Remote Medical Director, Utilization & Policy
UnitedHealth Group
- Remote job
UnitedHealth Group is seeking a Medical Director to provide physician support for Enterprise Clinical Services, focusing on clinical coverage determinations and evidence-based decision-making. You will collaborate with network and non-network physicians and senior clinicians to optimize care and cost effectiveness. The role allows remote work from anywhere in the United States, with responsibilities spanning coverage reviews, documentation, and peer discussions. #J-18808-Ljbffr UnitedHealth Group
$275k - $325k
...growing, TOI is changing oncology for the better. Utilization Management Medical Director OncologyWork Location: REMOTE (work from home)California Nevada Arizona... ...insights, and oversight of utilization management policies to optimize patient outcomes. Key Responsibilities...Remote workPolicyWork from home$248.5k - $373k
...373,000/yearJob Area: Medical & Clinical OperationsCompany... ...costs.The Medical Director provides physician... ...knowledge in various utilization management activities... ...the flexibility to work remotely * from anywhere within... ...proprietary coverage review policies, render coverage...Remote workPolicyMinimum wageFull timeWork experience placementLocal area- ...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... ...criteria and internal policies Maintain continuous case throughput...Remote workPolicyFull time
$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... ...medicine guidelines, and UM policies and procedures with...Remote workPolicyMinimum wageFull timeWork experience placementWork at officeLocal areaWork from home- Integra Partners seeks an experienced Utilization Review Medical Director to lead clinical reviews of DMEPOS requests within a remote UM environment. You will ensure decisions meet... .../Medicaid guidelines and internal policies while maintaining timely throughput and documented...Remote jobPolicy
$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... ...across the care continuum–including policy, prior authorization, payment...Remote workPolicyFlexible hours- ...Health is seeking a Part-Time Medical Director to provide physician... ...for medical management and utilization review programs. You will align clinical decisions and policies with evidence-based medicine... ...organizational standards in a fully remote role based in the United...Remote jobPolicyPart time
- Confidential is seeking a Medical Director to lead utilization management activities within a multidisciplinary... ..., and support appeals while guiding policy and disease management initiatives.... ...teams to improve care processes. Remote work is supported with Eastern daytime...Remote workPolicy
- ...Medical Director Utilization Management Location: Remote Preference EST or nearby Pittsburgh PA, NY, WV Duration: 6+ Months Contract Role with possible extension... ...escalated cases electronically using Medical Policy criteria sets to evaluate the medical necessity...Remote workPolicyContract workPrivate practice
- ...Group, through UnitedHealthcare, seeks a Medical Director of Clinical AI Innovation and... ...training, testing, and surveillance for utilization management criteria, leveraging InterQual... ...reports to UCS and collaborates with Medical Policy, Data Science, and UM leadership. #J-1...Remote jobPolicy
- ...Medical Director Utilization Management (Payer Side Experience Required)- (Remote) Duration: 30 Weeks with possible extension Location: Pittsburgh, PA Schedule: Monday Friday... ...case evaluations using established medical policy criteria. The Medical Director will...Remote workPolicyFull timeContract workPart timePrivate practiceMonday to FridayFlexible hours
$150 per hour
The Utilization Review Medical Director is responsible for conducting clinical reviews of Durable Medical Equipment... ...plan–specific criteria, internal policies, and regulatory requirements. This... ...and Additional Expectations: Remote role requiring consistent availability...Remote workPolicyHourly payFull timeContract workTemporary workPart timeLocal area$248.5k - $373k
...Medical Director Optum is a global organization that delivers care,... ...clinical knowledge in various utilization management activities with... ...the flexibility to work remotely from anywhere within the U.... ...proprietary coverage review policies, render coverage determinations...Remote jobPolicyMinimum wageFull timeWork experience placementLocal area$248.5k - $373k
...Medical Director Optum is a global organization that delivers care,... ...clinical knowledge in various utilization management activities with... ...the flexibility to work remotely from anywhere within the U.... ...proprietary coverage review policies, render coverage determinations...Remote jobPolicyMinimum wageFull timeWork experience placementLocal area$248.5k - $373k
...Medical Director For Utilization ManagementWellMed, part of the Optum family of businesses, is seeking an... ...You'll enjoy the flexibility to work remotely from anywhere within the U.S. as you... ...of medicine guidelines, and UM policies and procedures with counsel when criterion...Remote workPolicyMinimum wageFull timeWork experience placementWork at officeLocal areaWork from home- 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 jobPolicy
- ...UnitedHealth Group's Optum division seeks a Medical Director to provide physician support for... ...ensure appropriate medical review and policy adherence. The position requires an MD... ...license, and 5+ years of clinical practice. Remote work is available nationwide in the...Remote workPolicy
$102.9k - $190.5k
...Manages the behavioral health (BH) utilization review clinicians to ensure... ...management. This is a remote opportunity supporting BH UM.... ...with BH utilization management policies and procedures Identifies... ...~ Advanced understanding of medical necessity criteria for a broad...Remote workPolicyFull timePart timeWork at officeFlexible hours- A healthcare management organization is seeking a Remote Medical Director to lead the review of medical records and provide expert decision-making... ...ensuring compliance with national guidelines and company policies. Ideal candidates will have significant clinical experience...Remote jobPolicyContract workWeekend work
$223.8k - $313.1k
...The Behavioral Health Medical Director is responsible for behavioral... ...clinical guidelines, state policies, CMS policies and determinations... ...services Experience in utilization management review and case... ...Travel: While this is a remote position, occasional travel...Remote workPolicyFull timeTemporary workApprenticeshipWeekend work$217k - $284.8k
...Eisai, satisfying unmet medical needs and increasing... ...you.The Global Medical Director will provide medical... ...Medical Director will utilize expert medical/scientific... ...conjunction with the policies.Pipeline Strategy - (... ...ParticipationSummaryLocation: United States, Remote; New Jersey,...Remote workPolicyFull timeTemporary work$386.5k
...$579,500/yearJob Area: Medical & Clinical OperationsCompany... ...- starting with Utilization Management. The Medical Director, Clinical AI Innovation... ...models to ensure medical policies are accurately interpreted... ...the flexibility to work remotely * from anywhere within the...Remote workPolicyMinimum wageFull timeWork experience placementLocal area$280.84k - $393.18k
...President of Health Services, the Senior Medical Director Policy & Outcomes (Sr. Medical Director - P&... ...downstream connections to utilization management, population health, and other... ...a hybrid work schedule. (Mon & Fri - remote, Tues - Thurs onsite in Rancho Cucamonga...Remote workPolicyTemporary workLocal area- ...United StatesJob Area: Medical & Clinical... ...together.The Medical Director Clinical Informatics will... ...the flexibility to work remotely * from anywhere within... ..., author and maintain policies related to curation Provide... ...development teams to optimize utilization of clinical content in...Remote workPolicyMinimum wageWork experience placementLocal area
$248.5k - $373k
...Stay Billing Validation (SSBV) Medical Director to join our Clinical and... ...enjoy the flexibility to work remotely * from anywhere within the U... ...e.g., InterQual® or MCG) in utilization review or payment integrity... ...UnitedHealth Group's Telecommuter Policy Pay is based on several...Remote workPolicyMinimum wageFull timeWork experience placementLocal area$248.5k - $373k
...$373,000.00Job Area: Medical & Clinical OperationsCompany... ...of a team of medical directors, for the overall... ...Additionally, performs Utilization Management reviews and... ...and implementation of policies, procedures and clinical... ...flexibility to work remotely * from anywhere within...Remote workPolicyMinimum wageWork experience placementLocal areaWeekend work$206.01k
...Molecular Diagnostics Medicare Medical Director at Palmetto GBA oversees medical staff, analyzes utilization data, research emerging... ...providers and internal teams on policy issues. The role also includes... .../week) Monday-Friday working REMOTE in the United States or ONSITE...Remote workPolicyFull timeFor contractorsWork experience placementWork at officeLocal areaMonday to Friday$223.8k - $313.1k
Medical Director physician job in Texas : Become a part of our caring community... ..., or those experienced in Utilization Review are encouraged to... ..., CMS regulations, Humana policies, and recognized clinical standards... ...Travel: While this is a remote position, occasional travel...Remote workPolicyBi-weekly payTemporary workApprenticeshipWork at officeLocal areaWork from homeHome officeWork visaMonday to FridayWeekend work$190k - $200k
...We're seeking a board‑certified Medical Director (Internal Medicine or Family Practice... ...support our team. This role is fully remote and focuses on utilization management (UM), quality review,... ...business unit as needed. Consult on SUD policy and MCM cases when required. Review...Remote workPolicyFull time$215k - $408.5k
...clinical professional on our Medical Management/Health... ...: Full time Medical Director for our Health Plan in... ...leadership of all for utilization management, cost containment... ...goals and policies to improve quality and... ...approach to work with remote, hybrid, field or office...Remote workPolicyFull timePart timeWork at officeFlexible hoursWeekend work
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