Remote Medicaid Medical Policy Director
Cotiviti USA, LLC
- Remote job
A healthcare solutions provider is seeking a Research Medical Director responsible for providing leadership in clinical and policy research. This role involves analyzing and developing medical policies as well as interpreting medical coding guidelines. Candidates should possess an MD or DO degree with a strong background in research and project management. This position offers a competitive salary and the possibility of remote work from the United States. #J-18808-Ljbffr Cotiviti
$223.8k - $313.1k
...community The Behavioral Health Medical Director is responsible for... ...clinical guidelines, state policies, CMS policies and determinations... ...reference sources Learn Medicaid requirements and understand... ...Travel: While this is a remote position, occasional travel...Remote workFull timeTemporary workApprenticeshipWeekend work$174.07k - $374.92k
...Position Summary: This is a full-time, fully remote role. You can work from anywhere in the... ...impact on the health and well-being of Medicaid members across the country. Aetna... ...Virginia, and West Virginia. We are seeking a Medical Director to join our centralized Medical...Remote workHourly payFull timeTemporary workLocal areaWork from home- Humana is seeking a Behavioral Health Medical Director to lead clinical decision-making on... ...for services, aligned with Medicaid rules and Humana policies. Role requires an active medical license... ...experience in a health plan environment. Remote work from cluster states with...Remote job
- The American Speech-Language-Hearing Association is seeking a Director of Health Care Policy, Medicaid, in Rockville, MD. This exempt role leads the development and management of health care policies related to Medicaid, managed care, school-based funding, and privacy,...Suggested
- ...is seeking a Physician Administrator for the Ohio Department of Medicaid to lead and manage clinical oversight of Medicaid services.... ...s Medicaid population. The successful candidate must possess a medical license and demonstrate skills in collaboration, innovation, and...Suggested
- ***Remote and must live in or relocating to Idaho***JOB DESCRIPTION Job SummaryLeads and... ...adequacy for Medicare, Marketplace, and Medicaid services. • In conjunction with network... ...initiatives to positively influence the medical cost ratio (MCR) in each contracted region...Remote workContract workLive inWork at officeRelocation
$165k - $175k
...passion for shaping healthcare policy, advancing advocacy... ...Surgeons (ASPS) is seeking a Director of Government and Political Affairs... ...Project Manager Location: Remote in the US, Chicago or DC based... ...Alliance for Specialty Medicine, medical associations, specialty...Remote workFull timeLocal areaWorldwideFlexible hoursAfternoon shift$209.6k - $313.38k
...Medical Director, Global Medical Strategy Otsuka is a leader and innovator in the therapeutic area, with a strong portfolio of development... ...their work activities in compliance with all Otsuka internal policies and SOPs and with all applicable regional and federal...Remote workTemporary workLocal areaFlexible hours$120k - $135k
...#LifeatRealChem.Job Summary:Real Chemistry is looking for an Associate Director, Medical Strategy tojoin our growing team!Our Associate Directors... ...New York City, Boston, Chicago, Carmel, or San Francisco—or remotely within the US, depending on team and business needs.What you...Remote workWork at officeLocal area2 days per week$209.6k - $313.38k
...Remote Full time R12284 Otsuka is a leader and innovator in the therapeutic... ...of development and marketed assets. The Medical Director, Global Medical Strategy is a key leader... ...in compliance with all Otsuka internal policies and SOPs and with all applicable regional...Remote workFull timeTemporary workLocal areaWorldwideFlexible hours$122k - $203k
..., with an emphasis on Medicaid programs and the responsible... ....The Associate Director will oversee cross-functional... ...that aligns to agency policies and applicable... ...workplace.Benefits include:Medical, Rx, Dental & Vision... ...SummaryLocation: US - Remote (Any location); US -...Remote workFull timeFlexible hours- ...Lilly is seeking a Senior Director, Global Medical Affairs to lead the global medical strategy for Centessa's orexin program, guiding launch readiness... ...teams, and serving as the medical voice of the asset. Remote, US-based with travel. #J-18808-Ljbffr Jobleads-USRemote work
- Prime Therapeutics LLC is seeking a Sr. Dir. Clinical Acct Services to lead clinical account management for Medicaid PBM programs and related operations. This remote role oversees clinical staff, ensures regulatory compliance and drives client outcomes in cost and care...Remote job
- Blue Cross and Blue Shield of Nebraska seeks a physician leader to direct medical management strategies, improve patient outcomes, and manage cost for the assigned region. The role oversees utilization review, prior authorizations, and collaboration with providers, facilities...Remote job
- Johnson & Johnson is seeking a Medical Director, Dermatology in the US Immunology Medical Affairs group. The role is based in Horsham, PA, with a hybrid schedule (3 days in office, 2 days remote). You will lead Phase 3b/4 trials, real-world evidence studies, and investigator...Remote workWork at office
- A staffing agency is seeking an experienced Medical Director specializing in Rare Disease and Vaccines for a remote consulting role. The ideal candidate will provide strategic scientific guidance and translate complex data into actionable strategies. Applicants should have...Remote jobFlexible hours
- ***Remote and must live in NY or the Tristate area***JOB DESCRIPTIONJob SummaryProvides subject... ...strategies that positively impact the medical cost ratio (MCR) within each region. •... ...methodologies, primarily across Medicaid and Medicare lines of business, including...Remote workContract workLive inWork at office
$198k - $330k
Position SummaryYou will lead global medical activities for oncology assets and work closely... ...States and is hybrid, with a mix of remote and on-site work expected. Travel will be... ...please visit the Centers for Medicare and Medicaid Services (CMS) website at SummaryLocation...Remote workFull timeLocal areaWork from home- Revive BHS in Maryland seeks a Medical Billing Manager to oversee the Medicaid billing team, coordinating with Medical Billing Specialists and clients to ensure accurate submissions, documentation, and timely authorizations. This role drives effective billing workflows...Remote job
$225k - $275k
Overview The Research Medical Director is a key member of the Clinical and Policy research development area at Cotiviti. The... ...is a full‑time role and can work remotely in the US. Target start date... ...experience. Experience working with a Medicaid payer preferred. Knowledge of...Remote workFull timeWork at officeImmediate start$1,020 per month
...INITIATIVE SENIOR DIRECTOR, HEALTH PLANS The Context... ...dollars spent on medical care alone. The amount... ...institutions to redesign their policies and invest... ...North Carolina to use Medicaid dollars to provide patients... ...role and is fully remote within the US. THI expects...Remote workFull timeTemporary workInterim roleWork at officeFlexible hoursShift workWeekend workAfternoon shift$167.6k - $195.2k
...Medicare services. This role includes advising on national policies, evaluating medical therapies for impact on Medicare, and maintaining liaison... ...include medical and vision insurance, 401(k), and paid parental leave. #J-18808-Ljbffr Centers for Medicare & Medicaid ServicesFull time- The National Institute for Reproductive Health is seeking a Director of Policy and Research to lead policy work across abortion access, culturally congruent pregnancy care, and privacy protections. Reporting to the VP of Policy & Research, you will shape strategy and coordinate...Remote job
$110k - $130k
...regional and national Medicaid managed care organizations... ...with Account Director for complex accounts where... ...Account Manager Location: Remote, USA Base Salary... ...✅ Healthcare Coverage (Medical, Dental, Vision) ✅ 401... ...Employer. It is our firm policy to extend equal employment...Remote jobFull timeContract workLocal areaFlexible hours- Real Chemistry seeks a Medical Director, Publications to lead scientific strategy and content across accounts, ensuring credible, compliant... ...Chicago, San Francisco, Carmel (IN), or Lambertville (NJ), or remote within the US. Role requires working eastern US hours and...Remote work
$112.7k - $193.2k
...solid strategic mindset, and meaningful Medicaid and Medicare knowledge. This role requires... ..., you will have the flexibility to work remotely* as you take on some tough challenges.... ...adhere to UnitedHealth Group's Telecommuter Policy.Pay is based on several factors...Remote workMinimum wageFull timeWork experience placementLocal area$248.5k - $373k
...500 - $373,000/yearJob Area: Medical & Clinical OperationsCompany:... ...businesses in serving our Medicare, Medicaid and commercial members and... ...the flexibility to work remotely * from anywhere within the U.... ...each memberWork with medical director teams focusing on inpatient care...Remote workMinimum wageFull timeWork experience placementWork at officeLocal area- Novo Nordisk is seeking a Medical Director based in Princeton, NJ to serve as a subject-matter expert for Diabetes and Renal products. You... ...and align with Medical Affairs, Marketing and Global teams. Remote/home-office in the US with 20-30% overnight travel is expected...Remote workHome officeNight shift
- Razorfish Health in New York, NY is seeking a VP, Medical Director to provide medical, scientific, and strategic leadership for clients and internal teams. This senior medical voice translates complex science into compelling medical communications aligned with client goals...Remote job
$187.28k - $312.13k
Position SummaryA Medical Affairs Medical Director has strong clinical and scientific... ...alignment with relevant GSK policies and procedures.For all... ...with a mix of on-site and remote work. Exact on-site days will... ...Centers for Medicare and Medicaid Services (CMS) website at...Remote workFull timeLocal area
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