Remote Medicaid Medical Policy Director
Cotiviti USA, LLC
New York, NY
- 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
Vacancy posted 3 days ago
Similar jobs that could be interesting for youBased on the Remote Medicaid Medical Policy Director in New York, NY vacancy
- ...Humana Inc. seeks a Medical Director to lead Medicaid care strategy and operational decisions across a multi-state cluster. Responsibilities include reviewing complex clinical cases, ensuring regulatory compliance, and coordinating with external physicians to discuss...Remote job
- ...CVS Health, including Aetna, seeks a Medical Director for a remote role supporting Medicaid members nationwide. Lead medical management decisions, partner with clinicians, and ensure timely, clinically sound reviews for diverse plans. Requirements include MD/DO with...Remote job
- ...CVS Health Corporation is seeking a Medical Director for Medicaid to join the centralized Medical Management team. This fully remote role supports Aetna Better Health of Virginia while providing regional coverage across the Northeast and other plans as needed. The...Remote job
- ...Humana Inc. is seeking a Medical Director to lead Medicaid care strategy and operations, evaluating services, care levels, and sites of service within regulatory guidelines. You will review complex cases, assess medical records, and communicate decisions to internal...Remote job
- ...Pennsylvania (onsite/hybrid/remote with periodic in state... ...) Reports to: Chief Medical Officer Department:... ...regulatory performance for our Medicaid line of business across... ..., including medical policy, clinical guidelines,... ...leadership role (Medical Director or Deputy) specific to...Remote workFull timeContract workPart timeWork at officeRelocation
Geisinger
Danville, PAa month ago $223.8k - $313.1k
...community The Behavioral Health Medical Director is responsible for... ...clinical guidelines, state policies, CMS policies and determinations... ...other reference sources Learn Medicaid requirements and understand... ...cluster. Travel: While this is a remote position, occasional travel...Remote workWeekly payFull timeTemporary workApprenticeshipWeekend workHumana
Raleigh, NC1 day ago$174.07k - $374.92k
...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... ...West Virginia. We are seeking a Medical Director to join our centralized Medical Management...Remote workHourly payFull timeTemporary workLocal areaWork from home- ...Humana Inc. is seeking a Medical Director to lead Medicaid care strategy and operations in a remote nationwide role. This senior physician will evaluate requested... ...within regulatory guidelines, leveraging CMS policies and NCQA standards. The role requires MD or DO...Remote job
$191.5k - $355.6k
...service corporation is seeking a Physician (M.D. or D.O) to handle medical policy responsibilities and perform medical reviews while interacting... ..., and 5 years of clinical experience. The position is 100% remote, with a competitive compensation package ranging from $191,500...Remote job- ...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...
- ...Humana Inc is seeking a Medical Director for Behavioral Health to oversee complex behavioral health care strategies. This remote position requires a Doctor of Medicine or Osteopathy and board certification in Psychiatry, along with extensive experience in clinical services...Remote job
- ***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
$141.6k - $212.4k
..., supplemental health, medical stop-loss insurance, and... ...are designed for Medicaid and CHIP, Medicare Advantage... ...The opportunity: The Director, Health Plan Dental Solutions... ...independently in a remote environment while... ...employee California Privacy Policy and Notice.We do not require...Remote workFull timeWork at officeLocal areaFlexible hours$72k - $130k
Transformcap is seeking an Associate Director/Director of Medicaid Entitlement & Coverage Strategy to lead... ...role requires expertise in Medicaid policy and experience in healthcare... ...The position offers the flexibility of remote work, although candidates from certain...Remote job$174.07k - $374.92k
...Louisiana & West Virginia). **This is a remote based (work at home) based anywhere... ...US.** Responsibilities of this Medical Director role are related to Medicaid Appeals You will support the... ...Previous experience in Medicaid Policy and the use of Dynamo Appeals and Grievances...Remote workHourly payFull timeTemporary workLocal areaWork from home- 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 workFlexible hours
Clutch
United States1 day ago $238k - $357.5k
...Optum is hiring Medical Directors in remote, full-time roles. These positions are ideal for Ear, Nose & Throat physicians who want to apply their clinical expertise in a strategic, administrative setting that improves care outcomes. Your impact includes coverage reviews...Remote workFull timeOptum
Phoenix, AZ1 day ago- ...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 work
Avanir Pharmaceuticals
United States2 days ago $86.3k - $118.7k
...Digital Space LLC is hiring a Product Manager-Medicaid & Duals to oversee insurance products... ...of related experience. The position is remote, accommodates EST/CST hours, and offers a... ...plus bonus eligibility. Benefits include medical, dental, vision, and 401(k) plans. #J-18...Remote work$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 shiftPositively Partners
Attleboro, MAmore than 2 months ago$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$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- ...Medicaid Program Health Manager At Blue Cross and Blue Shield of Minnesota, we are committed... ...: Teleworking is working full time remote. Hybrid is a minimum of 2 days onsite.... ...benefits package which may include: ~ Medical, dental, and vision insurance ~ Life insurance...Remote workFull timeFor contractorsWork at office2 days per week
- ...Medicaid Project Manager-RHTP Job Description Key Responsibilities Lead the project management and operational implementation... ...reports. Minimum Requirements Master's degree in Public Policy, Public Administration, Public Health, Healthcare Administration...Remote workTemporary work
RICEFW Technologies Inc
Providence, RI1 day ago $150k - $188k
...care, including hospitals, health systems, medical groups, academic medical centers,... ...affiliate network development. Assistance with Medicaid managed care program participation. Patient... ...a client engagement. We will consider remote hires, but prefer an in‑office presence through...Remote workPermanent employmentFull timeContract workWork at office2 days per weekECG Management Consultants
San Diego, CA2 days ago- ...Centene Corp. is seeking a Medical Director for our Health Plan in New Hampshire. This full-time role offers remote/hybrid flexibility and requires active medical practice with NH licensure. You will direct medical management, quality improvement, and credentialing...Remote jobFull time
- ...MetroPlus in New York seeks a Medical Director focused on health care utilization management. The position involves overseeing medical necessity reviews, conducting peer discussions, and guiding policy implementation. Candidates should possess a Doctor of Medicine or Doctor...Remote job
- ...active, unrestricted license in the United States to perform medical reviews and support medical policies for the assigned regions. The role emphasizes analytics, communication, and strategic thinking within a remote, Monday–Friday schedule. Preferred candidates have...Remote jobWork at officeMonday to Friday
$140k - $180k
...Biolink360 is seeking a Senior Director, Policy, Research & Analysis to lead health policy strategy for pharmaceutical and biotech clients. With a compensation range of $140K-$180K plus bonus, this remote role requires a seasoned leader who can navigate complex policy...Remote workBioLink 360
New York, NY2 days ago- ***Remote and must live in Washington***JOB DESCRIPTIONJob SummaryProvides subject matter... ...control 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
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Remote Medicaid Medical Policy Director. Be the first to apply!
Related searches
- health account manager New York, NY
- home health manager New York, NY
- hospital account manager New York, NY
- senior manager clinical operations New York, NY
- medical education manager New York, NY
- change healthcare project manager New York, NY
- regional director of clinical operations New York, NY
- public health project manager New York, NY
- director population health New York, NY
- director of clinical quality New York, NY