Remote Medical Director, Utilization Management
The Mississippi Bar
- Remote job
WellMed Medical Management, Inc. is seeking a Medical Director for Utilization Management to support the UM program and optimize medical necessity determinations across plans.You'll work remotely from anywhere in the United States, require an MD/DO/MBBS with board certification in Family or Internal Medicine, an active unrestricted license, and 5+ years of post-residency clinic experience, collaborating with CMS criteria and care-management protocols.J-18808-Ljbffr The Mississippi Bar
- ...GuideWell Mutual Holding Corporation is seeking a Medical Director to lead all utilization management reviews (Pre-service, Post-service, Concurrent Review and Appeals) and to collaborate with physician providers and Case Managers on complex cases. The ideal candidate...Remote work
$275k - $325k
...and growing, Starling Oncology is changing oncology for the better. For more information, visit Utilization Management Medical Director Oncology Work Location: REMOTE (work from home) California Nevada Arizona Oregon...Remote workWork from home$248.5k - $373k
...$373,000.00/yearJob Area: Medical & Clinical OperationsCompany... ...medicine physician to join our Utilization Management team. Optum is a clinician-... ...work and live.The Medical Director for Utilization Management... ...the flexibility to work remotely * from anywhere within the...Remote workMinimum wageFull timeWork experience placementWork at officeLocal areaWork from home$248.5k - $373k
...family medicine physician to join our Utilization Management team. Optum is a clinician-led care... ...way clinicians work and live. The Medical Director for Utilization Management will support... ...'ll enjoy the flexibility to work remotely * from anywhere within the U.S. as you...Remote workMinimum wageFull timeWork experience placementWork at officeLocal areaWork from home- 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
$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 area- Centene Corporation is seeking a clinical professional to lead Medical Management/Health Services for 28 million members. The role drives utilization management, quality improvement, and medical review across a national organization with flexible work options. The candidate...Remote jobFlexible hours
- ...Bickham Services Unlimited, LLC is seeking a Medical Director, Utilization Management to lead clinical utilization reviews for inpatient and post-acute... ...align with CMS, policies, and evidence-based criteria. Remote opportunity in New Jersey for a board-certified...Remote work
- ...listed on behalf of a partner company, who manages all applications and next steps. Our partner is looking for a Medical Director, Utilization Management (Home Health, Acute & Post-... ...as a key clinical authority within a remote utilization management environment. You...Remote workFull timePart timeLocal area
$75.3k - $135.4k
...Supervises the behavioral health (BH) utilization review clinicians to ensure... ...activities of BH utilization management team. Key details : Centene is hiring a remote Supervisor, Behavioral Health... ...preferred. Understanding of medical necessity criteria for a broad...Remote workFull timePart timeWork at officeLocal areaFlexible hours- ...supervision of clinical staff performing utilization reviews and specialty reviews using... ...criteria. You will mentor reviewers, ensure medical necessity decisions are accurate, and maintain... .... This role supports a flexible remote work model with occasional on-site collaboration...Remote jobFlexible hours
- ...family, is seeking an experienced physician to join the Utilization Management team. The Medical Director for Utilization Management will support WellMed... ...determinations and suggesting program improvements. This remote-friendly role offers the chance to influence care on...Remote work
$236.5k
Position Purpose:Assist the Chief Medical Director to direct and coordinate the medical management, quality improvement and... ...medical leadership of all for utilization management, cost containment, and... ...flexible approach to work with remote, hybrid, field or office work schedules...Remote workFull timePart timeWork at officeFlexible hoursWeekend work- ...Job Description Job Description: Manager of Clinical Utilization Management - Denial Compliance Location... ..., CA Position Type: Hybrid (85% remote, 15% onsite in Northridge, CA);... ...with physician reviewers, medical directors, and other relevant departments....Remote workPermanent employmentFull timeTemporary workFlexible hours
- ...CorroHealth is seeking a Medical Director, Concurrent Review, to evaluate hospitalizations nationwide... ...provide expert recommendations. This remote position offers a predictable schedule and a path to expand knowledge in Utilization Review. Ideal candidates hold an MD/DO...Remote work
- ...WellMed, part of the Optum family, seeks a Medical Director for Utilization Management to lead and optimize our UM program. This role focuses on medical... ...program improvements while fostering a collaborative, remote-friendly work environment across the U.S. You will...Remote work
$180 per hour
...REMOTE MEDICAL DIRECTOR – UTILIZATION MANAGEMENT & APPEALS $180/hour | W-2 Contract | Monday–Friday | 100% Remote | Potential Extension The Jacobson Group is seeking a Medical Director to support a health plan's Utilization Management and Appeals programs. This...Remote workContract workWork at officeMonday to Friday- ...UnitedHealth Group is hiring a Medical Director to provide physician support for Enterprise Clinical... ...necessity decisions. The role emphasizes utilization management, evidence-based medicine and cross-functional teamwork. Remote work within the United States is...Remote work
- ...CVS Health is seeking a Medical Director (Behavioral Health) for a remote-based role. The provider will lead utilization management, oversee behavioral health care management, and guide clinical policy and program development. Ohio licensure and board certification...Remote workFull timeWeekend work
- ...CVS Health is seeking a Medical Director (Behavioral Health) to lead the utilization management team remotely. You will provide psychiatric leadership, oversee high-risk cases, and ensure medical necessity decisions to deliver high-quality care for diverse health plans...Remote work
$78.62k - $105.16k
...Pay Plan Title: NurseManager, Utilization Management Working Title: Nurse Manager, Utilization Management – Physical Health Cost Center:... ...Posting Salary Range: $78,624 - $105,158 Office Location: Remote within North Carolina POSTING DETAILS: Make an Impact...Remote workFull timeWork experience placementWork at officeLocal areaImmediate startWork from homeFlexible hours- System Physician Advisor Medical Director Responsibilities and Job Description Overview:The... ...and other leadership related to case/utilization management and revenue cycle including the Lee Health... ...contracted providers involved in remote utilization review and physician...Remote workContract workFor contractorsMonday to FridayWeekend work3 days per week
- ...HJ Staffing is seeking an experienced physician leader for a remote Medical Director, Utilization Management (Home Health, Acute & Post-Acute) role. In this position, you will serve as the primary clinical authority for home health authorization requests while supporting...Remote workFull timeContract workPart timeLocal areaWork from home
$54.1k - $116.77k
...family and one community at a time. Behavioral Health Utilization Management Clinician Remote | Louisiana Preferred | Sunday - Thursday Schedule... ...behavioral health services and treatment plans to determine medical necessity and appropriateness of care Apply...Remote workHourly payFull timeTemporary workLocal area$286.07k - $353.38k
...to Work" since 2015.Position SummaryThe Vice President, Medical Director, Health Plan provides senior clinical leadership across the... ...health plan strategy.Provide clinical leadership across utilization management, care management, population health, quality, pharmacy, medical...Remote workFull timeHome office- ...Medical Director Utilization Management Location: Remote Preference EST or nearby Pittsburgh PA, NY, WV Duration: 6+ Months Contract Role with possible extension. Position Overview As part of a physician team, the Medical Director ensures utilization management...Remote workContract workPrivate practice
- Integra Partners seeks an experienced Utilization Review Medical Director to lead clinical reviews of DMEPOS requests within a remote UM environment. You will ensure decisions meet Medicare/Medicaid guidelines and internal policies while maintaining timely throughput and...Remote job
$250k - $350k
...company, is a specialized medical group dedicated to providing... ...primary care, longitudinal care management, remote monitoring, and real-time... ...quality, reduce avoidable utilization, and expand access for... ...Position Title: Medical Director Intention MA Location...Remote work- ...company is hiring a Physical Health Medical Director to work remotely in North Carolina. The Physical... ...within the Physical Health Medical Management Team, providing clinical oversight,... ...goals related to clinical quality, utilization management, and care coordination....Remote workTemporary workWork experience placementWork at officeRelocationFlexible hoursWeekend work
$190k - $200k
We're seeking a board‑certified Medical Director (Internal Medicine or Family Practice) to support our team. This role is fully remote and focuses on utilization management (UM), quality review, and clinical oversight for high‑volume cases. You will work closely with...Remote workFull time
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