Remote DMEPOS Utilization Review Medical Director
Integra Partners
- Remote job
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 documented rationale. Qualifications include MD/DO with board certification (IM/FM/PM&R), and proven UM experience. Strong communication, audit support, and familiarity with NCQA standards are required for this role. #J-18808-Ljbffr Integra Partners
- Integra Partners, a national DMEPOS network administrator, seeks a remote Utilization Review Medical Director. You will conduct clinical reviews of DMEPOS requests, ensure determinations meet Medicare/Medicaid guidelines, and maintain high-quality documentation in a fast...Remote jobFull time
- ...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... ...timely clinical reviews of DMEPOS authorization requests using...Remote workFull time
$150 per hour
The Utilization Review Medical Director is responsible for conducting clinical reviews of Durable Medical Equipment... ...Conduct timely clinical reviews of DMEPOS authorization requests using... ...Conditions and Additional Expectations: Remote role requiring consistent...Remote workHourly payFull timeContract workTemporary workPart timeLocal area- ...Medical DirectorCurative is seeking an enthusiastic and highly skilled Medical Director to join our growing team. This pivotal role will... ...overseeing and performing utilization reviews, prior authorizations, and... ...peer discussions. This is a remote position requiring a "...Remote workFull time
- ...global health services leader, seeks a Medical Director to support Enterprise Clinical Services... ...with leaders to optimize processes. This remote role offers flexibility to work from... ...with responsibilities including coverage reviews, documentation, peer discussions with...Remote job
$275k - $325k
...growing, TOI is changing oncology for the better. Utilization Management Medical Director OncologyWork Location: REMOTE (work from home)California Nevada Arizona Oregon... ...focus on direct utilization management for case review and clinical decision making. In this...Remote workWork from home- ...Description Job Description Medical Director of Prior Authorization and Utilization Management - Palm Springs, California... ...prior authorization, concurrent review, and utilization management... ...position can be structured as a hybrid remote role - you would not necessarily...Remote workPermanent employmentTemporary workRelocation package
$223.8k - $313.1k
...of our caring community The Medical Director relies on medical background and reviews health claims. The Medical Director... ..., or those experienced in Utilization Review are encouraged to apply.... ...information. Travel: While this is a remote position, occasional travel to...Remote workBi-weekly payFull timeTemporary workApprenticeshipWork at officeLocal areaWork from homeHome officeMonday to FridayWeekend work- ...WellMed, part of the Optum family, is seeking a Medical Director for Utilization Management to support utilization determinations and identify trends... ...current with CMS criteria, and participating in case reviews and medical necessity determinations. Qualified candidates...Remote work
- ...Bickham Services Unlimited, LLC seeks a Medical Director, Utilization Management for a 6-9 month contract based in Henderson, NV, with remote work option. Immediate start favored for reviewing inpatient and post-acute care decisions for Commercial and Medicare Advantage...Remote workContract workImmediate start
- ...UnitedHealth Group (Optum) is seeking a Medical Director to provide physician support to Enterprise Clinical Services, shaping clinical coverage determinations, quality improvement, and cost-effective care for members. You will collaborate with network and non-network...Remote work
- ...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... .... Work Arrangement ~ Fully remote; must be willing to work rotational...Remote workContract workLocal areaFlexible hoursWeekend work
$240k - $250k
...Medical Director Utilization ManagementWe are looking for physicians who have expertise in Internal Medicine... ...appropriateness of services by reviewing clinical information and applying evidence... ...and perspectives.This is a remote-first role that may require travel to...Remote workFlexible hours$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... ...processesParticipates in case review and medical necessity...Remote workMinimum wageFull timeWork experience placementWork at officeLocal areaWork from home$275k - $300k
The Oncology Institute is seeking a Medical Director for Utilization Management Oncology to provide strategic oversight and support key clinical initiatives. This remote role involves conducting medical reviews of oncology treatment plans and ensuring compliance with evidence...Remote job- Starling Oncology is seeking a Medical Director to provide clinical expertise in utilization management for oncology care. You will review and guide medical necessity decisions, collaborating with physicians, operations, and payers to optimize outcomes and value-based care...Remote job
- CVS 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 the enterprise oncology initiatives with emphasis on prior authorization, peer-to-...Remote jobWork from home
- Valenz Health is seeking a Part-Time Medical Director to provide physician leadership for medical management and utilization review programs. You will align clinical decisions and... ..., and organizational standards in a fully remote role based in the United States. You will...Remote jobPart time
- UnitedHealth Group seeks a Medical Director to lead clinical coverage reviews and benefit determinations within Enterprise Clinical Services... ..., communication, and remediation of utilization management. You can work remotely from anywhere in the United States, with responsibilities...Remote job
- ...Group in Minnesota seeks a Medical Director to provide physician support... ...determinations and medical necessity reviews. The role partners with a... ...high-quality care, advances utilization management, and communicates... ...and non-network physicians. Remote work from anywhere in the U....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
$248.5k - $373k
...medicine physician to join our Utilization Management team. Optum is a... ...work and live. The Medical Director for Utilization Management will... ...processes Participates in case review and medical necessity... ...*All employees working remotely will be required to adhere to...Remote workMinimum wageFull timeWork experience placementWork at officeLocal areaWork from home- ...Medical Director Utilization Management (Payer Side Experience Required)- (Remote) Duration: 30 Weeks with possible extension Location: Pittsburgh, PA Schedule: Monday Friday... ...responsible for conducting medical necessity reviews, appeals, and escalated case evaluations...Remote workFull timeContract workPart timePrivate practiceMonday to FridayFlexible hours
$125 per hour
...highest quality of care while efficiently utilizing healthcare resources. HCP’s vision is... ...specialized clinical consulting and medical review services in support of HCP’s medical management... .... Services will generally be performed remotely and on an as-needed basis, based on HCP...Remote workHourly payFull timeTemporary workPart timeFor contractorsLocal areaFlexible hours- ...A peer review organization is seeking a full-time remote Utilization Management Physician Reviewer. Ideal candidates must hold an MD, DO, or DPM degree with active board certification and unrestricted medical license in relevant states. The role involves performing detailed...Remote workFull timeWork from home
- 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
$248.5k - $373k
...deliver clinical coverage and medical claims reviews. Our role is to empower... ...health care costs. The Medical Director provides physician support... ...knowledge in various utilization management activities with... ...skills *All employees working remotely will be required to adhere...Remote jobMinimum wageFull timeWork experience placementLocal area- ...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
- ...Internal Medicine or Family Medicine physician to join the Utilization Management team. The Medical Director will support WellMed Medical Management by making UM... ...utilization trends to improve the program. Remote work is available from anywhere in the U.S. The role...Remote work
- ...WellMed, part of Optum, seeks an experienced physician to join the Utilization Management team as Medical Director. This remote role supports WellMed Medical Management, Inc. with UM determinations and program improvements, aiming to optimize care for seniors nationwide...Remote work
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