementLocal area- ...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 jobQuality
- 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 jobQualityFlexible hours
$248.5k - $373k
...medicine physician to join our Utilization Management team. Optum is a... ...work and live. The Medical Director for Utilization Management will... ...organizational confidentiality Provides quality assurance and education of... ...*All employees working remotely will be required to adhere...Remote workQualityMinimum wageFull timeWork experience placementWork at officeLocal areaWork from home- 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 jobQualityWeekend work
- Title: Medical Director, Utilization Management (Commercial & MA) Start Date: 08/10/... ...possibility of an extension. Fully remote opportunity Looking for an... ...Commercial and/or Medicare Advantage populations. Minimum... ...clinical expertise to quality improvement initiatives involving...Remote workQualityContract workWork at officeImmediate start
$225.7k - $428.9k
...professional on our Medical Management/Health... ...Full time Medical Director Centene Corporation... ...to affordable, high-quality services to Medicaid and Medicare members, as well as... ...leadership of all for utilization management, cost... ...approach to work with remote, hybrid, field or...Remote workQualityFull timePart timeWork at officeFlexible hoursWeekend work$225.7k - $428.9k
...professional on our Medical Management/Health... ...Full time Medical Director \n Centene Corporation... ...affordable, high-quality services to Medicaid and Medicare members, as well as... ...of all for utilization management, cost containment... ...to work with remote, hybrid, field or office...Remote workQualityFull timePart timeWork at officeFlexible hoursWeekend work- ...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
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