Medicaid Medical Director (Remote) — Utilization & Quality
CVS
New York, NY
- Remote job
CVS Health is seeking a Medical Director to lead medical management for Medicaid populations with a national scope, primarily supporting Aetna Better Health of Louisiana. In this remote role, you will oversee utilization management, prior authorizations, and peer-to-peer consultations, guiding clinical decisions and collaborating with multidisciplinary teams to improve quality and outcomes. The position requires MD or DO with ABMS/AOA board certification, an active medical license, and 5+ years #J-18808-Ljbffr CVS Health
Vacancy posted 4 days ago
Similar jobs that could be interesting for youBased on the Medicaid Medical Director (Remote) — Utilization & Quality in New York, NY vacancy
$275k - $315k
...Title: Medical Director of Utilization Management Summary: Step into a strategic... ...clinical strategy, quality improvement, and cost-effectiveness... ...management with Medicare/Medicaid (MLTC, MAP, D-SNP, MAPD).... ...with a hybrid schedule (3 days remote / 2 days onsite)...Remote workQualityWork at officeMonday to FridayShift work2 days per weekMedix™
New York, NY-1$215k - $408.5k
...Purpose: Assist the Chief Medical Director to direct and coordinate the medical management, quality improvement and credentialing... ...leadership of all for utilization management, cost containment,... ...flexible approach to work with remote, hybrid, field or office work...Remote workQualityFull timePart timeWork at officeFlexible hoursWeekend work$140 - $142 per hour
...Integrated Resources Inc. Title: Medical Director Location: REMOTE Duration: 06+ months (... ...for productivity, quality, and compliance metrics... ...evolving workflows, tools, and utilization management practices.... ...Medicare Advantage, Managed Medicaid and/or Commercial...Remote workQualityContract work$90.9k - $129.9k
...Gainwell, you will lead quality assurance efforts for a... ...readiness. Utilize Azure DevOps (ADO) or similar... ...supporting healthcare, Medicaid, PBM, Fraud, Waste & Abuse... ...role ~ Fully remote options from most US locations... ...childbirth, or related medical condition), age, sexual...Remote workQualityFull timeFlexible hours$300k - $350k
...health conditions. The Medical Director is Willow's senior practicing... ...accountable for the quality and safety of care delivered... ...staff grows Location: Remote (New York and North Carolina... ...setting. Familiarity with Medicaid behavioral health delivery in...Remote workQualityFull timeMonday to Friday- ...prioritize safety and quality in everything we do. Join... ...at a time. *** Fully remote position; PT preferred... ..., population health medical management team built... ...outcomes. As a Medical Director on this team of 8 physicians... ...and lead utilization management activities....Remote workQualityHourly payFull timeTemporary workLocal area
$174.07k - $374.92k
...accountable and prioritize safety and quality in everything we do. Join us... ...Summary This is a remote-based (work from home) role.... .... In this role as Medical Director (Behavioral Health), you will... ...day physician oversight for utilization management team, including the...Remote workQualityHourly payFull timeTemporary workLocal areaWork from homeWeekend workCVS Health
United States3 days ago$195.2k - $341.6k
...Medical Director Job Summary: The Medical Director is responsible for supporting staff by... ...cases suspected of fraud, abuse, and quality of care concerns Participate in development... ...activities Assist in the review of utilization data to identify variances in patterns...Remote workQualityHourly payWork at officeWeekend workAfternoon shiftCareSource
United States1 day ago- ...needs. We partner with Medicaid health plans to... ...provide personalized, high-quality care that helps young... ...Flourish Health is seeking a Director, Health Plan Success... ..., clinical outcomes, utilization, and operational... ...Job Type: Full-Time Remote, with some travel required...Remote workQualityOngoing contractFull timeContract workLocal areaHome officeMonday to Friday
$50 - $170 per hour
- /Healthcare - Medical Director# Healthcare - Medical Director at MolinaCompensation... ...DO) to provide non-clinical utilization management services for... ..., with documentation, quality improvement participation, and... ...experience; the position is remote, requires at least 20 hours...Remote workQualityHourly pay- CVS Health is seeking a Medical Director (Behavioral Health) to provide psychiatric leadership, oversee utilization management, and drive high-quality care across a multidisciplinary team. This remote-based role prefers Ohio residing physicians. You will participate in...Remote jobQualityWeekend work
$174.07k - $374.92k
...prioritize safety and quality in everything we do. Join... ...at a time. *** Fully remote position; candidates... ...touch, population health medical management team built... .... As a Medical Director on this team of 8 physicians... ...and lead utilization management activities....Remote workQualityHourly payFull timeTemporary workLocal area- ...and refine cost-effective and high quality strategic provider networks -... ...regarding cost control initiatives, medical cost ratio (MCR), non-emergent utilization, and Consumer Assessment of... ...systems, and ancillary providers with Medicaid, Medicare, and or Marketplace products...Remote workQualityFull timeContract workWork at office
- ...products that seek to improve the quality of life for people living... ...at Telix The Associate Medical Director, Prostate Cancer... ...competitive intelligence, clinical utility evidence, and evolving clinical... .... We have hybrid and remote employees located all around...Remote workQualityFull timeWork at office
- ...the delivery of high-quality, evidence-based, trauma... ...Behavioral Health Program Director. RESPONSIBILITIES:... ...to participate in Medicaid, Medicare, and other federally... ...multiple priorities, utilize sound clinical... ...working in a Hybrid or remote work environment. Resides...Remote workQualityWork at officeLocal area
Care Compass Network
Binghamton, NY4 days ago - Medical Director / Psychiatrist Full-Time Preferred | Part-Time & Flexible... ..., nursing, clinical, Quality/Compliance, Human Resources,... ...leadership, on-site presence, and remote work will be developed... ...health, outpatient psychiatry, Medicaid-funded services, child and adolescent...Remote workQualityFull timePart timeRelocation packageFlexible hours
Ponessa Behavioral Health
Lancaster, PA2 days ago $71.5k - $102.1k
...It takes great medical minds to create powerful solutions... ...Manager, Clinical Quality who is responsible for... ...knowledge of CMS, Medicaid, accreditation standards... ...required; additional utilization management, case management... ...in this role Remote- U.S. Up to 20%...Remote workQualityFull timeFlexible hours$41.6k - $49.92k
...benefits are offered: medical, dental, vision, AD&D,... ...environment. This position is a remote role with the ability... ..., and policies Utilize all available job aids,... ...accounts while also meeting quality standards as determined... ..., Medicare and Medicaid Strong attention to...Remote workQualityHourly payFull timeTemporary workWork at officeLocal area$112.7k - $193.2k
...Job Description - Director of Health Optimization... ...and Iowa - Remote (2378177) Director... ...removing barriers to quality care. The work you... ...experience for Medicaid and DSNP populations... ...address members' non-medical needs, helping to... ...care to members utilizing non-medical services...Remote jobQualityMinimum wageFull timeWork experience placementLocal areaMonday to Friday$236.5k
...clinical professional on our Medical Management/Health... ...leadership of all for utilization management, cost containment, and medical quality improvement activities.... ...Assists Chief Medical Director in planning and establishing... ...approach to work with remote, hybrid, field or...Remote jobQualityFull timePart timeWork at officeFlexible hoursWeekend work$231.9k
Join to apply for the Remote Medical Director - California role at RemoteWorker US 1 day ago Be among... ...coordinate the medical management, quality improvement and credentialing... ...Provides medical leadership of all for utilization management, cost containment, and medical...Remote jobQualityFull timeWork at officeFlexible hoursWeekend work- ...confidentiality, and demonstrates qualities endorsed by following... ...to assure appropriate medical equipment is arranged... ...appropriate through utilization of the hospital... ...mechanisms (Medicare, Medicaid and third-party payers... ...multi-day travel to remote locations by boat or small...Remote workQualityTemporary workLocal areaFlexible hoursShift work
$71.5k - $97.5k
...members receive timely, high-quality, and coordination... ...Position Responsibilities: Utilize high-quality, evidence-... ...collaboration with medical and behavioral health... ...for Medicare and Medicaid Services (CMS) and the... ...Workstyle: This is a remote position that will require...Remote workQualityFull timeTemporary workApprenticeshipWork at officeWork from homeHome officeMonday to Friday$272.69k - $373.8k
...Overview: Sentara Medical Group is currently seeking a Site... ...5 FTE as the SVBGH Medical Director of Quality, Regulatory, & Safety and 0... ...variation, optimizes utilization, and maintains an engaged,... ...positions that are available as remote work, Sentara Health employs...Remote workQualityFull timeTemporary workLive inLocal areaShift work$60k
...service and post-service utilization reviews and appeals... ...with our Medical Director to perform benefit and... ...Experience with Medicare and Medicaid (not required, but highly... ...opportunities Remote Opportunities We... ...mission is to improve the quality of life for the...Remote workQualityFull timeTemporary workLocal area$223.8k - $313.1k
...caring community The Medical Director relies on medical... ...Medical Director conducts Utilization Management of the... ...Advantage and Managed Medicaid. Utilization management... .... Work Style: Remote in the contiguous US,... ...leading to a better quality of life for people with...Remote workQualityFull timeContract workTemporary workApprenticeshipWork at officeWork from homeHome officeMonday to Friday- Your Role The Medical Management team ensures that Blue Shield is on the cutting... ...in California. The Medical Director, Arbitrations and UM MD Float is... ...in at least 3 of the following: utilization management, Medicare, NCQA/URAC or quality programs, medical policies and procedures...QualityFull timePart timeWork at officeFlexible hours
- ...Gainwell Technologies LLC is seeking a Senior Drug Rebate Quality Assurance professional to lead quality strategies for the Medicaid Drug Rebate solution, ensuring compliance and guiding junior staff. You will partner with internal teams and clients to drive quality improvements...Remote workQuality
Gainwell Technologies LLC
Ohio-1 $152.25k - $253.75k
...health systems, IDNs, academic medical centers, community oncology... ...~ Knowledge of healthcare quality measures, value-based care, interoperability... ...-success skills. ~ GSK-Remote Data to Insights, Digital... ...the Centers for Medicare and Medicaid Services (CMS) website atRemote workQualityLocal area$85k
...immediate opening for a Utilization Management Coordinator... ...key position is a remote office position and needs... ...purpose of ensuring medically appropriate services are... ...for clinical quality of program structure,... ...the behavioral health Medicaid benefit, non-emergent...Remote workQualityFull timeContract workTemporary workFor contractorsWork at officeImmediate startFlexible hours
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Medicaid Medical Director (Remote) — Utilization & Quality. Be the first to apply!
Related searches
- director environmental health & safety New York, NY
- director of clinical education New York, NY
- health economics manager New York, NY
- lead clinical data manager New York, NY
- medical affairs manager New York, NY
- associate director clinical data management New York, NY
- clinical manager New York, NY
- remote healthcare project manager New York, NY
- entry level healthcare project manager New York, NY
- director of clinical quality New York, NY