Remote Medical Director, Utilization & Policy
Vālenz Health®
- Remote job
Valenz Health is seeking a Part-Time Medical Director to provide physician leadership for medical management and utilization review programs. You will align clinical decisions and policies with evidence-based medicine, regulations, and organizational standards in a fully remote role based in the United States. You will collaborate with operational leadership to develop standards, oversee medical necessity determinations, and drive quality improvement across programs, fostering high-quality, #J-18808-Ljbffr Vālenz Health®
$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
...0 - $373,000.00Job Area: Medical & Clinical OperationsCompany... ...together.The Medical Director Oncology will provide utilization review determinations and... ...the flexibility to work remotely * from anywhere within the... ...all clinically relevant policies and processes are informed...Remote workPolicyMinimum wageWork experience placementLocal area- ...Judi Health is seeking a Medical Director for the Clinical Enterprise team to oversee utilization management, prior authorizations, and appeals for commercial and government... ..., and expertise in internal medicine, PBM operations, and UM policy development. #J-18808-Ljbffr...Remote workPolicy
- ...Medical DirectorCurative is seeking an enthusiastic... ...highly skilled Medical Director to join our growing team... ...and performing utilization reviews, prior authorizations... .... This is a remote position requiring a "... ..., established medical policies, and evidence-based guidelines...Remote workPolicyFull time
$240.12k - $315.16k
...re Oscar. We're hiring an Associate Medical Director to join our Utilization Management Team. Oscar is the first... ...Director.Work Location: This is a remote position, open to candidates holding... ...and Oscar internal guidelines and policies, while utilizing clinical acumen.Clearly...Remote workPolicyFull timeImmediate startWork from homeHome office$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- ...Medical Director, Utilization Management The Medical Director, Utilization Management is responsible... ...UPMC Health Plan members. This fully remote role will be responsible for assuring... ...issues in accordance with the established policies of the Health Plan. Actively...Remote workPolicyWork at office
- ...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
- ...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
- ...MetroPlus in New York seeks a Medical Director focused on health care utilization management. The position involves overseeing medical necessity reviews, conducting peer discussions, and guiding policy implementation. Candidates should possess a Doctor of Medicine or Doctor...Remote jobPolicy
- ...Altais is seeking a Medical Director of Utilization and Medical Management for a remote, one-month opportunity. The role reports to Senior Medical Director and collaborates... ...care across the continuum. You will lead UM policy development, chair committees, and interact with...Remote jobPolicy
$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
- ...Behavioral Health Utilization Manager The Behavioral Health Utilization... .... Collaborate with Medical Directors when clinical complexity requires... ...Uphold all organizational policies, professional standards, and... ...Demands: Primarily remote role with periodic travel to...Remote workPolicyWork at office
- The Judge Group is seeking a Medical Director for a remote, ongoing assignment focused on post-acute care. You will perform timely medical-necessity... ..., supervise physician-to-physician calls, and ensure policy-driven decisions with strong documentation across systems....Remote jobPolicy
$275k - $325k
...Astrana is seeking a California-licensed Medical Director - Utilization (UM) to provide clinical oversight... ...of authorization criteria and policies based on the latest medical standards... ...Conditions This position is fully remote, with some travel to SoCal required as...Remote workPolicyFull timePart timeShift work- Centene is seeking a Director of Utilization Management Hospice CoE to guide enterprise strategy, governance, and operations... ...across Medicaid and Marketplace populations. Based remotely in Missouri, you will lead policy application, performance improvement, and budget...Remote jobPolicy
$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$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$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$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$110 - $130 per hour
...Title: Medical Director Location: Remote Duration: 6 Months with possible extension/Conversion FTE... ...the Chief Medical Director to lead utilization management, quality improvement, credentialing... ...unit as needed. Consult on SUD policy and MCM cases when required....Remote workPolicy- ...Medical DirectorHartford, Connecticut, United StatesUpward... ...Health!The Medical Director will partner with... ...need, high-risk, high-utilizing patients. Job requires... .... The role is primary remote, but residence in the... ...and provider systems, policies, and regulations to ensure...Remote workPolicyFlexible hours
$386.5k
...579,500/yearJob Area: Medical & Clinical OperationsCompany... ...UHC Nation Medical Director Clinical Program... ...pragmatic trials, medical policy impact analyses, and... ...the flexibility to work remotely * from anywhere within... ...medical policies, utilization management processes,...Remote workPolicyMinimum wageFull timeWork experience placementLocal area$223.8k - $313.1k
Medical Director physician employment in Texas : Become a part of our caring... ...clinical guidelines, state policies, CMS policies and... ...clinical services Experience in utilization management review and case management... ...Travel: While this is a remote position, occasional travel...Remote workPolicyTemporary workApprenticeshipWork at officeWork from homeHome officeWork visaWeekend work$173k - $250k
...circumstances. Job Summary: The Medical Director will report to the Senior Medical Director of Utilization Management, Member Appeals & Grievances, and Medical Policy (Senior Medical Director of... ...in You: * Full-time remote work * Competitive salaries...Remote workPolicyFull timeWork at officeFlexible hours$160 - $170 per hour
...Medical DirectorAs the Medical Director, you will ensure utilization management responsibilities are performed in accordance with... ...position will be Full-Time and Remote.Conduct electronic review of escalated cases against medical policy criteria, which may include telephonic...Remote workPolicyFull timePrivate practiceWork at officeLocal area- ...and resourcesJob SummaryThe Medical Director will serve as a clinical subject... ...for supporting the plan utilization management, medical review and... ...but not limited to medical policy development, quality... ...position is eligible to work remotely, hybrid or onsite in accordance...Remote workPolicyWork at officeImmediate startRelocation
- ...Providing direct clinical services (remote or in-person); Serving as... ...as a team member on the Medical and Behavioral Health... ...Develop and update protocols, policies, and procedures that are culturally... ...procedures; Assess quality, utilization, and effectiveness of...Remote workPolicyHourly payFull timePart time
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