Remote Medical Director: Claims & Utilization Equity
Optum
- Remote job
Optum, a global health care company, is seeking a Medical Director to provide physician leadership for Enterprise Clinical Services. You will guide clinical coverage determinations, collaborate with network and non-network physicians, and help drive cost-effective, high-quality care for members. The position requires an MD/DO, active license, board certification, and 5+ years of clinical practice. Strong communication, data interpretation, and proficiency with MS Word, Outlook, and Excel are #J-18808-Ljbffr Optum
$248.5k - $373k
...000/yearJob Area: Medical & Clinical OperationsCompany... ...and medical claims reviews. Our role... ...costs.The Medical Director provides physician... ...in various utilization management activities... ...flexibility to work remotely * from anywhere... ...recognition programs, equity stock purchase and...Remote workEmployment EquityClaimsMinimum wageFull timeWork experience placementLocal area$248.5k - $373k
...Medical Director Optum is a global organization that delivers... ...coverage and medical claims reviews. Our role is... ...knowledge in various utilization management activities... ...flexibility to work remotely from anywhere within... ...programs, equity stock purchase and 40...Remote jobEmployment EquityClaimsMinimum wageFull timeWork experience placementLocal area$248.5k - $373k
...Medical Director Optum is a global organization that delivers... ...coverage and medical claims reviews. Our role is... ...knowledge in various utilization management activities... ...flexibility to work remotely from anywhere within... ...programs, equity stock purchase and 40...Remote jobEmployment EquityClaimsMinimum wageFull timeWork experience placementLocal area$248.5k - $373k
...000/yearJob Area: Medical & Clinical OperationsCompany... ...to work remotely * from anywhere within... ...with medical director teams focusing on... ...clinical review, medical claim review and... ...QualificationsHands-on utilization and/or quality... ...recognition programs, equity stock purchase and...Remote workEmployment EquityClaimsMinimum wageFull timeWork experience placementWork at officeLocal area$248.5k - $373k
...000/yearJob Area: Medical & Clinical OperationsCompany... ...(SSBV) Medical Director to join our... ...flexibility to work remotely * from anywhere... ...short-stay inpatient claims to ensure accurate... ...or MCG) in utilization review or payment... ...recognition programs, equity stock purchase and...Remote workEmployment EquityClaimsMinimum wageFull timeWork experience placementLocal area$173k - $250k
...Job Summary: The Medical Director will report to the Senior... ...Medical Director of Utilization Management, Member... ...in You: • Full-time remote work • Competitive salaries... ...goals • Reviews claims involving complex, controversial... ...needs, internal equity, and market-...Remote workEmployment EquityClaimsFull timeWork at officeFlexible hours- ...Background Check. Diversity, Equity and Inclusion: Quantum... ...fortunate position of adding a Medical Director to our incredible team.... ...improved outcomes Performs utilization review and case management support... ...the sensitive data entrusted to us. #LI-HW1 #LI-Remote...Remote workEmployment EquityPermanent employmentFull timeCasual work
$206.01k
...Diagnostics Medicare Medical Director at Palmetto GBA oversees... ...staff, analyzes utilization data, research emerging... ...Monday-Friday working REMOTE in the United States or... ...matters. Develops claim adjudication criteria... ...location, and internal equity. About Palmetto GBA...Remote workEmployment EquityClaimsFull timeFor contractorsWork experience placementWork at officeLocal areaMonday to Friday$248.5k - $373k
...000/yearJob Area: Medical & Clinical OperationsCompany... ...and medical claims reviews. Our role... ...costs.The Medical Director provides physician... ...in various utilization management activities... ...employees working remotely will be required to... ...recognition programs, equity stock purchase and...Remote workEmployment EquityClaimsMinimum wageFull timeWork experience placementLocal area- Optum in the United States is seeking a Medical Director to provide physician support to Enterprise Clinical Services, guiding clinical and... .... The role emphasizes applying clinical knowledge to utilization management and communicating with network and non-network physicians...Remote jobEmployment EquityClaims
$240k - $250k
...Medical Director Utilization Management We are looking for physicians who have expertise in Internal... ...backgrounds and perspectives. This is a remote-first role that may require travel to... ...authorization data with post-service claims validation, we're creating a...Remote workClaimsFlexible hours$238k - $357.5k
...help us advance health equity on a global scale. Join... ...Growing together . The Medical Director Oncology will provide utilization review determinations and... ...the flexibility to work remotely * from anywhere within the... ...(e.g., quality metrics, claims and health record data,...Remote jobEmployment EquityClaimsFull timeWork experience placementLocal area$174.07k - $374.92k
...The Radiation Oncology Medical Director supports the CVS... ...managing oncology specific utilization of providers, clinical... ...necessary. This is a remote based (work from home)... ...reviews and review of claim determinations, In the... ...target in the company’s equity award program. Great...Remote workEmployment EquityClaimsHourly payFull timeTemporary workLocal areaWork from homeWeekend work$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... ...recognition programs, equity stock purchase and 401...Remote workEmployment EquityMinimum wageFull timeWork experience placementWork at officeLocal areaWork from home$80k - $95k
...population health, and utilization management. IntusCare... ...Teams, Medical Directors, and provider networks... ...participant care and related claims are: Reasonable and... ...Competitive salary and equity package. ~... ...location: This is a fully remote role based in the...Remote workEmployment EquityClaims$172.36k - $258.55k
Physician Advisor, Utilization Management (CA License Required... ...(CA License Required)remote type: Fully... ...Advisor works with Senior Medical Officers, Regional Medical... ...4. Reviews the entire claim denial process,... ...assistance to Quality Director. 10. Works with Extensivists...Remote jobClaims$206.31k
...achieve that purpose. Job Summary The Medical Director, Utilization Management provides clinical... ...and processing, pre and post payment claims review activities, payment integrity... ...improvement, regulatory compliance, and health equity. Demonstrated ability for teamwork...Employment EquityClaimsFull timeLocal area$30.64 - $45.8 per hour
...Utilization Review NurseThe Utilization Review Nurse gathers... ..., certifies the medical necessity and assigns... ...of CorVel. This is a remote position.Essential Functions... ...to the appropriate claims staff/customerCollects... ...qualifications, internal employee equity, and market conditions...Remote workEmployment EquityClaimsMinimum wageFull timeWork at officeLocal areaFlexible hours$248.5k - $373k
...$373,000/yearJob Area: Medical & Clinical OperationsCompany... ....As part of the Focus Claims Review team at Optum, the Medical Director provides leadership,... ...the flexibility to work remotely * from anywhere within the... ...and recognition programs, equity stock purchase and 401k...Remote workEmployment EquityClaimsMinimum wageFull timeWork experience placementWork at officeLocal area- ...Medical Director Opportunity At Karoo Health Karoo Health is a cardiovascular... ...company connects clinical, claims, pharmacy, and patient data... ..., transitions of care, remote patient management, or chronic... ...Competitive salary and equity. Fully-remote work environment...Remote workEmployment EquityClaims
$248.5k - $373k
...$373,000/yearJob Area: Medical & Clinical OperationsCompany... ....As part of the Focus Claims Review team at Optum, the Medical Director provides leadership,... ...the flexibility to work remotely * from anywhere within the... ...and recognition programs, equity stock purchase and 401k...Remote workEmployment EquityClaimsMinimum wageFull timeWork experience placementWork at officeLocal area$248.5k - $373k
...- $373,000.00Job Area: Medical & Clinical OperationsCompany... ....As part of the Focus Claims Review team at Optum, the Medical Director provides leadership,... ...the flexibility to work remotely * from anywhere within the... ...and recognition programs, equity stock purchase and 401k...Remote workEmployment EquityClaimsMinimum wageWork experience placementWork at officeLocal area$386.5k
...500/yearJob Area: Medical & Clinical OperationsCompany... ...National Medical Director of Orthopedic and... ...to work remotely * from anywhere within... ...for modernizing utilization management and retrospective... ..., quality and claims data to identify... ...programs, equity stock purchase and...Remote workEmployment EquityClaimsMinimum wageFull timeWork experience placementWork at officeLocal area$248.5k - $373k
...Medical Director For Utilization Management WellMed, part of the Optum family of businesses, is seeking... ...'ll enjoy the flexibility to work remotely from anywhere within the U.S. as you... ...incentive and recognition programs, equity stock purchase and 401k contribution...Remote jobEmployment EquityMinimum wageFull timeWork experience placementWork at officeLocal areaWork from home$220k - $245k
...daily lives.As the Director of Health... ...productivity gains, utilization reduction, or risk... ...to ensure economic claims are scientifically... ...within digital health, medical devices, diagnostics... ...or decentralized/remote health... ...salaries, meaningful equity, and consistent pay...Remote workEmployment EquityClaimsFull timeWork at officeRelocation- ...is hiring a full-time Utilization Review Liaison! In this... ...position is fully remote and offers the opportunity... ...toward the medical insurance plan of your... ...Investigate denied claims and assist in efforts... ...committed to diversity, equity, inclusion, and belonging...Remote workEmployment EquityClaimsFull timeWork at officeHome office
- The Utilization Review Nurse gathers demographic and clinical... ..., certifies the medical necessity and assigns... ...of CorVel. This is a remote position. ESSENTIAL FUNCTIONS... ...to the appropriate claims staff/customer... ...qualifications, internal employee equity, and market conditions...Remote workEmployment EquityClaimsMinimum wageWork at officeLocal areaFlexible hours
$29 - $52 per hour
...performing compliance reviews of medical and administrative... ...providers who submit claims for payment. This position will utilize information from claims data... ...schedule.This position is Remote in Massachusetts. You... ...and recognition programs, equity stock purchase and 401k contribution...Remote workEmployment EquityClaimsHourly payMinimum wageFull timeContract workWork experience placementLive inLocal areaMonday to FridayShift work$30.64 - $45.8 per hour
...Job Description The Utilization Review Nurse gathers demographic... ..., certifies the medical necessity and assigns... ...CorVel. This is a remote position. ESSENTIAL... ...to the appropriate claims staff/customer Collects... ..., internal employee equity, and market conditions...Remote workEmployment EquityClaimsHourly payMinimum wageFull timeWork at officeLocal areaFlexible hours$91.7k - $163.7k
...Clinical Lead For Utilization Management Optum is a... ...the flexibility to work remotely from anywhere within the... ...management coding, claim adjudication strategy,... ...medicine to evaluate medical literature, clinical guidelines... ...recognition programs, equity stock purchase and 401...Remote jobEmployment EquityClaimsMinimum wageFull timeWork experience placementWork at officeLocal area
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