Remote Medical Director, Claims & Utilization
$248.5k - $373kUnitedhealth Group
UnitedHealth Group is seeking a Medical Director to provide physician support for Enterprise Clinical Services. The role involves conducting clinical reviews, managing medical benefits, and collaborating with multidisciplinary teams. Candidates must hold an M.D. or D.O., have an active medical practice license, and possess at least 5 years of clinical experience. Remote work flexibility is offered, and compensation ranges between $248,500 and $373,000, along with a comprehensive benefits package. #J-18808-Ljbffr
$248.5k - $373k
...Medical Director Optum is a global organization that delivers care, aided... ...coverage and medical claims reviews. Our role is to empower... ...clinical knowledge in various utilization management activities with a... ...the flexibility to work remotely from anywhere within the U.S...Remote workClaimsMinimum wageWork experience placementLocal area$248.5k - $373k
...Optum is seeking an experienced Medical Director to provide physician support, ensuring cost-effective quality medical care for members. The... ...at least 5 years of clinical experience. Flexibility to work remotely is offered, alongside a competitive compensation package...Remote workClaims$248.5k - $373k
...Optum is seeking a Medical Director to support Enterprise Clinical Services operations. This role focuses on clinical review processes and... ...lead initiatives to advance health optimization. In this role, remote work flexibility is available within the U.S. The position...Remote workClaims$248.5k - $373k
...SafetyCall International in Eden Prairie, Minnesota, is seeking a Medical Director to oversee clinical reviews and ensure quality medical care... ...D.O. with a minimum of 5 years of clinical experience. This remote position requires strong communication skills and the ability...Remote workClaims- ...A leading U.S. healthcare company is seeking a Medical Director to provide medical interpretation and make determinations regarding service... ...teams to ensure quality healthcare delivery. This role is mostly remote but may require occasional travel to company offices. #J-1880...Remote workClaims
- ...UnitedHealth Group is seeking a Medical Director in San Jose, California, to support Enterprise Clinical Services operations. The successful... ...5 years of clinical experience in Sleep and Pulmonology. Remote flexibility is available. Comprehensive benefits and a supportive...Remote workClaims
- ...A leading healthcare company in Michigan is seeking a Medical Director to oversee clinical decisions and ensure compliance with national guidelines... .../Medicaid populations. This position allows for occasional remote work, with responsibilities primarily involving medical...Remote workClaimsCasual work
- ...A leading healthcare company is seeking a Medical Director to review inpatient medical claims and lead clinical decision-making without the irregular hours of bedside care. Candidates should have an MD or DO, with over 5 years of clinical experience and Board Certification...Remote workClaims
$270k
...information systems. The Medical Management team is at... ...-oriented Medical Director with a strong background... ...Integrity (PI) and Utilization Management (UM). This... ...with data analytics, claims, and FWA departments to... ...Additionally, we embrace a remote-first culture that...Remote workClaimsFull timeWork experience placementWork at officeFlexible hours- A leading healthcare provider is seeking a Medical Director to review health claims and ensure compliance with clinical standards. The ideal candidate... ...salary and is based in Sacramento, CA, with standard hours and some remote work flexibility. #J-18808-Ljbffr Humana IncRemote jobClaims
$110 - $130 per hour
...Title: Medical Director Location: Remote Duration: 6 Months with possible extension/Conversion FTE We’re... ...the Chief Medical Director to lead utilization management, quality improvement, credentialing... ...complex/controversial services and claims appeals. Support physician committee...Remote workClaims$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,... ...complex/controversial services and claims appeals. Support physician committee...Remote workClaimsFull time- ...Medical Director-Ortho- CM & UR Brighton Health Plan Solutions REMOTE-100% PART TIME MANAGED CARE About The Role Brighton Health... ...and experience in managed care utilization and case management to support... ...resolution of their members’ claims. Your interest and help leading...Remote workClaimsPart timeWork at office
- ...JOB DESCRIPTION Job Summary Provides medical oversight and expertise in appropriateness... ...to plan members. • Supports plan utilization management program and accompanying action... ...• Conducts retrospective reviews of claims and appeals and resolves grievances related...Remote workClaimsWork at officeLocal area
- ...JOB DESCRIPTION Job Summary Provides medical oversight and expertise in appropriateness... ...to plan members. • Supports plan utilization management program and accompanying action... ...• Conducts retrospective reviews of claims and appeals and resolves grievances related...Remote workClaimsWork at officeLocal area
$238k - $357.5k
...Connecting. Growing together.The Medical Director Oncology will provide utilization review determinations and support... ...ll enjoy the flexibility to work remotely from anywhere within the U.S. as... ...other data (e.g., quality metrics, claims and health record data,...Remote workClaimsFull timeWork experience placementLocal area$236.5k
...clinical professional on our Medical Management/Health... ...the Chief Medical Director to direct and coordinate... ...leadership of all for utilization management, cost containment... ...quality. Reviews claims involving complex,... ...approach to work with remote, hybrid, field or office...Remote workClaimsFull timePart timeWork at officeFlexible hoursWeekend work$269.5k - $425.5k
...Overview Medical Director - Clinical Review / DRG - Remote. Optum is a global organization that delivers care, aided by technology, to help millions... ...success in collaboration with hospital utilization management and claims adjudication teams. Collaborate with IT partners...Remote workClaimsMinimum wageFull timeWork experience placementLocal area$221.3k - $420.5k
...Remote Medical Director - South CarolinaJoin to apply for the Remote Medical Director - South Carolina... ...medical leadership of all for utilization management, cost containment, and medical... ...and health care quality.Reviews claims involving complex, controversial, or...Remote workClaimsWork at officeFlexible hoursWeekend work$79.8k - $126k
...Medical Director - Texas Licensed (5pm-9pm CT) Remote Judi Health is an enterprise health technology company providing... ...Platform (EHP), which consolidates all claim administration-related workflows... ...for Capital Rx’s clinical utilization management (UM) programs, consultative...Remote workClaimsWork at officeLocal areaShift work$248.5k - $373k
...deliver clinical coverage and medical claims reviews. Our role is to... ...health care costs. The Medical Director provides physician support to... ...knowledge in various utilization management activities with a... ...enjoy the flexibility to work remotely * from anywhere within the U...Remote workClaimsMinimum wageWork experience placementLocal area$292.3k
...Group, the National Accounts Medical Director (NA MD) serves as the senior... ...away from retrospective claim reviews toward forward‑looking... ...translating complex clinical and utilization insights into clear, client‑... ..., and follow‑up tracking. Remote Work Work remotely from...Remote workClaimsFull timeWork at officeLocal areaShift work$200.4k - $343.5k
...National Medical Director Of Musculoskeletal Health At UnitedHealthcare... ...the flexibility to work remotely * from anywhere within the U... ...development for modernizing utilization management and retrospective... ...Evaluate clinical, quality and claims data to identify opportunities...Remote workClaimsMinimum wageFull timeWork experience placementWork at officeLocal area$231.9k
...Remote Behavioral Medical Director - Texas Join to apply for the Remote Behavioral Medical Director -... ...Provides medical leadership of all for utilization management, cost containment, and... ...and health care quality. Reviews claims involving complex, controversial, or...Remote workClaimsFull timeWork at officeFlexible hoursWeekend work$250k - $300k
...We are seeking a Remote Medical Director to replace a retiring physician. This is a long-term, non... ...for high-risk patients. Participate in claims review, appeals, provider relations,... ...as a resource to providers regarding utilization management. Requirements Doctor of...Remote workClaimsLive in$223.8k - $313.1k
...of our caring community The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments... ..., or those experienced in Utilization Review are encouraged to... ...information. Travel: While this is a remote position, occasional travel...Remote workClaimsBi-weekly payFull timeTemporary workApprenticeshipWork at officeLocal areaWork from homeHome officeMonday to FridayWeekend work- ...expansive network reach that medical businesses need to get... ...with an exceptional remote workforce across the... ..., the Medical Director will lead a team of UM... ...in‑depth knowledge of utilization management principles,... ...prior authorization, claims appeals/denials, either...Remote workClaimsHourly payWork at officeLocal area
$223.8k - $313.1k
...a part of our caring community The Medical Director uses their medical background, experience... ...teams focusing on quality management, utilization management, case management, discharge... ...information. Travel: While this is a remote position, occasional travel to Humana's...Remote workClaimsBi-weekly payFull timeTemporary workApprenticeshipWork at officeWork from homeHome office- ...off, sick time, 401(k), remote work. Location United... .... Benefits info Medical, dental, vision, life... ...Medicare Contractor Medical Director (CMD) provides medical... ...policies, reviewing medical claims, and promoting... ...insurance industry, a utilization review firm, or another...Remote workClaimsPermanent employmentTemporary workFor contractorsWork experience placementWork at officeLocal areaImmediate start
$174.07k - $374.92k
## Medical Director -SpineApplyremote type: Remotelocations: CT - Work from... ...resources.\*\*This is a remote based (work at home) based anywhere... ....Leads all aspects of utilization review/quality assurance, directing... ...reviews ad reviews of claim determinations, providing clinical...Remote workClaimsHourly payFull timeTemporary workLocal areaWork from home
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