Remote Medical Director & Surgeon, Claims & UM Expert
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- Remote job
Optum is seeking a Medical Director to provide physician support for Enterprise Clinical Services, guiding coverage determinations and cost-effective care. The role emphasizes applying clinical expertise to post-service reviews, collaborating with network and non-network physicians, and ensuring timely, high-quality medical decisions. You can work remotely from anywhere in the U.S. This leadership position requires an MD/DO with board certification and strong EBMs, plus extensive clinical #J-18808-Ljbffr Tnafp
$248.5k - $373k
...0.00 - $373,000.00/yearJob Area: Medical & Clinical OperationsCompany: UnitedHealth... ...together.As part of the Focus Claims Review team at Optum, the Medical Director provides leadership, organization... ...ll enjoy the flexibility to work remotely * from anywhere within the U.S....Remote workClaimsMinimum wageFull timeWork experience placementLocal areaMonday to FridayFlexible hours- UnitedHealth Group seeks a Medical Director to provide physician support for Enterprise Clinical Services. The role focuses on clinical review, benefit coverage determinations, and cost-effective care across networks. The position supports post-service reviews and interacts...Remote jobClaims
- Optum is seeking a Medical Director to provide physician support to Enterprise Clinical Services and to lead clinical and operational processes... ...involvement in utilization management. The position offers remote work within the United States, with responsibilities...Remote jobClaims
- UnitedHealth Group is seeking a Medical Director to provide physician support for Enterprise Clinical Services, focusing on clinical reviews, benefit coverage determinations and cost-effective care delivery. This role supports network and non-network providers and drives...Remote jobClaimsFlexible hours
$248.5k - $373k
...500 - $373,000/yearJob Area: Medical & Clinical OperationsCompany:... ...enjoy the flexibility to work remotely * from anywhere within the U.... ...each memberWork with medical director teams focusing on inpatient... ...appeals clinical review, medical claim review and provider appeals...Remote workClaimsMinimum wageFull timeWork experience placementWork at officeLocal area$248.5k - $373k
...500 - $373,000/yearJob Area: Medical & Clinical OperationsCompany:... ...clinical coverage and medical claims reviews. Our role is to... ...health care costs.The Medical Director provides physician support to... ...enjoy the flexibility to work remotely * from anywhere within the U....Remote workClaimsMinimum wageFull timeWork experience placementLocal area- ...Partners, a national DMEPOS network administrator, seeks a remote Utilization Review Medical Director. You will conduct clinical reviews of DMEPOS requests,... .../DO, board certification in Internal Medicine, Family Medicine, or PM&R, and UM/NCQA #J-18808-Ljbffr Remote GenieRemote jobFull time
$280.84k - $393.18k
...Services, the Senior Medical Director Policy & Outcomes (Sr.... ...provider relations, and claims.Serve as a liaison... ...Director focusing on UM to coordinate daily huddles... ...Physician’s and Surgeon’s Certificate issued by... ...schedule. (Mon & Fri - remote, Tues - Thurs onsite in...Remote workClaimsTemporary workLocal area- ...Associate Medical Director In support of the CMO, the Associate Medical Director is responsible... ...and clinical decision making of the UM program, including but not limited to rendering... ...medical guidelines and parameters for claims review Assist in the training of NHP...Remote workClaimsContract workWork at officeLocal areaWork from homeHome officeMonday to FridayWeekend work
$190k - $200k
We're seeking a board‑certified Medical Director (Internal Medicine or Family Practice... ...our team. This role is fully remote and focuses on utilization management (UM), quality review, and clinical... ...complex/controversial services and claims appeals. Support physician...Remote workClaimsFull time- ...seeking a highly skilled, hands-on Medical Bill Review (Working)... ...will serve as a Subject Matter Expert (SME) and Expert Witness for legal... ...stipend are provided for remote workspace. About Dane Street... ...process over 200,000 insurance claims annually for leading national...Remote workClaimsContract workTemporary work
$248.5k - $373k
...500.00 - $373,000.00Job Area: Medical & Clinical OperationsCompany:... ...a member of a team of medical directors, for the overall quality, effectiveness... ...enjoy the flexibility to work remotely * from anywhere within the U.S... ...in managed care UM activities/ coverage reviewsExperience...Remote workMinimum wageWork experience placementLocal areaWeekend work$174.07k - $374.92k
...Summary The Radiation Oncology Medical Director supports the CVS Health... ...management when necessary. This is a remote based (work from home)... ...predetermination reviews and review of claim determinations, In the... ...Qualifications Previous UM experience with a Health Plan...Remote workClaimsHourly payFull timeTemporary workLocal areaWork from homeWeekend work- ...Detroit seeks an attorney to join the staff counsel team, handling BI/UM and PIP cases. You may work from home or at an approved location... ...managing cases from intake to resolution, and collaborating with Claims and leadership to improve outcomes. #J-18808-Ljbffr Farmers...Remote jobClaimsWork from home
- ...Logan Health is seeking a Medical Billing & Collections Specialist for a remote, full-time position. The specialist will ensure the accuracy of claim submissions and handle various billing responsibilities. The role requires 1+ year of experience in a medical setting,...Remote workClaimsFull time
- Vytwo seeks a Physician ED Claims Reviewer for a 12-month remote assignment. The clinician will conduct clinical review of claims and UM authorization requests to determine clinical necessity... .... Ideal candidates hold an active US medical license with 3-5 years of emergency...Remote jobClaims
- ...026-09-06UnitedHealth Group is seeking a Medical Coder to perform CPT/HCPCS/ICD-10 coding... ...compliance.You will prepare and transmit claims using billing software, coordinate with providers... ...revenue and minimize denials. This remote role offers flexible hours within EST...Remote workClaimsFlexible hours
$65k - $150k
..., and communities.The RoleAs a Product Expert for Veeva Compass, you will be the primary... ...IQVIA, Komodo (i.e., prescription and medical claims, payer data, sales/performance data... ...variable bonus and/or stock bonus.#LI-Remote#LI-AssociateVeeva’s headquarters is located...Remote workClaimsWork at officeLocal areaWork from home3 days per week- ...care for vulnerable populationsApply nursing judgment to analyze medical records, documentation, and billing dataCollaborate with... ...utilization review, case management, quality improvement, compliance, or claims review is a plus—but not required.Why Join Us:Mission-driven...Remote workClaimsWork from home
- ...spotting subtle meaning shifts, awkward literal translations, hallucinated claims, or culturally mismatched phrasing. Reliable, self-directed, and able to deliver consistent quality in an hourly, remote contractor workflow across time zones. Prior experience with AI...Remote workClaimsHourly payFor contractorsShift work
$120k - $140k
...Additionally, you will enjoy:Medical, Dental, and Vision Insurance;... ...careerJob DescriptionThis is a remote position and can be located... ...OverviewThe Commercialization Expert serves as the strategic bridge... ...this person analyzes technical claims, business models, market fit,...Remote workClaimsFull time- ...Prolific is seeking Biology Experts and Life Science Professionals in Jacksonville, Florida, to join our Expert Network for evaluating... ...academia. Responsibilities include fact-checking AI technical claims and assessing experimental logic. The role includes flexible work...Remote workClaimsHourly payFlexible hours
$170.6k - $250k
...Who are you? You are a recognized expert in both deep learning and autonomous vehicle... ...US-based HERE employees include health (Medical/Dental/Vision) insurance, retirement savings... .... Offers of employment and any related claims are subject to the successful completion...Remote workClaims- ...Optum, part of UnitedHealth Group, seeks a Medical Director to lead the claims review program and oversee medical services quality and coordination... ...providers, guiding clinical criteria and policy development. Remote work is available nationwide within the U.S. The...Remote workClaims
- ...Optum is seeking a Medical Director to lead claims review, provide clinical oversight, and ensure quality across medical services. The role involves... ...and shaping policies for medical programs and services. Remote work offered across the U.S. with focus on regulatory...Remote workClaims
- ...leading pet insurance provider is seeking a Claims Adjuster in New York, NY. The role... ...claims processing and evaluating veterinary medical records. Ideal candidates should have at... ...be capable of working independently in a remote setting. This position offers an opportunity...Remote workClaims
$248.5k - $373k
...Medical Director Optum is a global organization that delivers care, aided by technology to help... ...You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take... ...Experience in managed care UM activities/ coverage reviews Experience...Remote jobMinimum wageWork experience placementLocal areaWeekend work$19.86 - $38.85 per hour
...UnitedHealth Group invites applications for the role of Medical Coder, offering a national remote position. This full-time role involves performing code reviews on provider inquiries and claims, ensuring compliance through medical record audits. Applicants must have a...Remote workClaimsHourly payFull time- ...-by-step problem‑solving while providing expert feedback that helps models produce answers... ...quality. This is an hourly paid, fully remote contractor role with flexible work‑from‑anywhere... ...‑checking habits and comfort validating claims using reputable sources when required by...Remote workClaimsHourly payFor contractorsFlexible hours
- ...UnitedHealth Group’s Optum is hiring a Medical Director to lead the claims review program. You will oversee medical services, coordinate with physicians... ...criteria for medical programs. This role offers remote work from anywhere in the U.S. and requires board certification...Remote workClaims
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