Remote Medical Director: Quality & Utilization Champion
Vetted Solutions
- Remote job
Vetted Solutions is seeking a clinical professional responsible for leading medical management, quality improvement, and credentialing within a health services team in Washington. The role focuses on providing medical leadership for utilization management, cost containment, and quality initiatives, performing reviews, and supporting performance improvement programs across capitated provider networks. You will participate in committees, help expand the provider network, conduct rounds for #J-18808-Ljbffr Vetted Solutions
- 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
- ...Corporation is seeking a clinical leader to assist the Chief Medical Director in directing and coordinating medical management, quality improvement, and credentialing. The role provides medical leadership for utilization management, cost containment, and quality improvement...Remote job
- ...in the fortunate position of adding a Medical Director to our incredible team. This physician... ...provide improved outcomes Performs utilization review and case management support on complex... ...data 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... ...leaders to support evidence-based high quality and cost-effective care delivery across the network...Remote workWork from home- ...Corporation is seeking a clinical leader to direct medical management, quality improvement, and credentialing for the Medical Management... ...team. You will partner with the Chief Medical Director to optimize utilization, cost containment, and care quality for Centene’s 28...Remote job
- A diversified healthcare organization is seeking a clinical professional to lead medical management services. Responsibilities include overseeing utilization review, coordinating quality improvement initiatives, and collaborating with various clinical teams to ensure optimal...Remote jobFlexible hours
- ...Corporation is seeking a full-time Medical Director to join the Medical Management/Health Services team. You will oversee utilization management, quality improvement, and credentialing, and... ...offers flexible work arrangements (remote, hybrid, field or office) with competitive...Remote jobFull timeWork at officeFlexible hours
$248.5k - $373k
...373,000/yearJob Area: Medical & Clinical OperationsCompany... ...costs.The Medical Director provides physician... ...coverage determinations, quality improvement and cost... ...knowledge in various utilization management activities... ...the flexibility to work remotely * from anywhere within...Remote workMinimum wageFull timeWork experience placementLocal area- ...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, is seeking a Medical Director for Utilization Management to support utilization determinations and identify trends in order to improve the UM program. The role involves developing and maintaining efficient UM processes, staying current...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
- ...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 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... ...multidisciplinary team committed to high-quality, cost-effective care and...Remote work
- ...seeks an Internal/Family Medicine physician to lead utilization management. You will determine medical necessity, review cases, and drive UM protocol improvements... ...active participation in physician meetings, with a strong focus on quality and patient care. #J-18808-Ljbffr...Remote work
$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... ...confidentialityProvides quality assurance and...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... ...management teams to uphold quality, compliance, and defensible... ...while accommodating primarily remote work with a North #J-18808-...Remote job
- Integra Partners is seeking a Utilization Review Medical Director to lead clinical reviews of DMEPOS requests within a high-volume UM environment. The... ...or PM&R, and experience in utilization management. Remote work during standard business hours is supported, with opportunities...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... ...and utilization management with a flexible hybrid remote arrangement. The position offers a competitive salary...Remote workRelocation packageFlexible hours
- 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
- Optum is seeking a Medical Director to provide physician support for Enterprise Clinical Services... ...clinical coverage determinations and utilization management. You will collaborate with... ...processes for benefit coverage, quality improvement, and cost effectiveness for...Remote job
- ...Health is seeking a Part-Time Medical Director to provide physician... ...for medical management and utilization review programs. You will align... ...organizational standards in a fully remote role based in the United... ...necessity determinations, and drive quality improvement across programs,...Remote jobPart time
- ...Medical Director, Utilization Management The Medical Director, Utilization Management is responsible for assuring... ...commitment and delivery of comprehensive high-quality health care to UPMC Health Plan members. This fully remote role will be responsible for assuring...Remote workWork at office
- 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
$248.5k - $373k
...Medical Director Optum is a global organization that delivers care, aided... ...coverage determinations, quality improvement and cost effectiveness... ...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- ...A leading virtual health company is seeking a Director of Clinical Quality to oversee its clinical quality functions in the virtual... ..., including expertise in quality improvement and utilization management. This is a remote position with a focus on maintaining high...Remote work
$150 per hour
The Utilization Review Medical Director is responsible for conducting clinical reviews of Durable Medical Equipment... ...of observed trends, potential quality concerns, or opportunities to... ...Conditions and Additional Expectations: Remote role requiring consistent...Remote workHourly payFull timeContract workTemporary workPart timeLocal 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... ...confidentialityProvides quality assurance and education of current medical...Remote workMinimum wageFull timeWork experience placementWork at officeLocal areaWork from home- ...Partners, a national DMEPOS network administrator, seeks a remote Utilization Review Medical Director. You will conduct clinical reviews of DMEPOS requests,... ...meet Medicare/Medicaid guidelines, and maintain high-quality documentation in a fast-paced, real-time queue. This...Remote jobFull time
$140k - $175k
...About the Role The Director of Clinical Quality serves as Equip's primary... ...providing direct oversight of the Utilization Management (UM) program.... ...directly to the VP of Medical Operations & Quality and serves... ...or compliance staff) in a remote or telehealth setting. ~...Remote workWork at officeLocal areaWork from homeHome officeFlexible hours- ...level clinical specialist to review appeals and manage quality programs. This role offers remote work from anywhere in the U.S. and opportunities to... ..., regulatory responses, and communications with medical directors. Required credentials include an active MD/DO license...Remote job
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