Senior Medical Director - Utilization Management (Remote)
NHSHP
Boston, MA
- Remote job
UnitedHealth Group's Optum is hiring a Medical Director to lead clinical coverage reviews and provider collaborations across Enterprise Clinical Services. You will guide benefit determinations and support cost-effective, high-quality care for members. You'll work remotely from anywhere in the U.S., collaborating with a multidisciplinary team, participating in holiday and call coverage, and ensuring compliance with regulatory standards while advancing evidence-based medicine and patient outcomes. #J-18808-Ljbffr NHSHP
Vacancy posted 1 day ago
Similar jobs that could be interesting for youBased on the Senior Medical Director - Utilization Management (Remote) in Boston, MA vacancy
- Centene Management Company LLC is seeking a remote Utilization Management leader to oversee BH UM clinicians and ensure appropriate care for members. The role involves guiding UM practices, tracking performance, and aligning with regulatory standards. Requires nursing...Remote jobSeniorFlexible hours
$102.9k - $190.5k
Position Purpose Manages the behavioral health (BH) utilization review clinicians to ensure appropriate... ...Oversees and works with senior leadership on utilization... ...management. This is a remote opportunity supporting BH... ...understanding of medical necessity criteria for a...Remote workSeniorWork at officeFlexible hours$275k - $325k
...affiliate locations of care across five states and growing, TOI is changing oncology for the better. Utilization Management Medical Director OncologyWork Location: REMOTE (work from home)California Nevada Arizona Oregon FloridaThe Medical Director role provides clinical...Remote workWork from home- Centene Corporation seeks a senior leader to manage BH utilization review clinicians in a remote capacity, ensuring compliant, cost-effective member care and coordinating with BH senior leadership on UM strategies. The role requires an active clinical license (LCSW, LMHC...Remote jobSenior
$248.5k - $373k
...$373,000/yearJob Area: Medical & Clinical OperationsCompany... ...experience, and manage health care costs.The Medical Director provides physician support... ...clinical knowledge in various utilization management activities... ...the flexibility to work remotely * from anywhere within the...Remote workMinimum wageFull timeWork experience placementLocal area- ...To support Utilization Management operations, the full-time Utilization Review Medical Director will conduct clinical reviews of Durable Medical Equipment (DME) requests remotely, ensuring compliance with Medicare and Medicaid guidelines while maintaining productivity...Remote workFull time
Virtual Vocations Inc
United States2 days ago - ...WellMed, part of Optum, seeks an Internal/Family Medicine physician to lead utilization management. You will determine medical necessity, review cases, and drive UM protocol improvements within a collaborative, patient‑focused team across Texas markets. The role emphasizes...Remote work
Colorado
Brooklyn, NY3 days ago - ...Job Description Job Description Medical Director of Prior Authorization and Utilization Management - Palm Springs, California: Please consider becoming part... ...This position can be structured as a hybrid remote role - you would not necessarily be required to reside...Remote workPermanent employmentTemporary workRelocation package
Curative
Palm Springs, CA10 days ago $248.5k - $373k
...000.00/yearJob Area: Medical & Clinical OperationsCompany... ...to join our Utilization Management team. Optum is a clinician... ...and live.The Medical Director for Utilization... ...flexibility to work remotely * from anywhere within... ...face of health care for seniors. WellMed hasmore than...Remote workMinimum wageFull timeWork experience placementWork at officeLocal areaWork from home- Medical Director - Sphere Senior (Part-Time) Department: Clinical Leadership, Sphere... ...Field-Based (In-Home) + Remote Clinical Oversight About... ...primary care, complex care management, care transitions support... ...structures: M&M review, utilization review, care committee...Remote workSeniorFull timeContract workPart timeWork at officeShift workWeekend work
- ...Health is hiring a Radiation Oncology Medical Director to oversee oncology utilization, policy implementation, and review processes in a remote, home-based role. The position supports... ..., peer-to-peer reviews, and case management. The role requires MD/DO, board certification...Remote jobWork from home
- ...Job Description Job Description Medical Director of Prior Authorization and Utilization Management - Palm Springs, California: Please consider becoming part... ...This position can be structured as a hybrid remote role - you would not necessarily be required to reside...Remote workRelocation package
Curative
Palm Springs, CA9 days ago - Sacbar is seeking a Medical Director of Prior Authorization and Utilization Management in Palm Springs, CA. The role focuses on prior authorization, concurrent review... ...utilization management with a flexible hybrid remote arrangement. The position offers a competitive salary...Remote workRelocation packageFlexible hours
- UnitedHealth Group seeks a Medical Director to lead clinical coverage reviews and benefit determinations within Enterprise... ...knowledge, communication, and remediation of utilization management. You can work remotely from anywhere in the United States, with responsibilities...Remote job
- The Oncology Institute is seeking a Medical Director to provide clinical expertise in assessing medical necessity, appropriateness, and efficiency of oncology care with a focus on utilization management for case reviews and clinical decision making. In this collaborative...Remote job
- UnitedHealth Group, through UnitedHealthcare, seeks a Medical Director of Clinical AI Innovation and Performance. This senior physician leads clinical AI model training, testing, and surveillance for utilization management criteria, leveraging InterQual and custom content....Remote job
- Integrated Management Strategies (IMS) is seeking an experienced Sr Review Coordinator to join our healthcare consulting practice. This role is fully remote within the US and focuses on utilization review of plans of service for home and community-based programs, impacting...Remote jobSeniorContract workWork from home
$248.5k - $373k
...medicine physician to join our Utilization Management team. Optum is a clinician... ...work and live. The Medical Director for Utilization Management... ...the face of health care for seniors. WellMed has more than 22,... ...fluency *All employees working remotely will be required to adhere...Remote workMinimum wageFull timeWork experience placementWork at officeLocal areaWork from homeColorado
Brooklyn, NY3 days ago$150 per hour
The Utilization Review Medical Director is responsible for conducting clinical reviews of Durable Medical Equipment... ...to support Integra’s Utilization Management (UM) operations. Role functions... ...Conditions and Additional Expectations: Remote role requiring consistent...Remote workHourly payFull timeContract workTemporary workPart timeLocal areaIntegra Partners
Troy, MI11 days ago$219k - $286.9k
...Health is hiring a Physician Reviewer to join our Utilization Management team. You will determine the medical appropriateness of inpatient, outpatient, and pharmacy... ...and applying evidence-based guidelines. This remote role in the United States offers work from home with...Remote jobSeniorWork from home$172.36k - $258.55k
Physician Advisor, Utilization Management (CA License Required) page... ...(CA License Required)remote type: Fully... ...committed to serving seniors and those who need it... ...Advisor works with Senior Medical Officers, Regional Medical... ...to Quality Director. 10. Works with Extensivists...Remote job$248.5k - $373k
...Medical Director Optum is a global organization that delivers care, aided... ...seamless experience, and manage health care costs. The Medical... ...knowledge in various utilization management activities with a... ...enjoy the flexibility to work remotely from anywhere within the U.S...Remote jobMinimum wageFull timeWork experience placementLocal area$248.5k - $373k
...Medical Director Optum is a global organization that delivers care, aided... ...seamless experience, and manage health care costs. The Medical... ...knowledge in various utilization management activities with a... ...enjoy the flexibility to work remotely from anywhere within the U.S...Remote jobMinimum wageFull timeWork experience placementLocal area- ...Consulting Group, LLC is seeking a Technical Project Manager (TPM) to lead complex transformation programs from a remote posture with work-from-home eligibility, based... ...enterprise platform rollouts, with a focus on utilities and energy sectors. You will partner with...Remote jobSeniorWork from home
$75.3k - $135.4k
Centene Corporation is seeking a Clinical Supervisor to oversee the utilization management team ensuring appropriate care for members. The ideal candidate will supervise day-to-day activities, collaborate on complex member care issues, and maintain compliance with healthcare...Remote jobSenior$150k - $175k
A leading executive search firm is seeking a Utility Solutions Sales Director to drive market penetration within the utility sector. This remote position requires extensive travel and strong sales experience in electrical products or related solutions. The ideal candidate...Remote jobSenior- DuCharme, McMillen & Associates, Inc. is seeking a property tax professional to manage complex returns for utility and energy clients. You will oversee centralized filings, advise on asset classifications, and lead a multidisciplinary team across state lines. The role...Remote jobSenior
- LIBERTY Dental Plan is seeking a Senior Staff Dentist to lead utilization management and clinical review across Commercial, Medicare Advantage, and Medicaid programs. You will adjudicate dental claims, prior authorizations, and referrals while guiding quality and compliance...Remote jobSenior
$175 per hour
Location:Remote - North Carolina, United StatesJob ID: R0100898Date Posted:2025-08-21Company Name:HITACHI ENERGY USA INCProfession... ...: Full timeRemote:YesJob Description:We are seeking a Senior Product Director Utility Market North America. This is a remote opportunity. The...Remote workSeniorFull time- Centene Corporation is seeking a clinical leader to assist the Chief Medical Director in directing medical management, quality improvement and credentialing for the business unit. You will lead utilization management, drive cost containment and ensure high-quality care...Remote job
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Senior Medical Director - Utilization Management (Remote). Be the first to apply!
Related searches
- healthcare program manager Boston, MA
- hospital manager Boston, MA
- clinical research manager Boston, MA
- medical director Boston, MA
- senior director clinical operations Boston, MA
- director of health information management Boston, MA
- director sr. director clinical operations Boston, MA
- medical director remote Boston, MA
- director behavioral health Boston, MA
- remote healthcare project manager Boston, MA