Remote Medical Director, Medicaid Quality & Care
UnitedHealthcare
UnitedHealthcare is seeking a Medical Director for Community & State in Wisconsin. You will provide clinical leadership to enhance the member experience across Medicaid populations while shaping quality improvement initiatives. This role allows remote flexibility and offers a chance to impact the health care system positively. Required qualifications include an active medical license and board certification with 5+ years of clinical experience. #J-18808-Ljbffr
$248.5k - $373k
...Corporation is seeking a Chief Medical Officer for UnitedHealthcare Community... ...leadership role focuses on quality improvement and enhancing member experience across Medicaid. The candidate will work with... .... This position offers remote flexibility within Wisconsin and...Remote work- ...CenCal Health is seeking a Medical Director to oversee clinical management and ensure quality care for its members. Reporting to the Chief Medical Officer, this position... ...care principles. This role is hybrid or remote, and requires local residency or willingness to...Remote workLocal areaRelocation
$110 - $130 per hour
...A healthcare staffing company is seeking a Medical Director to lead utilization management and quality improvement for Medicare inpatient care. This remote role requires board-certified physicians with active medical licenses in FL and TX. Key responsibilities include...Remote work- 6AM City, LLC is seeking a Remote Medical Director – Psychiatrist to join their Managed Care team. This role is essential for approving or denying claims related to Behavioral Health across various lines of business. The ideal candidate will have a strong background in...Remote work
- ...Stryker Corporation is looking for a full-time Clinical Care Manager to support Medicaid members, primarily focused on those currently or formerly... ...experience in clinical care. You will have flexibility to work remotely if residing in certain areas in Washington, providing...Remote workFull time
- ...UnitedHealthcare is hiring a Clinical Care Manager in Tacoma, WA, to support Medicaid members in their reentry process. This role involves coordinating care... .... The position offers a full-time schedule with remote work options for those in Thurston or Pierce County....Remote workFull time
$40 - $54 per hour
...Texas Health Institute is seeking a Clinical Care Manager in Tacoma, WA, to provide targeted case management services for Medicaid members. The role requires a Bachelor's... ...planning, and work with community resources. Remote work flexibility is provided for local candidates...Remote workHourly payLocal area- ...The University of Minnesota School of Nursing is seeking a Clinical Care Manager to work with Medicaid members in Tacoma, WA. This full-time role focuses on providing care coordination and support to individuals leaving incarceration. Responsibilities include managing...Remote workFull timeFlexible hours
$40 - $54 per hour
UnitedHealth Group is looking for a full-time Clinical Care Manager in Tacoma, WA, to support Medicaid members by providing essential care coordination and... .... Candidates will enjoy the flexibility to work remotely if located in Thurston or Pierce County. A competitive...Remote jobHourly payFull time- ...personalized clinical nutrition care, behavior change tools,... ...regional and national Medicaid managed care... ...Foodsmart delivers high-quality, safe, and efficient care... ...our benefits and perks Remote-First Company Unlimited... ...location Healthcare Coverage (Medical, Dental, Vision) 401k &...Remote workLocal areaFlexible hours
$40 per hour
...RN Clinical Case Manager – Medicaid Long Term Care. This will be full time. RN... ...including: Prior authorizations, Medication reviews, Condition... ...referrals Identify and escalate quality of care concerns through... ...and quality standards in a remote/field-based environment Required...Remote workWeekly payFull timeLocal areaImmediate startMonday to Friday$223.8k - $313.1k
...Humana Inc is seeking a Behavioral Health Medical Director who will be responsible for the... ...and operations of behavioral health care. This remote role requires a Doctor of Medicine or... ...providers, and ensuring compliance with Medicaid requirements. A comprehensive...Remote work- A major healthcare insurer is seeking a Medical Director in Ohio. This remote role requires an MD or DO degree and a strong background in Medicare and Medicaid. Responsibilities include reviewing clinical cases, ensuring compliance, and improving medical management operations...Remote work
$95k - $105k
...industry-leading speed, quality, and accuracy. We're reshaping... ...results for a remote team of nurses and other... ...contributes to the development of medical review guidelines and... ...understanding of Managed Care requirements under the Medicare/Medicaid and other third-party payor...Remote workHourly payContract workFor contractorsFor subcontractorWork from homeHome officeShift work- ...entrepreneurs, starting in autism care. We help clinicians... ...is full-time. This role is remote-friendly, but we are also... ...York City office. Role: Director of Clinical Quality and Outcomes We are... ...including understanding of medical necessity, audits, and reimbursement...Remote workFull timeWork at officeFlexible hoursShift work
- ...health services organization is seeking a Medical Director to ensure compliance with healthcare... ...evaluate medical necessity for Medicare and Medicaid services. Required qualifications... ...clinical experience. The role supports remote work and requires participation in call...Remote work
- ...Geisinger in Pennsylvania is seeking a Medical Director to lead the clinical strategy for its Medicaid line. This role involves... ...departments to deliver high-quality care. The ideal candidate will have... ...position offers onsite/hybrid/remote options with periodic travel within...Remote work
$223.8k - $313.1k
...Become a part of our caring community The Medical Director relies on medical background and... ...to advancing the quality of inpatient care through... ...Medicare Advantage, Managed Medicaid, or Commercial lines of business... .... Travel: While this is a remote position, occasional travel...Remote workBi-weekly payFull timeTemporary workApprenticeshipWork at officeLocal areaWork from homeHome officeMonday to FridayWeekend work$47.41 - $70.52 per hour
...our Manager, Clinical Quality Improvement, you will lead... ...across Medicare, Medicaid and Commercial space. You... ...Manager will work with medical groups and health plans... ...both office-based and remote QI staff. To be successful... ...experience in managed care health plan setting or...Remote workWork at officeLocal area- ...patient health. We combine quality data-driven solutions... ...path to quality care. With human-centered,... ...to serve as Clinical Medical Director in support of CMS Healthcare... ...programs (Medicare, Medicaid, or CHIP) preferred Excellent... ...we are open to remote candidates in the following...Remote work
$248.5k - $373k
...Overview The Chief Medical Officer for... ...focused on improving quality, supporting thoughtful... ...experience across Medicaid, D‑SNP, and LTC... ...closely with the Director of Clinical Operations... ...to work remotely* as you take on some... ...and NPS Identify care gaps and help advance...Remote workWork experience placementLocal area- ...DESCRIPTION Job SummaryProvides medical oversight and expertise... ...behavioral health care programs within... ...overarching strategy to provide quality and cost-effective... ...with regional medical directors to standardize behavioral... ...for Medicare and Medicaid Services (CMS). • Assists...Remote workWork at officeLocal area
- ...Pennsylvania (onsite/hybrid/remote with periodic in... ...Reports to: Chief Medical Officer Department... ...for our Medicaid line of business across... ...). Partner with Quality, Utilization... ...quality, cost-effective care and strong... ...leadership role (Medical Director or Deputy) specific...Remote workFull timeContract workPart timeRelocation
- ...DESCRIPTION Job Summary Provides medical oversight and expertise in... ...receive the most appropriate care in the most effective setting.... ...strategy to provide quality and cost-effective member care... ...Facilitates conformance to Medicare, Medicaid, NCQA and other regulatory requirements...Remote workWork at officeLocal area
$250k
...The Utilization Review Medical Director is responsible for... ...accordance with Medicare and Medicaid guidelines, health... ...observed trends, potential quality concerns, or... ...clinical standards of care, and regulatory updates... ...Expectations Full-time remote role requiring consistent...Remote workFull timeTemporary workLocal area$202k - $303k
...Job Description The Medical Director participates in the broad array... ...Utilization Management, quality management, member care management, and medical policy... ..., NCQA/HEDIS/CMS and/or Medicaid Star Ratings, and/or... ...There may be opportunity for remote work within all jobs...Remote workContract workWork at officeLocal areaWork from homeHome officeAfternoon shift- ...Miami. The role involves coordinating care management for Medicaid enrollees, ensuring compliance with care standards, and maintaining quality metrics. The ideal candidate will have... ...travel within the region, while initial training will be conducted remotely. #J-18808-LjbffrRemote workWork at office
$250k - $350k
...Healthcare, an Essen Health Care company, is a specialized medical group dedicated to... ...longitudinal care management, remote monitoring, and real-time... ...are designed to improve quality, reduce avoidable utilization... ...Position Title: Medical Director – Intention MA...Remote work- ...conduct the search for a Senior Director, Quality Ratings and Network Performance . This is a remote position with quarterly travel... ...been providing quality health care to Washington families and supporting... ...performance, with a focus on Medicaid, Exchange, and D-SNP...Remote workContract workHome office
$186.2k - $363.09k
...Molina Healthcare is seeking a qualified physician to provide medical oversight in Mississippi. The role focuses on ensuring appropriate care for members while participating in utilization management and quality assurance activities. Strong experience in the healthcare...Remote work
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