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
...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- 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... .../Medicaid guidelines and internal policies while maintaining timely throughput and documented...Remote jobPolicy
- Confidential is seeking a Medical Director to lead utilization management activities within a multidisciplinary... ..., and support appeals while guiding policy and disease management initiatives.... ...teams to improve care processes. Remote work is supported with Eastern daytime...Remote workPolicy
$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- ...Group, through UnitedHealthcare, seeks a Medical Director of Clinical AI Innovation and... ...training, testing, and surveillance for utilization management criteria, leveraging InterQual... ...reports to UCS and collaborates with Medical Policy, Data Science, and UM leadership. #J-1...Remote jobPolicy
$248.5k - $373k
...Medical Director Optum is a global organization that delivers care,... ...clinical knowledge in various utilization management activities with... ...the flexibility to work remotely from anywhere within the U.... ...proprietary coverage review policies, render coverage determinations...Remote jobPolicyMinimum wageFull timeWork experience placementLocal area$150 per hour
The Utilization Review Medical Director is responsible for conducting clinical reviews of Durable Medical Equipment... ...plan–specific criteria, internal policies, and regulatory requirements. This... ...and Additional Expectations: Remote role requiring consistent availability...Remote workPolicyHourly payFull timeContract workTemporary workPart timeLocal area- 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
$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- ...fortunate position of adding a Medical Director to our incredible team. This... ...improved outcomes Performs utilization review and case management... ...ethics, privacy, and security policies. Protect and take care of... ...entrusted to us. #LI-HW1 #LI-Remote What’s in it for you Compensation...Remote workPolicyPermanent employmentCasual work
- 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... ...on applicable benefit plans, medical policies, clinical criteria, CMS regulations,...Remote workPolicyContract workWork at officeImmediate start
- A healthcare management organization is seeking a Remote Medical Director to lead the review of medical records and provide expert decision-making... ...ensuring compliance with national guidelines and company policies. Ideal candidates will have significant clinical experience...Remote jobPolicyContract workWeekend work
$223.8k - $313.1k
...The Behavioral Health Medical Director is responsible for behavioral... ...clinical guidelines, state policies, CMS policies and determinations... ...services Experience in utilization management review and case... ...Travel: While this is a remote position, occasional travel...Remote workPolicyFull timeTemporary workApprenticeshipWeekend work$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$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- ...United StatesJob Area: Medical & Clinical... ...together.The Medical Director Clinical Informatics will... ...the flexibility to work remotely * from anywhere within... ..., author and maintain policies related to curation Provide... ...development teams to optimize utilization of clinical content in...Remote workPolicyMinimum wageWork experience placementLocal 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- ...Medical Director Massachusetts Company Overview: Upward Health... ...high-need, high-risk, high-utilizing patients. Job requires a leader... ...populations. The role is primary remote, but residence in the state... ...payer and provider systems, policies, and regulations to ensure...Remote workPolicyFlexible hours
$248.5k - $373k
...enjoy the flexibility to work remotely * from anywhere within the U... ...Prior authorization, utilization management and claims review... ...for each member Work with medical director teams focusing on inpatient... ...UnitedHealth Group's Telecommuter Policy Compensation for this...Remote workPolicyMinimum wageWork experience placementLocal area- ...Candidates must have an active medical license in PA, NY, or WV ,... .... Description: Medical Director Job Description This job,... ...physician team, ensures that utilization management responsibilities are... ...electronically and using Medical Policy criteria sets to evaluate the...Remote workPolicyPrivate practice
$248.5k - $373k
...Stay Billing Validation (SSBV) Medical Director to join our Clinical and... ...enjoy the flexibility to work remotely * from anywhere within the U... ...e.g., InterQual® or MCG) in utilization review or payment integrity... ...UnitedHealth Group's Telecommuter Policy Pay is based on several...Remote workPolicyMinimum wageFull timeWork experience placementLocal area- ...Role - Medical Director Client - Highmark (working with preferred... ...vendor) Location - Remote Employment -... ...physician team, ensures that utilization management responsibilities... ...electronically and using Medical Policy criteria sets to evaluate...Remote workPolicyContract workPart timePrivate practice
$206.01k
...Molecular Diagnostics Medicare Medical Director at Palmetto GBA oversees medical staff, analyzes utilization data, research emerging... ...providers and internal teams on policy issues. The role also includes... .../week) Monday-Friday working REMOTE in the United States or ONSITE...Remote workPolicyFull timeFor contractorsWork experience placementWork at officeLocal areaMonday to Friday$230.6k - $384.4k
...Medical Director The job profile for this position is Medical Director, which is a Band 5... ...success. Medical Director: Inpatient Utilization and Population Management ABOUT OUR... ...case management, developing medical policies and evaluating new technologies and treatments...Remote workPolicyLocal areaWork from home- ...Medical Director The Medical Director serves as the clinical leader and... ..., peer review activities, policy development, and quality assurance... ...(CVO), health plan, or utilization management operation. The... ...While this position allows remote work, the individual must reside...Remote workPolicyContract work
$195.2k - $341.6k
...Medical Director The Medical Director is responsible for supporting staff by providing training... ...Participate in development of policies and procedures Participates in quality... ...activities Assist in the review of utilization data to identify variances in patterns...Remote workPolicyHourly payWork at officeWeekend workAfternoon shift$160 - $170 per hour
...Medical Director As the Medical Director, you will ensure utilization management responsibilities are performed in accordance with... ...position will be Full-Time and Remote. What You'll Do:... ...escalated cases against medical policy criteria, which may include telephonic...Remote workPolicyHourly payFull timeApprenticeshipPrivate practiceWork at officeLocal area$236.5k
...Medical Director Opportunity You could be the one who changes everything... ...leadership of all for utilization management, cost containment... ...and establishing goals and policies to improve quality and cost-... ...flexible approach to work with remote, hybrid, field or office work...Remote workPolicyFull timePart timeWork at officeFlexible hoursWeekend work
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