Sign up to access all features of our service.
  • Job search
  • Favorites
  • Create a CV
    New
  • Salaries
  • Subscriptions

Remote Medical Director, Utilization & Coverage

Sustainable World, Inc.

Boston, MA
  • Remote job

UnitedHealth Group is seeking a Medical Director to provide physician support for Enterprise Clinical Services, focusing on clinical coverage reviews, quality improvement, and cost-effective care for members. This role collaborates with network and non-network providers, supports pre-service determinations, and requires an MD or DO, board certification, active license, 5+ years of practice, and strong skills in Evidence Based Medicine along with MS Word/Outlook/Excel. #J-18808-Ljbffr Sustainable World, Inc.

Vacancy posted 2 days ago
Similar jobs that could be interesting for youBased on the Remote Medical Director, Utilization & Coverage in Boston, MA vacancy
  •  ...Group in Minnesota seeks a Medical Director to provide physician support...  ...Services and oversee clinical coverage determinations and medical...  ...high-quality care, advances utilization management, and communicates...  ...and non-network physicians. Remote work from anywhere in the U.... 
    Remote job

    Texas Health Institute

    Brooklyn, NY
    2 days ago
  • Optum is hiring a Medical Director to provide physician support for Enterprise Clinical Services and lead clinical coverage determinations. You will collaborate with leadership to maintain...  ...and participation in clinical rounds. Remote work is available from anywhere in the... 
    Remote job

    Optum

    Boston, MA
    4 days ago
  • Optum is seeking a Medical Director to provide physician support for Enterprise Clinical Services, focusing on pre-service benefit...  ...with providers, and participate in holiday and call coverage. The role supports remote work from anywhere in the U.S. #J-18808-Ljbffr... 
    Remote job

    Colorado Psychiatric

    Boston, MA
    2 days ago
  •  ...United States invites applications for a Medical Director who will provide physician support to...  ...Clinical Services and oversee clinical coverage determinations. You will collaborate with...  ...toward optimal care. The role offers remote work from anywhere in the U.S., with participation... 
    Remote job

    Sacbar

    Boston, MA
    2 days ago
  • UnitedHealth Group is seeking a Medical Director to provide physician support for Enterprise Clinical Services, focusing on clinical coverage determinations and cost-effective care. You will collaborate with leadership to maintain medical policies and ensure quality outcomes... 
    Remote job

    Tnafp

    Brooklyn, NY
    2 days ago
  • UnitedHealth Group is seeking a Medical Director to provide physician support to Enterprise Clinical Services and oversee clinical coverage reviews and medical necessity determinations...  ...benefit language interpretation, with flex remote work across the U.S. This full-time... 
    Remote job
    Full time
    Flexible hours

    Texas Health Institute

    Phoenix, AZ
    4 days ago
  •  ...and incentive compensation Coverage: Health, vision and dental...  ...fortunate position of adding a Medical Director to our incredible team....  ...improved outcomes Performs utilization review and case management...  ...protecting the sensitive data entrusted to us. #LI-HW1 #LI-Remote... 
    Remote work
    Permanent employment
    Full time
    Casual work

    Quantum Health

    Remote
    9 hours ago
  • $275k - $325k

     ...growing, TOI is changing oncology for the better. Utilization Management Medical Director OncologyWork Location: REMOTE (work from home)California Nevada Arizona...  ...patients to clarify and discuss treatment options and coverage. Evaluate clinical and utilization data to... 
    Remote work
    Work from home

    The Oncology Institute

    Cerritos, CA
    3 days ago
  •  ...Medical Director Curative is seeking an enthusiastic and highly skilled...  ...overseeing and performing utilization reviews, prior authorizations...  ...peer discussions. This is a remote position requiring a "roll up...  ...premiums for you and 50% coverage for dependents on the base plan... 
    Remote work
    Full time
    Flexible hours

    CURAtive

    United States
    1 day ago
  • $248.5k - $373k

     ...373,000/yearJob Area: Medical & Clinical OperationsCompany...  ...we deliver clinical coverage and medical claims...  ...care costs.The Medical Director provides physician...  ...knowledge in various utilization management activities...  ...the flexibility to work remotely * from anywhere within... 
    Remote work
    Minimum wage
    Full time
    Work experience placement
    Local area

    UnitedHealth Group

    Minneapolis, MN
    1 day ago
  •  ...Description Job Description Medical Director of Prior Authorization and Utilization Management - Palm Springs, California...  ...can be structured as a hybrid remote role - you would not necessarily...  ...bonus ~ Paid malpractice with tail coverage Requirements: MD or DO... 
    Remote work
    Permanent employment
    Temporary work
    Relocation package

    Curative

    Palm Springs, CA
    11 days ago
  • UnitedHealth Group seeks a Medical Director to lead clinical coverage reviews and benefit determinations within Enterprise Clinical Services...  ...knowledge, communication, and remediation of utilization management. You can work remotely from anywhere in the United States, with... 
    Remote job

    ISHE

    Brooklyn, NY
    2 days ago
  •  ...Description Job Description Medical Director of Prior Authorization and Utilization Management - Palm Springs, California...  ...can be structured as a hybrid remote role - you would not necessarily...  ...bonus ~ Paid malpractice with tail coverage Requirements: MD or DO... 
    Remote work
    Relocation package

    Curative

    Palm Springs, CA
    10 days ago
  •  ...Professional Job Description Title: Medical Director Utilization Management Job Type: 3 Months Contract Location: Remote - CA Shift: 8AM 5PM Mon Fri PST...  ...make appropriate medical necessity and coverage determinations . Conduct and participate... 
    Remote work
    Contract work
    Work at office
    Shift work

    Pacer Group

    California
    1 day ago
  • $248.5k - $373k

     ...Medical Director Optum is a global organization that delivers care,...  ...expectations as we deliver clinical coverage and medical claims reviews....  ...knowledge in various utilization management activities with...  ...the flexibility to work remotely from anywhere within the U.... 
    Remote job
    Minimum wage
    Full time
    Work experience placement
    Local area

    UnitedHealth Group

    Providence, RI
    1 day ago
  • $248.5k - $373k

     ...Medical Director Optum is a global organization that delivers care,...  ...expectations as we deliver clinical coverage and medical claims reviews....  ...knowledge in various utilization management activities with...  ...the flexibility to work remotely from anywhere within the U.... 
    Remote job
    Minimum wage
    Full time
    Work experience placement
    Local area

    UnitedHealthcare At Home

    Cambridge, MA
    2 days ago
  • $150 per hour

    The Utilization Review Medical Director is responsible for conducting clinical reviews of Durable Medical Equipment...  ...and Additional Expectations: Remote role requiring consistent...  ...Company-paid short term disability coverage (location restrictions may apply) ~... 
    Remote work
    Hourly pay
    Full time
    Contract work
    Temporary work
    Part time
    Local area

    Integra Partners

    Troy, MI
    12 days ago
  • Title: Medical Director, Utilization Management (Commercial & MA) Start Date: 08/10/2026 End Date: 02/10...  ...a possibility of an extension. Fully remote opportunity Looking for an immediate...  ...criteria, Commercial medical policies, coverage guidelines, and member benefit plans.... 
    Remote work
    Contract work
    Work at office
    Immediate start

    Bickham Services Unlimited, LLC

    Henderson, NV
    4 days ago
  • Optum is seeking a Medical Director to provide physician support for Enterprise Clinical Services, focusing on pre-service benefit determinations...  ..., cost-effective care for members. The position offers remote work within the United States, with responsibilities spanning... 
    Remote job

    Texas Health Institute

    Boston, MA
    2 days ago
  • CareOregon, Inc. seeks a Medical Director to oversee benefit/utilization management, clinical and wellness programs for members. The role involves leadership of QA, case/disease/quality management, and collaboration with physicians to improve care and utilization outcomes... 
    Remote job
    Work from home

    CareOregon, Inc.

    Kansas City, MO
    2 days ago
  •  ...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 Medicare and Medicaid guidelines while maintaining productivity... 
    Remote work
    Full time

    Virtual Vocations Inc

    United States
    3 days ago
  • CorroHealth is seeking a Medical Director, Concurrent Review, to evaluate hospitalizations nationwide...  ...provide expert recommendations. This remote position offers a predictable schedule and a path to expand knowledge in Utilization Review. Ideal candidates hold an MD/DO... 
    Remote job

    CorroHealth Inc

    New York, NY
    3 days ago
  • Optum is seeking a Medical Director to provide physician support to Enterprise Clinical...  ...and operational processes for coverage determinations and medical...  ...network physicians and involvement in utilization management. The position offers remote work within the United States,... 
    Remote job

    Texas Health Institute

    Eden Prairie, MN
    2 days ago
  • Integra Partners is seeking a Utilization Review Medical Director to lead clinical reviews of DMEPOS requests within a high-volume UM environment. The...  ...or PM&R, and experience in utilization management. Remote work during standard business hours is supported, with opportunities... 
    Remote job

    Integra Partners

    Troy, MI
    1 day ago
  • 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 Medicare/Medicaid guidelines and internal policies while maintaining timely throughput and... 
    Remote job

    Integra Partners

    Brooklyn, NY
    1 day ago
  • Humana Inc. is seeking a Medical Director to lead inpatient medical necessity reviews, applying national guidelines, CMS regulations, Humana...  .... You will analyze complex hospital cases, craft clear utilization determinations, and communicate outcomes to external providers... 
    Remote job
    Monday to Friday

    Humana Inc

    Denver, CO
    19 hours ago
  •  ...Beacon Hill is seeking a Medical Director (MD/DO) for Raleigh, North Carolina, with a strong focus on physical health utilization management and clinical leadership. The role collaborates...  ...UM functions while accommodating primarily remote work with a North #J-18808-Ljbffr
    Remote work

    Beacon Hill

    United States
    3 days ago
  •  ...Job Title: Medical Director (Utilization Management) - Remote (USA) | Contract-to-Hire | US Citizen Only Location: 100% Remote (United States) Schedule: Full-Time | Monday-Friday | 9:00 AM - 5:00 PM EST (Flexible after training) Employment Type... 
    Remote work
    Full time
    Contract work
    Monday to Friday
    Flexible hours

    Trispoke Managed Services Pvt Ltd

    United States
    4 days ago
  • $240k - $250k

     ...Medical Director Utilization Management We are looking for physicians who have expertise in Internal Medicine including medical and surgical...  ...people of different backgrounds and perspectives. This is a remote-first role that may require travel to Boston, MA for new... 
    Remote work
    Flexible hours

    Venturefizz Product Management Community

    United States
    23 hours ago
  • $248.5k - $373k

     ...- $373,000.00/yearJob Area: Medical & Clinical OperationsCompany:...  ...medicine physician to join our Utilization Management team. Optum is a...  ...clinicians work and live.The Medical Director for Utilization Management...  ...the flexibility to work remotely * from anywhere within the U.... 
    Remote work
    Minimum wage
    Full time
    Work experience placement
    Work at office
    Local area
    Work from home

    UnitedHealth Group

    San Antonio, TX
    3 days ago

Do you want to receive more vacancies?

Subscribe and receive similar vacancies to Remote Medical Director, Utilization & Coverage. Be the first to apply!