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
- Integra Partners is seeking a Utilization Review Medical Director to lead clinical reviews of DMEPOS requests within a high-volume UM environment. The role emphasizes... ...PM&R, and experience in utilization management. Remote work during standard business hours is supported...Remote job
$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- ...CorroHealth is seeking a Medical Director, Concurrent Review, to evaluate hospitalizations nationwide. The... ...provide expert recommendations. This remote position offers a predictable... ...and a path to expand knowledge in Utilization Review. Ideal candidates hold an MD...Remote work
- Optum is seeking a Medical Director to provide physician support for Enterprise Clinical Services, overseeing clinical coverage determinations and utilization management. You will collaborate with leadership to maintain processes for benefit coverage, quality improvement...Remote job
- ...fortunate position of adding a Medical Director to our incredible team.... ...treatment. Conducts daily review of individual cases and has... ...improved outcomes Performs utilization review and case management... ...entrusted to us. #LI-HW1 #LI-Remote What’s in it for you...Remote workPermanent employmentFull timeCasual work
$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$223.8k - $313.1k
...part of our caring community The Medical Director relies on medical background and reviews health claims. The Medical... ...Medicine, 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$248.5k - $373k
...373,000/yearJob Area: Medical & Clinical OperationsCompany... ...and medical claims reviews. Our role is to... ...care costs.The Medical Director provides physician support... ...knowledge in various utilization management activities... ...the flexibility to work remotely * from anywhere within...Remote workMinimum wageFull timeWork experience placementLocal area- ...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
- ...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
$80 - $120 per hour
...Remote | Utilization Management & Case Management Clinical Review Consultant We are sharing a specialised part-time consulting opportunity for United States-based... ...in utilization management, case management, medical necessity review, care coordination, discharge planning...Remote jobHourly payWeekly payContract workPart timeFor contractorsFlexible hoursNight shift$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- Beacon Hill is seeking a Medical Director (MD/DO) for Raleigh, North Carolina... ...focus on physical health utilization management and clinical... ...-making. The candidate will review medical necessity criteria,... ...while accommodating primarily remote work with a North #J-18808-...Remote job
- Sacbar is seeking a Medical Director of Prior Authorization and Utilization Management in Palm Springs, CA. The role focuses on prior authorization, concurrent review, and utilization management with a flexible hybrid remote arrangement. The position offers a competitive...Remote workRelocation packageFlexible hours
- 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
- ...Medical Director, Utilization Management The Medical Director, Utilization Management is responsible... ...UPMC Health Plan members. This fully remote role will be responsible for assuring... ...business strategies. Provide expedited review and determination of medically...Remote workWork at office
$248.5k - $373k
...373,000/yearJob Area: Medical & Clinical OperationsCompany... ...and medical claims reviews. Our role is to... ...care costs.The Medical Director provides physician support... ...knowledge in various utilization management activities... ...All employees working remotely will be required to adhere...Remote workMinimum wageFull timeWork experience placementLocal area- ...Medical Director, Utilization Management The Medical Management team ensures that Blue Shield is on the cutting edge of medical, medication, and... ...In this role you will deliver and collaborate on clinical review activities, which includes management of the physician...Full timePart timeWork at officeLocal areaWork from homeHome office2 days per week
$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 wageFull timeWork experience placementLocal area$248.5k - $373k
...Medical Director For Utilization ManagementWellMed, part of the Optum family of businesses, is seeking an... ...You'll enjoy the flexibility to work remotely from anywhere within the U.S. as you... ...processesParticipates in case review and medical necessity determinationMaintain...Remote workMinimum wageFull timeWork experience placementWork at officeLocal areaWork from home- Centene Corporation is seeking a Medical Director to lead utilization management, quality improvement, and medical review activities. You will partner with Chief Medical Director to shape goals, policies, and cost-effective care for a diverse member population. The role...Remote job
- ...clinical professional responsible for leading medical management, quality improvement, and... ...focuses on providing medical leadership for utilization management, cost containment, and quality initiatives, performing reviews, and supporting performance improvement programs...Remote job
- ...a clinical leader to assist the Chief Medical Director in directing and coordinating medical management... ...role provides medical leadership for utilization management, cost containment, and... ...support performance improvement initiatives, review complex medical cases, and collaborate...Remote job
- Spectrum Healthcare Resources seeks a Utilization Manager Registered Nurse (UMRN) to work entirely from home in a fully remote role. The nurse will review cases, educate patients on appropriate care, and manage health care costs for dependents of active duty and eligible...Remote jobWork from homeMonday to Friday
- 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 jobFull timeWork from home
$219k - $286.9k
Oscar 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...Remote jobWork from home- ...WellMed Medical Management, Inc. seeks an Internal Medicine/Family Medicine physician to join our Utilization Management team as Medical Director. You will make UM determinations, monitor CMS criteria, and help shape medical necessity decisions within a managed care framework...Remote work
- ...Job Title: Medical Director (Utilization Management) - Remote (USA) | Contract-to-Hire | US Citizen Only Location: 100% Remote (United States) Schedule: Full-Time | Monday-Friday | 9:00 AM - 5:00 PM EST (Flexible after training) Employment Type...Remote workFull timeContract workMonday to FridayFlexible hours
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