Remote Utilization Review Medical Director (DMEPOS)
$250kIntegra Partners
- Remote job
A national healthcare solutions provider is seeking a Utilization Review Medical Director to conduct clinical reviews of Durable Medical Equipment requests. This full-time role emphasizes adherence to workflow timelines and requires an MD or DO degree along with board certification. Responsibilities include evaluating clinical documentation and ensuring compliance with Medicare and Medicaid guidelines. The position offers a competitive salary of $250,000 annually and various benefits, with remote work opportunities available in Michigan and other states. #J-18808-Ljbffr Integra Partners
$250k
...The Utilization Review Medical Director is responsible for conducting clinical reviews of Durable Medical Equipment... ...Conduct timely clinical reviews of DMEPOS authorization requests using... ...Additional Expectations: Full-time remote role requiring consistent availability...Remote workFull timeTemporary workLocal area- ...Medical Director Opportunity At Curative Curative is building the future of health insurance... ...for overseeing and performing utilization reviews, prior authorizations, and making crucial... ...peer-to-peer discussions. This is a remote position requiring a "roll up your sleeves...Remote workFull timeFlexible hours
- ...Description: Manager of Clinical Utilization Management - Denial... ...Position Type: Hybrid (85% remote, 15% onsite in Northridge, CA... ...managing daily tasks, performance reviews, and any necessary... ...collaboration with physician reviewers, medical directors, and other relevant...Remote workPermanent employmentFull timeTemporary workFlexible hours
- ...will lead the operational areas of the Utilization Management (UM) program including... ...prospective, concurrent, and retrospective reviews. As a Medical Director, UM you ensure all patient care... ...Affairs. Work Arrangement Remote role Monday through Friday from 8...Remote workLocal areaMonday to FridayFlexible hoursWeekend workAfternoon shift
- ...JOB DESCRIPTION Medical Director - Utilization Management (Payer Side Experience Required)- (Remote) Duration: 30 Weeks with possible extension Location:... ...responsible for conducting medical necessity reviews, appeals, and escalated case evaluations using...Remote workFull timeContract workPart timePrivate practiceMonday to FridayFlexible hours
$122.44k
...develop staff in administration of the Medical Review and Prior Authorization programs for commercial... ...companies. Location: This is a remote position. Typical work hours are from 8... ...0 years healthcare program management, utilization/case management, or medical review...Remote workContract workFor contractorsWork experience placementWork at officeLocal areaMonday to Friday- ...Medical Director Utilization Management Location: Remote Preference EST or nearby Pittsburgh PA, NY, WV Duration: 6+ Months Contract Role with possible extension... ...most current clinical standards. The incumbent reviews escalated cases electronically using Medical...Remote workContract workPrivate practice
$238k - $357.5k
...Medical Director Oncology Optum is a global organization that delivers care, aided by technology... ...Director Oncology will provide utilization review determinations and support case and... ...You'll enjoy the flexibility to work remotely from anywhere within the U.S. as you...Remote jobFull timeWork experience placementLocal area$248.5k - $373k
...Medical Director Optum is a global organization that delivers care, aided... ...coverage and medical claims reviews. Our role is to empower... ...clinical knowledge in various utilization management activities with a... ...enjoy the flexibility to work remotely from anywhere within the U.S...Remote jobMinimum wageWork experience placementLocal area- ...Your Role The Medical Management team ensures that Blue Shield is on the cutting... ...system in California. The Medical Director, Utilization Management - will report to the Sr. Medical... ...deliver and collaborate on clinical review activities, which includes management...Full timeWork at office
$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... ...determination processes Participates in case review and medical necessity determination...Remote jobMinimum wageFull timeWork experience placementWork at officeLocal areaWork from home- ...Your Role The Medical Management team ensures that Blue Shield... ...) is on the cutting edge of utilization management reimagined to accelerate... ...in California. The Medical Director, Utilization Management - Commercial Prior Authorization Review will report to the Senior...Full timeWork at office
$280k
...value to those who need it most. The Medical Director, Utilization Management, will be responsible for... ...Criteria, Clover Health’s medical policies reviews to determine medical necessity or if... ...policy. Additionally, we embrace a remote-first culture that supports...Remote workFull timeWork experience placementWork at officeLocal areaFlexible hours- .... Seek the advice of the Medical Director when appropriate, according... ...performance of administrative reviews Performing comprehensive... ...certifications and appeals, utilizing medical appropriateness criteria... ...members. BCBST is a remote-first organization with many...Remote workContract workCasual workWork at officeWork from homeRelocation package
- ...patient outcomes. Our talented remote workforce spans the country... ...benefits that include: Medical, dental and vision insurance... ...The Supervisor, Clinical Review plays a critical role in providing... ...clinical staff who conduct utilization review and/or specialty...Remote workContract work
- ...outpatient behavioral health utilization management clinicians:... ...standards. • Collaborate with Medical Directors when clinical complexity requires further review, ensuring decisions align with... ...Physical Demands: • Primarily remote role with periodic travel to the...Remote workWork at office
- ...Medical Director Of Case Management And Utilization Review Location: Miramar, Florida At Memorial, we are dedicated to improving the health, well-being and, most of all, quality of life for the people entrusted to our care. An unwavering commitment to our service...Work experience placementShift work
$57.24k - $62.18k
...salary and benefits, including medical, dental, vision, long-term... ...Holidays ~ Work-life balance. ~ Remote/hybrid setting (once trained)... ...: This individual will utilize clinical knowledge and... ...defer decision to a second level reviewer. This individual interfaces...Remote workTemporary workWork at officeWork from homeMonday to FridayFlexible hours- ...Health is seeking a Clinical Review Coordinator to support our... ...Infusion Pharmacy and work Remotely (USA) . Join us in Simplifying... ...Weekends or Holidays ~ Affordable Medical, Dental, and Vision Insurance... ...to resolve denials by utilizing nationally recognized criteria...Remote jobImmediate startMonday to FridayFlexible hours
- ...position leads and oversees the team focusing on utilization management inpatient medical necessity reviews and transitions of care (TOC) efforts, including post... ...that goals are achieved. Collaborate with the Director of Clinical Utilization Management to develop and...Remote workFull timeTemporary workPart timeWork experience placementWork at officeTrial periodFlexible hours
$211.2k - $277.2k
...We're hiring a Physician Reviewer to join our Utilization Management team. Oscar... ...You will determine the medical appropriateness of inpatient... ...into the Associate Medical Director, Utilization Management.... ...Work Location: This is a remote position, open to candidates...Remote workFull timeLocal areaWork from homeHome officeWeekend work$35 - $45 per hour
...Registered Nurse (RN) | Utilization Review Location: Corpus Christi, TX Agency: Mindlance Health Pay: $35 to $45 per hour... ...Monthly and quarterly member contact and will include 80% travel. Remote role. Will require a driver’s license. Member assessments...Remote workHourly payFull timeContract workImmediate startShift work3 days per week- ...Senior Utilization Review Specialist Within Health is revolutionizing eating disorder treatment... ...telehealth platform. We provide remote clinical services at the Partial Hospitalization... ...efficient methods for ensuring the medical necessity and appropriateness of prescribed...Remote workWork at officeWork from homeShift work
$25.01 per hour
...Medical Review Coordinator Turn Your Medical Knowledge Into Meaningful Remote Work Remote Opportunity (Missouri, Kansas, and Illinois residents only) Compensation... ...guidelines and criteria (FDA, EBAA, SOPs) Perform utilization-style reviews and make decisions based on...Remote workImmediate start- ...Description Job Description Vivo HealthStaff is recruiting for a Utilization Review Physician based in New York for a Managed Care Insurance... ...for the health plan. Responsible for the administration of medical services for company health plan utilizing the evidence-...Remote job
$35 - $45 per hour
...Registered Nurse (RN) | Utilization Review Location: Corpus Christi, TX Agency: Mindlance... ...contact and will include 80% travel. Remote role. Will require a driver’s license.... ...to partner with top-tier hospitals and medical institutions nationwide, helping you land...Remote workHourly payFull timeContract workImmediate startShift work3 days per week- ...Remote Registered Nurse Position Join a stable work-from-home team! This is a great opportunity... ...care for hospitalized patients ~2 years of Utilization Review (UR) experience reviewing hospital admissions for medical necessity ~ Must live within one hour of the...Remote workFull timeReliefLocal areaWork from homeMonday to FridayFlexible hoursShift work
$75 - $85 per hour
...Resource/Case Management Location: Remote Type: Contract | 27 Weeks Shift... ...Resource Department to lead Case Management, Utilization Review, and Social Work in an acute care... ...healthcare staffing firms in the US providing Medical, Clinical and Non-Clinical services to...Remote workContract workTraineeshipMonday to FridayShift workRotating shiftDay shift- ...nationally recognized Independent Review Organization (IRO), is expanding its... ...Psychiatrist with an active New York medical license and Workers’ Compensation Board Certification to conduct Utilization Reviews. This is a fully remote, non-clinical role offering...Remote workPrice workExtra incomeFor contractorsFlexible hours
$1,600 - $1,800 per week
...Now Hiring: Registered Nurse – Utilization Management Location:... ..., no holidays, no telehealth/remote work Minimum Qualifications... ...Utilization Management, Utilization Review, or Case Management... ...Ambulatory, Case Management, or Medical-Surgical (ANCC or NCQA)...Remote workContract workImmediate startMonday to Friday
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