Remote Medical Director — Utilization & Care Standards
Integrated Resources Inc
- Remote job
A healthcare management organization is seeking a Remote Medical Director to lead the review of medical records and provide expert decision-making. This role demands a blend of clinical experience, leadership, and the ability to guide a team while ensuring compliance with national guidelines and company policies. Ideal candidates will have significant clinical experience, an MD or DO degree, and a passion for quality in healthcare. The position offers a contract employment type and requires working 40 hours a week with some weekend coverage. #J-18808-Ljbffr Integrated Resources, Inc.
- .... We prioritize preventive care while leveraging data and technology... ...who need it most. The Medical Director, Utilization Management, will be... ...regulatory and compliance standards. How will success... ...Additionally, we embrace a remote-first culture that supports...Remote workFull timeWork at officeLocal areaFlexible hours
- ...Staffing is urgently seeking a Medical Director of Utilization Management to join a... ...of inpatient and post-acute care reviews, evaluating medical... ...compliance. Location: 100% Remote Schedule: Full-Time, Monday... ...are committed to the highest standards of confidentiality and...Remote workFull timeMonday to Friday
$213.1k - $308.3k
...977 as the Senior Care Action Network, SCAN... ...care for the most medically and socially... ...serve. The Job The Utilization Management (UM) Physician Medical Director provides physician... ...URAC accreditation standards. The Medical Director... ...Mode - Mostly Remote: Employees who reside...Remote workFor contractorsWork at officeLocal areaRelocation- ...Services Unlimited, LLC is seeking a Medical Director, Utilization Management to lead clinical utilization... ...reviews for inpatient and post-acute care, ensuring medical necessity determinations... ..., and evidence-based criteria. Remote opportunity in New Jersey for a board-...Remote work
$75.3k - $135.4k
...behavioral health (BH) utilization review clinicians to ensure appropriate care for members and supervises... ...? Centene is seeking a remote Supervisor, Behavioral... ..., and efficiency standards Works with BH utilization... .... Understanding of medical necessity criteria for...Remote workFull timePart timeWork at officeFlexible hours$58.82k - $98.03k
...Category: Clinical Care The future is... ...Behavioral Health Utilization Care Manager , you... ..., ensuring medical necessity and alignment... ...will be entirely remote . This position... ...regularly with medical directors. Within the scope... ...professional standards. Provides all customers...Remote workFull timeWork experience placementWork at officeLocal areaImmediate startMonday to FridayShift work$238k - $357.5k
...organization that delivers care, aided by technology to help... ...an Inpatient Care Management Medical Director to join our Optum team. This... ...staff to manage inpatient care utilization at a hospital, market,... ...enjoy the flexibility to work remotely * from within the State of Missouri...Remote jobMinimum wageFor contractorsWork experience placementLocal area$248.5k - $373k
...Medical Director For Utilization Management WellMed, part of the Optum family of businesses, is seeking... ...Management team. Optum is a clinician-led care organization that is changing the way... ...You'll enjoy the flexibility to work remotely from anywhere within the U.S. as you...Remote jobMinimum wageFull timeWork experience placementWork at officeLocal areaWork from home- ...Humana Inc is seeking a Medical Director to lead inpatient medical necessity reviews and utilization management with a focus on quality... ...medicine, critical care, or ED experience to assess... ...and support Humana’s care standards. This remote position requires MD or DO,...Remote work
$248.5k - $373k
...3,000.00Job Area: Medical & Clinical OperationsCompany... ...that delivers care, aided by... ...a team of medical directors, for the overall quality... ..., performs Utilization Management reviews... ...flexibility to work remotely * from anywhere within... ...regulatory agency standards and requirements (...Remote workMinimum wageWork experience placementLocal areaWeekend work- ...Health Choice is seeking a Behavioral Health Utilization Manager with nursing credentials to... ...established criteria for admission and ongoing care. You will communicate outcomes to... ...psychiatric/managed care settings, with remote work arrangements and strong clinical decision...Remote work
$223.8k - $313.1k
...Become a part of our caring community The Medical Director relies on medical background... ...or those experienced in Utilization Review are encouraged to... ...and recognized clinical standards. Analyze complex hospital... ...Director. Work Style: Remote in the contiguous US, may...Remote workFull timeTemporary workApprenticeshipWork at officeLocal areaWork from homeHome officeMonday to FridayWeekend work$215k - $408.5k
...Assist the Chief Medical Director to direct and coordinate... ...leadership of all for utilization management, cost containment... ...-effectiveness of care and service for... ...quality accreditation standards preferred. Actively... ...approach to work with remote, hybrid, field or...Remote workFull timePart timeWork at officeFlexible hoursWeekend work$320k - $340k
...partner is looking for a Lead Medical Director, Utilization Management based in the... ...inpatient admissions, and other care requests. Alongside... ...access, and outcomes. This remote-first role combines hands-on... ...coverage policies, and clinical standards. Lead and manage a...Remote workFull timeWork at officeFlexible hours- Clover Health is seeking a Medical Director, Utilization Management, to lead evaluation of outpatient referrals and inpatient admissions for medical... ...while maintaining licensure and board-certification standards across the organization. #J-18808-Ljbffr Clover HealthRemote job
$207.8k - $346.3k
...make an impact? As a Medical Director at EviCore, part of Evernorth... ...high-quality patient care. Collaborate with... ...’ll start training remotely in a structured... ...state and federal laws, Utilization Review Accreditation... ...for Quality Assurance standards is a plus Ability to...Remote jobLocal areaWork from homeMonday to Friday$255k - $367.03k
...977 as the Senior Care Action Network, SCAN... ...care for the most medically and socially... ...we serve. Medical Director Responsibilities Leadership... ...outcomes and utilization rates. Use this data... .../documentation standards, guidelines, and quality... ...Work Mode: Remote/Field Robust Wellness...Remote workFor contractorsWork from homeWeekend work- ...Description Location: Fully Remote | Candidates must be... ...physician leader for a remote Medical Director, Utilization Management (Home Health, Acute... ...(NCD/LCD), Milliman Care Guidelines (MCG), and health... ...leadership to promote documentation standards and alignment with evidence...Remote workPart timeLocal areaImmediate startWork from home
- Medical Director, Utilization Management Location: New Jersey - Fully Remote Work Arrangement: Remote Job Type: Contract Contract Length... ...for extension Schedule: Standard business hours; schedule to be... ...on inpatient and post-acute care reviews. This position is responsible...Remote workHourly payContract workImmediate start
- ...of All-Inclusive Care for the Elderly (PACE... ...comprehensive medical care along with support... ...: The Medical Director is the senior... ...Committee and uses utilization and safety data (ED... ...administrative, community, or remote environments,... .... ~ Operate standard office equipment...Remote workFor contractorsWork at officeWork from home
$125 per hour
...together comprise our health care delivery system... ...care while efficiently utilizing healthcare resources.... ...clinical consulting and medical review services in... ...generally be performed remotely and on an as-needed basis... ...practices, clinical standards, and applicable regulatory...Remote workHourly payFull timePart timeFor contractorsLocal areaFlexible hours- ...DESCRIPTION Job Summary Provides medical oversight and expertise in... ...receive the most appropriate care in the most effective setting... ...members. • Supports plan utilization management program and... ...leadership and consultation for NCQA standards/guidelines for the plan...Work at officeLocal area
- ...seeks a regional medical leader to guide musculoskeletal... ...value-based care initiatives across... ...the region from a remote position. The Regional Medical Director will provide... ...strategies with quality, utilization, and cost-... ...compliance with regulatory standards while advancing...Remote job
- ...and detail oriented Medical Director to join our team. The... ...drive improvements in care delivery. After completion... ...meet the highest standards of care and adhere to... ....This is a remote position.ESSENTIAL DUTIES... ...willingness to obtain.Utilization management experience...Remote jobFull timeWork at officeLocal areaImmediate startWork from homeMonday to FridayShift work
$248.5k - $373k
...Medical Director For UnitedHealthcare Community & State New... ...simplifying the health care experience, creating... ...opportunity to shape utilization management, quality... ...support evidence-based standards of care Promote... ...York-based role with remote flexibility Occasional...Remote workMinimum wageWork experience placementLocal area- ...company is hiring a Physical Health Medical Director to work remotely in North Carolina. The... ...goals related to clinical quality, utilization management, and care coordination. This position will... ..., and organizational standards Review Approval and Denial of...Remote workTemporary workWork experience placementWork at officeRelocationFlexible hoursWeekend work
- ...Clinical Supervisor Location: Remote (must be located in... ...is a value-based palliative care provider group dedicated to... ...families while reducing avoidable medical utilization during the final years of... ...accreditation, and organizational standards, policies, and procedures...Remote work
$248.5k - $373k
...373,000/yearJob Area: Medical & Clinical OperationsCompany... ...that delivers care, aided by technology to... ...care costs.The Medical Director provides physician support... ...knowledge in various utilization management activities... ...flexibility to work remotely * from anywhere within...Remote workMinimum wageFull timeWork experience placementLocal area$248.5k - $373k
...373,000/yearJob Area: Medical & Clinical OperationsCompany... ...that delivers care, aided by technology to... ...at Optum, the Medical Director provides leadership, organization... ...flexibility to work remotely * from anywhere within... ...regulatory agency standards and requirements (e.g....Remote workMinimum wageFull timeWork experience placementWork at officeLocal area$248.5k - $373k
...373,000/yearJob Area: Medical & Clinical OperationsCompany... ...that delivers care, aided by technology to... ...care costs.The Medical Director provides physician support... ...knowledge in various utilization management activities... ...flexibility to work remotely * from anywhere within...Remote workMinimum wageFull timeWork experience placementLocal area
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Remote Medical Director — Utilization & Care Standards. Be the first to apply!
- health account manager New York, NY
- project manager health New York, NY
- clinical research director New York, NY
- medical director oncology New York, NY
- senior director clinical development New York, NY
- healthcare project manager New York, NY
- hospital manager New York, NY
- associate director clinical operations New York, NY
- clinical research manager New York, NY
- associate director clinical research New York, NY





