Radiology Utilization Medical Director
Evolent
Evolent is seeking an FMD in Radiology to play a crucial role within the utilization management team. The position involves reviewing imaging cases, ensuring compliance with medical necessity guidelines, and providing clinical rationale during peer-to-peer discussions. Applicants should possess an MD/DO/MBBS, a minimum of five years’ medical practice experience, and an active clinical license. Evolent emphasizes a collaborative work environment and offers competitive compensation along with comprehensive benefits. #J-18808-Ljbffr
- ...Evolent is seeking a FMD, Radiology to join their utilization management team. This role requires serving as a physician match reviewer for imaging cases and ensuring compliance with medical review processes. Ideal candidates will have a minimum of five years' experience...Suggested
- ...A healthcare organization is seeking a Medical Director for Utilization Management to ensure compliant care decisions for Medicare Advantage members. This remote position requires expertise in clinical decision-making, particularly with MCG guidelines and utilization...SuggestedRemote work
- ...A health care organization is looking for a Medical Director for its National Utilization Management Team. This remote position requires reviewing medical records and making clinical determinations, requiring at least 5 years of clinical experience post-residency. The...SuggestedRemote workWeekend work
$120 per hour
...Direct message the job poster from The Judge Group Medical Director – National Utilization Management Team (One Weekend per Month) Location: Remote (U.S. only; must reside in the U.S.) Pay Rate: $120/hour Start Date: ASAP Schedule: 40 hours per week with rotating weekend...SuggestedOngoing contractPermanent employmentFull timeContract workImmediate startRemote work$275k
...Medical Director, Hematology/Oncology (Utilization Management & Clinical Strategy) Full-Time Remote (Post-Onboarding) U.S. Licensed MD/DO A nationally recognized healthcare organization is seeking an experienced Hematology/Oncology physician to serve in a high...SuggestedFull timeRemote workRelocation packageMonday to Friday$248.5k - $373k
...Optum is seeking a Medical Director for Utilization Management to support WellMed. This role involves making utilization management determinations and identifying trends in service utilization. The ideal candidate will have an M.D. or D.O. degree, board certification...Remote work$250k
...Integra Partners is seeking a full-time Utilization Review Medical Director to conduct clinical reviews of Durable Medical Equipment requests. The role requires an MD or DO degree, board certification, and experience in utilization management. Responsibilities include...Full timeRemote work- ...Medical Director – Utilization Management Remote | Full-Time (40 hrs/week) We are partnering with a national health plan organization to identify an experienced Utilization Management Medical Director to support a high-volume, payer-side clinical review operation. This...Full timeContract workImmediate startRemote work
$110.88 - $124.74 per hour
...A community-based healthcare organization is seeking a Medical Director of Utilization Management to oversee and coordinate clinical management, ensuring compliance with regulatory requirements. This role requires at least 3-5 years of health plan experience and a current...Hourly payDaily paidRemote workFlexible hours$130 - $140 per hour
...Remote Medical Director - Utilization Management (6-12 month contract, potential for long-term hire!) Must hold MD license in PA, NY or WV. Job Summary Medix is partnering with a premier national health plan to identify an experienced Medical Director for a Utilization...Hourly payContract workRemote workFlexible hours- ...Medix™ is looking for experienced Utilization Management Medical Directors for a remote contract opportunity. This role is ideal for physicians with strong payer-side utilization management experience who can thrive in a high-volume review environment. The position offers...Full timeContract workRemote workFlexible hours
$150 - $165 per hour
...A healthcare consulting firm is seeking a Medical Director for a four-month engagement starting April 1. This role will provide clinical leadership in utilization management and oversee appeals related to Medicare Advantage and other lines of business. Responsibilities...Hourly payContract work- ...Availity is seeking a Medical Director to lead the Utilization Management team for their Auth AI platform. Responsibilities include overseeing a team, ensuring the accuracy and validation of medical policies, and collaborating with cross-functional teams. Ideal candidates...Remote work
- ...our employees consistently vote us one of the “Best Places to Work in PA.” The Medical Director provides medical guidance and support to the full spectrum of Capital’s Clinical Utilization Management activities and programs. Supports appropriate Utilization Management...For contractorsFlexible hoursWeekend work
- ...Now Hiring: Medical Director – Utilization Management 100% Remote | Must work PST hours Medicare Advantage | Inpatient & Post-Acute Focus We’re looking for an experienced Medical Director (Utilization Management) to help lead clinical integrity and medical necessity decision...Immediate startRemote work
$227.6k - $385k
...Health is seeking a physician to join a dedicated team focusing on utilization management. This role involves managing escalated cases... ...potentially advising on cases. Minimum qualifications require a Medical Doctor or Osteopathic Doctor degree and 5 years in clinical care...- ...A health insurance provider is seeking a Medical Director in Pennsylvania to oversee clinical utilization management activities. This independent contract role requires at least five years of clinical experience and three years in managed care. Responsibilities include...Contract workPart time
$190k - $200k
...A healthcare management company is seeking a fully remote Medical Director to support their team in utilization management and clinical oversight for high-volume cases. The ideal candidate will have an MD or DO with board certification in Internal Medicine or Family Practice...Remote work$94 - $99 per hour
...Field Medical Director, Radiology (Neurology) Join to apply for the Field Medical Director, Radiology (Neurology) role at Evolent Overview Evolent... ...As a FMD, Radiology you will be a key member of the utilization management team. We can offer you a meaningful way to make...Work at officeImmediate start- ...Evolent is seeking a Vascular Surgery Field Medical Director to join our utilization management team. This role allows you to make a significant impact in patients’ lives while enjoying better work-life balance in a collaborative environment. The ideal candidate will...
- ...A leading healthcare organization is looking for a Cardiology Field Medical Director. In this role, you will be pivotal in utilization management, conducting specialty reviews and providing clinical rationale for appeals. Required qualifications include an MD/DO degree...
- ...ABOUT THIS POSITION The Clinical Product Consultant for Utilization Management is a member of the Customer Success Organization who will... ...salary + bonus, if applicable) Customizable benefits package (3 medical plans with Health Saving Account company match) We offer...Live outLocal areaRemote workFlexible hours
- ...A leading healthcare facility in the United States seeks a Clinical Product Consultant for Utilization Management. The role involves providing clinical insights, ensuring product accuracy, and managing implementation milestones. Candidates should have a BSN, extensive...Remote workFlexible hours
- ...A healthcare management organization is seeking a Remote Medical Director to lead the review of medical records and provide expert decision-making. This role demands a blend of clinical experience, leadership, and the ability to guide a team while ensuring compliance...Contract workRemote workWeekend work
$85k - $106.3k
...or care manager generated requests for medical services and renders clinical determinations... ..., and discharge planners in utilization tracking, care coordination, and monitoring... ...approves services or consults with medical directors when case does not meet medical necessity...Work experience placementFlexible hoursWeekend work- ...Job Description Job Description The Medical Director provides full scope of patient care... ...outcomes for patients and their families. Utilizes evidence-based diagnosis and treatment... ...Neurology, Neurosurgery, Interventional Neuro-Radiology, Vascular Neurology or Neuro-Critical...
$223.8k - $313.1k
...experience. This remote role may require occasional travel to Humana's offices. The position offers a salary range of $223,800 to $313,100 per year, eligible for bonus incentives and comprehensive benefits, including medical, dental, and vision coverage. #J-18808-Ljbffr HumanaRemote work$95k - $115k
...Operational oversight of Interventional Radiology (IR) patient coordination, pre-procedure... ...and exam area in collaboration with the medical and administrative staff of the practice... ...manager, including IR suite & recovery area utilization and room turnover workflow. Monitor...Temporary workWork at officeLocal area$78.5k - $90k
...facility in New York City seeks a full-time Care Manager for Behavioral Health. This role focuses on conducting managed care and utilization management reviews, optimizing patient experiences from admission to discharge. The ideal candidate will hold a Master's degree,...Full time- You're now leaving the Clover Health Website. The information you will be accessing is provided by another organization or vendor. If you do not intend to leave our site, please click Cancel. Clover provider services uses a third-party website. The form for submitting ...
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