Remote Medical Director - High-Volume Utilization & Appeals
Teamware Solutions Inc.
New York, NY
- Remote job
Teamware Solutions Inc. is seeking a Medical Director to review escalated medical cases, determine medical necessity, and ensure compliance with clinical guidelines and health care regulations. This 100% remote leadership role involves collaboration with multidisciplinary teams and guiding policy development. The ideal candidate holds an MD or DO, active license in PA/NY/WV, board certification, 5+ years of direct patient care, and UM experience in payer settings, with familiarity with #J-18808-Ljbffr Teamware Solutions Inc.
Vacancy posted 2 days ago
Similar jobs that could be interesting for youBased on the Remote Medical Director - High-Volume Utilization & Appeals in New York, NY vacancy
$180 per hour
...REMOTE MEDICAL DIRECTOR – UTILIZATION MANAGEMENT & APPEALS $180/hour | W-2 Contract | Monday–Friday | 100% Remote | Potential... ...UM team to ensure appropriate, high-quality, and medically necessary... ...working remotely and managing a high-volume caseload A GREAT FIT FOR...Remote workContract workWork at officeMonday to FridayThe Jacobson Group
United States3 days ago- ...Medical Director Curative is seeking an enthusiastic and highly skilled Medical Director to join... ...overseeing and performing utilization reviews, prior... .... This is a remote position requiring... ...regulations and appeal processes. Collaborate... ...to manage a high volume of cases...Remote workFull timeFlexible hours
CURAtive
United States4 days ago - ...Staffing is seeking an experienced physician leader for a remote Medical Director, Utilization Management (Home Health, Acute & Post-Acute) role. In... ...authorization requests while supporting acute, post-acute, appeals, reconsiderations, and outpatient medical necessity...Remote workFull timeContract workPart timeLocal areaWork from home
$275k - $315k
...Job Description Title: Medical Director of Utilization Management \n \n Summary... ..., complex case reviews, appeals, and peer-to-peer discussions... ...$275,000 - 315,000 / year \n High-impact leadership role with a hybrid schedule (3 days remote / 2 days onsite)\n...Remote workWork at officeMonday to FridayShift work2 days per weekMedix™
New York, NY2 days ago$236.5k
...Purpose:Assist the Chief Medical Director to direct and... ...leadership of all for utilization management, cost containment... ...and coordinate care for high-risk patients,... ...teams, network providers, appeals team, medical and pharmacy... ...approach to work with remote, hybrid, field or...Remote workFull timePart timeWork at officeFlexible hoursWeekend workCentene
Austin, TX3 days ago$236.5k
...professional on our Medical Management/Health... ...the Chief Medical Director to direct and... ...leadership of all for utilization management, cost containment... ...care for high-risk patients,... ...network providers, appeals team, medical and... ...approach to work with remote, hybrid, field or...Remote jobFull timePart timeWork at officeFlexible hoursWeekend work- ...Medical Director Utilization Management Location: Remote Preference EST or nearby Pittsburgh PA, NY, WV Duration: 6+... ...management and advises the team on high-risk and complex cases. Special... ...Complete initial determinations, appeals, grievances, and other reviews...Remote workContract workPrivate practice
- ...seeking a licensed professional to join their staff Remotely as their new Medical Director - Utilization Management. \n About the Opportunity: \n \n... ...-based research. \n Review medical necessity and appeal cases. \n Analyze utilization patterns, retrospective...Remote jobMonday to FridayShift work
Tandym Health
New York, NY26 days ago - ...Staffing is urgently seeking a Medical Director of Utilization Management to join a... ...compliance. Location: 100% Remote Schedule: Full-Time, Monday... ...while making independent, high-stakes decisions. You have... ...speed in a fast-paced, high-volume environment. You are committed...Remote workFull timeMonday to Friday
$225k - $275k
...Job Description Job Description Medical Director (Utilization Management) - Remote Role! Compensation: $225,000 to... ...in advancing value-based care and high-performing provider networks.... ...medical necessity review, provider appeals, care management, population health...Remote workFull timeFlexible hoursProtouch Staffing
Los Angeles, CA1 day ago$215k - $269k
...Medical Director - Physical Health Charllotte, NC (Primarily remote, no expectation to be in the office... ...ensures high quality, evidence... ...clinical quality, utilization management, and... ...concurrent reviews, appeals, and level of... ...Complete expected case volume as expected by...Remote workPermanent employmentFull timeWork at officeWeekend work360X Staffing
Charlotte, NC3 days ago- .... invites applications for a Corporate Medical Director to provide clinical interpretation and... ...services. You will oversee grievance and appeal reviews, ensure compliance with... ...role emphasizes independent judgment on highly complex cases, collaboration with cross...Remote job
- ...Inc. is seeking a Corporate Medical Director to provide medical interpretation... ...reviews for grievance and appeals across Medicare, Medicaid,... ...independent decisions on highly complex issues, and collaborate... ...clinical experience, with remote work across #J-18808-Ljbffr...Remote job
$386.5k
.../yearJob Area: Medical & Clinical OperationsCompany... ...starting with Utilization Management. The Medical Director, Clinical AI... ...to work remotely * from anywhere... ...production, appeals, audits, and quality... ...on AI use in high impact... ...down early due to volume of applicants.At...Remote workMinimum wageFull timeWork experience placementLocal areaUnitedHealth Group
Minnetonka, MN4 days ago$248.5k - $373k
...- $373,000/yearJob Area: Medical & Clinical OperationsCompany... ...the flexibility to work remotely * from anywhere within... ...Primary Responsibilities:The Appeals and Grievances Medical Director is responsible for... ...may come down early due to volume of applicants.At UnitedHealth...Remote workMinimum wageFull timeWork experience placementWork at officeLocal areaUnitedHealth Group
Cypress, CA2 days ago- ...Clinical Claims Appeals Manager who is a... ...clinical appeals, utilization management, medical necessity review... ...plan medical directors, external review... ...second-level appeal volumes, overturn rates,... ...guidance for high-risk or difficult... ...in a desk or remote office environment...Remote workFull timeCasual workWork at officeAfternoon shift
- ...seeking an experienced and highly organized Manager of Clinical Appeals to lead our clinical... ...background in clinical review, medical necessity denials, payer... ...in clinical appeals, utilization review, or medical... ...plans. Experience managing remote and/or offshore teams (Philippines...Remote work
Health Business Solutions
Florida, NY4 days ago - ...Job Description \n Utilization Management Medical Director Oncology\n \n \n \n \n Work Location: REMOTE (work from home)\n \n \n The Medical Director role provides clinical expertise in assessing the medical necessity, appropriateness, and efficiency of oncology...Remote workWork from home
Starling Oncology
Cerritos, CA17 days ago $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... ...AZ, GA, MS, NC, ND, OK, OR, or TX is highly desirable - you should be willing to...Remote workFlexible hoursCohere Health
United States4 days ago$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... ...AZ, GA, MS, NC, ND, OK, OR, or TX is highly desirable – you should be willing to...Remote workFlexible hoursVenturefizz Product Management Community
United States22 hours ago$110 - $130 per hour
Title: Medical Director Location: Remote Duration: 6 Months with possible extension/Conversion FTE We’re hiring... ...the Chief Medical Director to lead utilization management, quality improvement, credentialing, and appeals for high-volume inpatient and post-acute care reviews...Remote work$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... ...come down early due to volume of applicants....Remote workMinimum wageFull timeWork experience placementWork at officeLocal areaWork from homeUnitedHealth Group
San Antonio, TX3 days ago$262.15k - $393.22k
...Together.The Regional Medical Director, Non-Acute Utilization Management (RMD Non-... ..., denial, appeal, and overturn trends... ...to increase use of high-quality, cost-effective... ...MLR, authorization volume, approval/denial/appeal... ...requiring a combination of remote work, home-based...Remote workFull timeWork at officeLocal areaWork from homeAlignment Healthcare
Fresno, CA6 days ago$190k - $200k
...seeking a board‑certified Medical Director (Internal Medicine or... ...team. This role is fully remote and focuses on utilization management (UM), quality... ...clinical oversight for high‑volume cases. You will work closely... ...services and claims appeals. Support physician committee...Remote workFull time- GuideWell Mutual Holding Corporation is seeking a Medical Director to lead all utilization management reviews (Pre-service, Post-service, Concurrent Review and Appeals) and to collaborate with physician providers and Case Managers on complex cases. The ideal candidate holds...Remote job
- CAI is seeking a Medical Director to ensure utilization management is performed per current clinical standards. This full-time, remote role requires leadership in medical reviews, policy adherence... ...include case determinations, appeals reviews, and drafting rationales compliant...Remote jobFull time
- UnitedHealth Group's UnitedHealthcare division seeks an Appeals and Grievances Medical Director to lead clinical reviews and adjudicate cases across multiple health plans. This remote position offers high impact work, cross-functional collaboration, and ongoing professional...Remote jobFlexible hours
$250k - $325k
...Description We are seeking a patient-focused Medical Director to lead a rapidly growing functional... ...physician who thrives in a fast-paced, high-performance environment and is... ...Innovation in healthcare delivery \n \n Remote candidates will not be considered \n...Remote workNortek Medical Staffing
Boca Raton, FL4 days ago$200k - $250k
# Medical Director, Utilization ManagementManaged Care & Clinical ProgramsOrlando, FloridaOctober 5, 202... ...coverage determinations, and clinical appeals for a national health plan, ensuring... ...area, with a combination of onsite and remote days* Monday through Friday, standard...Remote workHourly payFull timeMonday to Friday- ...Humana Inc. is seeking a Corporate Medical Director who will review medical records, interpret... ...appropriateness of services for appeals decisions. This remote role requires leadership across... ...products with independent judgment on highly complex clinical cases. The...Remote job
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Remote Medical Director - High-Volume Utilization & Appeals. Be the first to apply!
Related searches
- medical product manager New York, NY
- clinical supervisor lmft lcsw New York, NY
- behavioral health supervisor New York, NY
- clinical program manager New York, NY
- lead clinical data manager New York, NY
- associate medical director New York, NY
- occupational health manager New York, NY
- director behavioral health New York, NY
- junior clinical data manager New York, NY
- clinical manager New York, NY