Remote Medical Director - Clinical Policy & Review Expert
$170 - $175 per hourCAI
CAI is seeking a motivated Medical Director to oversee utilization management while ensuring clinical standards are met. With a remote working structure, this full-time role requires strong decision-making skills and a commitment to client care. Candidates should possess an MD or DO, board certification in a recognized specialty, and licensure in relevant states. The ideal candidate will have 5 years of clinical experience along with strong skills in case management and critical thinking. Compensation is competitive, with a pay range of $170.00-$175.00 per hour, alongside benefits including health insurance and a 401k. #J-18808-Ljbffr
Vacancy posted 1 day ago
Similar jobs that could be interesting for youBased on the Remote Medical Director - Clinical Policy & Review Expert in Frankfort, KY vacancy
$170 - $175 per hour
...CAI is seeking a motivated Medical Director for remote work, responsible for ensuring compliance with the highest clinical standards. This role involves... ...with multidisciplinary teams, review processes, and engaging with healthcare policies. The ideal candidate will have...Remote workPolicyHourly payFull timeCAI
Charleston, WV1 day ago$170 - $175 per hour
...CAI is seeking a Medical Director to lead utilization management responsibilities at the highest clinical standards. This position is a full-time, remote role ideal for candidates with clinical expertise and decision-making skills.The ideal candidate will ensure compliance...Remote workPolicyHourly payFull timeCAI
Sacramento, CA3 days ago$170 - $175 per hour
...CAI seeks a motivated Medical Director to oversee utilization management and ensure compliance with the highest clinical standards. This Full-Time, Remote position requires a Medical Doctor (MD) or Doctor of Osteopathic Medicine (DO) with at least 5 years of clinical...Remote workPolicyHourly payFull timeCAI
Maryland1 day ago$223.8k - $313.1k
...A leading healthcare company is seeking a Medical Director to provide expert clinical reviews and advance patient outcomes. This remote position emphasizes collaboration and structured decision-making. Ideal candidates will have significant clinical experience and demonstrated...Remote workHumana
Springfield, IL3 days ago$125 per hour
...Remote (North America) Position Overview We are recruiting senior medical education experts to serve as Panel Review Subject Matter Experts for an AI-powered learning... ...students in pre-clinical training and board exam... ...Employment Opportunity policy, we do not...Remote workPolicyHourly payContract workOsmosis
New York, NY1 day ago- ...in Michigan is seeking a Medical Director to oversee clinical decisions and ensure compliance... ...national guidelines and policies. The ideal candidate needs... ...allows for occasional remote work, with responsibilities... ...primarily involving medical reviews and teamwork within a...Remote workPolicyCasual work
Humana
Lansing, MI20 hours ago $175 per hour
...About the job Remote | Gastroenterology Clinical Review Expert - $175-$240/hour We are sharing a specialised... ...clinical data review, and structured medical annotation workflows. This role... ...recruitment and opportunity matching in accordance with our Privacy Policy:Remote workPolicyHourly payWeekly payContract workPart timeFor contractors10 hours per weekFlexible hours24-MAG LLC
United States1 day ago$60 - $75 per hour
...About the job Remote | Learning Content & Education Review Expert - $60-$75/hour We are sharing a specialised part-time consulting opportunity for... ...may be processed by 24-MAG LLC for recruitment and opportunity matching in accordance with our Privacy Policy:Remote workPolicyHourly payWeekly payContract workPart timeFor contractorsFlexible hours24-MAG LLC
United States1 day ago- ...Medical Director Opportunity At Curative Curative is building... ...utilization reviews, prior authorizations... ...will serve as a key clinical expert, ensuring appropriate... ...discussions. This is a remote position requiring a... ...established medical policies, and evidence-based guidelines...Remote workPolicyFull timeFlexible hours
CURAtive
United States20 hours ago $50 - $95 per hour
...About the job Remote | Advanced CS Question Design & Review Expert - $50-$95/hour We are sharing a specialised part-time consulting opportunity for... ...may be processed by 24-MAG LLC for recruitment and opportunity matching in accordance with our Privacy Policy:Remote workPolicyHourly payWeekly payContract workPart timeFor contractors10 hours per weekFlexible hours24-MAG LLC
United States1 day ago- ...Medical Review And Prior Authorization Program Manager Lead, organize, and develop staff in... ...Strategy, including the integration of policy and education, that optimizes critical Medical... ...and external stakeholders. This is a remote position. Typical work hours are from 8:...Remote workPolicyWork experience placementWork at officeMonday to Friday
BlueCross BlueShield of South Carolina
United States1 day ago $250k
...The Utilization Review Medical Director is responsible for conducting clinical reviews of Durable Medical Equipment (DME)... ...plan–specific criteria, internal policies, and regulatory requirements. This... ...Expectations: Full-time remote role requiring consistent availability...Remote workPolicyFull timeTemporary workLocal areaIntegra Partners
United States3 days ago$269.5k - $425.5k
...Overview Medical Director - Clinical Review / DRG - Remote. Optum is a global organization that delivers care, aided by technology, to help millions of people... ...: adherence to UnitedHealthcare Group’s Telecommuter Policy. Compensation and Benefits Pay is based on factors...Remote workPolicyMinimum wageFull timeWork experience placementLocal areaOptum
Minneapolis, MN3 days ago$248.5k - $373k
...Connecting. Growing together.Clinical Advocacy & Support... ...coverage and medical claims reviews. Our role is to empower... ...care costs.The Medical Director provides physician... ...flexibility to work remotely * from anywhere within... ...proprietary coverage review policies, render coverage...Remote workPolicyMinimum wageWork experience placementLocal areaUnitedHealth Group
Boston, MA1 day ago- ...Partnership is seeking a Nurse Reviewer for Appeals and Hearings to coordinate... ...is a full-time, permanent remote role that complies with work-from-home policies. The ideal candidate should have at least 5 years of clinical or medical record coding experience, strong...Remote workPolicyPermanent employmentFull timeWork from homeFlexible hours
Downtown Boulder Partnership
El Paso, TX4 days ago - ...looking for a Utilization Review Registered Nurse to work remotely with a major health insurance... ...services align with medical necessity while adhering to confidentiality policies. The ideal candidate has over... ...utilization review and significant clinical experience in an acute...Remote workPolicy
Insight Global
Raleigh, NC1 day ago $223.8k - $313.1k
...caring community The Medical Director relies on medical background and reviews health claims. The... ...care through clinical expertise and thoughtful... ...Overview Perform expert clinical review of... ..., Humana policies, and recognized clinical... ...: While this is a remote position, occasional...Remote workPolicyBi-weekly payFull timeTemporary workApprenticeshipWork at officeLocal areaWork from homeHome officeMonday to FridayWeekend workHumana
Austin, TX3 days ago$122.44k
...staff in administration of the Medical Review and Prior Authorization... ...including the integration of policy and education, that optimizes... ...Location: This is a remote position. Typical work hours... ...claims in coordination with other clinical staff and underwriting teams....Remote workPolicyContract workFor contractorsWork experience placementWork at officeLocal areaMonday to FridayBlueCross BlueShield of South Carolina
Denver, CO4 days ago$250k
...divh2Utilization Review Medical Director/h2pThe Utilization Review Medical Director... ...responsible for conducting clinical reviews of Durable Medical... ...criteria, internal policies, and regulatory requirements... ...Expectations:/pulliFull-time remote role requiring consistent availability...Remote workPolicyFull timeTemporary work$150 per hour
...About the job Remote | Physician Clinical Review Expert - $150-$220/hour We are sharing a specialised... ...planning, patient care management, medical documentation, clinical compliance,... ...for recruitment and opportunity matching in accordance with our Privacy Policy:Remote workPolicyHourly payWeekly payContract workPart timeFor contractorsFlexible hours24-MAG LLC
United States1 day ago- ...Job Title: Physician Reviewer/Medical Director Location: Remote Duration: 24 months (possible extension) Note:... ...and AK Job Description: Evaluates clinical service requests made by an organization... ...of Physician Review Units' policies and procedures. Actively participates...Remote workPolicy
Careers Integrated Resources Inc
United States4 days ago $115 - $145 per hour
...professionals experienced in legal analysis, case review, legal writing, issue spotting,... ...This role supports current and upcoming remote consulting opportunities focused on structured... ...regulatory summaries, compliance notes, policy materials, or advisory-style legal...Remote jobPolicyHourly payWeekly payJob sharingContract workPart timeFor contractorsWork at officeFlexible hours24-MAG
New York, NY27 days ago$115 - $145 per hour
...legal writing, contract drafting, contract review, litigation, dispute resolution, and... ...This role supports current and upcoming remote consulting opportunities focused on legal... ...clarity, and alignment with documented deal or policy context Support structured review of...Remote jobPolicyHourly payWeekly payJob sharingContract workPart timeFor contractorsWork at officeFlexible hours24-MAG
New York, NY27 days ago$80 - $115 per hour
...permitting, building code compliance, plan review, jurisdictional requirements, zoning... ...This role supports current and upcoming remote consulting opportunities focused on construction... ...LLC for recruitment and opportunity matching in accordance with our Privacy Policy:...Remote jobPolicyHourly payWeekly payJob sharingContract workPart timeFor contractorsLocal areaFlexible hours24-MAG
New York, NY27 days ago- ...Resources, Inc ( IRI ) Title: Medical Director Location: REMOTE Duration: 06+ months (... ...’s work includes reviewing all submitted medical... ...hospital-based clinical scenarios, and providing expert decisioning on the requested... ...requirements, Company policies, clinical standards,...Remote workPolicyContract work
Integrated Resources
New York, NY1 day ago $105 - $115 per hour
EPITEC is seeking a Physician Reviewer to evaluate clinical service requests and utilize medical expertise for decision-making. The role is non-patient-facing and involves... .... This position offers flexible hours, fully remote work (excluding CA, NY, HI, or AK), and...Remote jobPolicyHourly payFlexible hours$65 - $95 per hour
...About the job Remote | Nursing Clinical Review Expert - $65-$95/hour We are sharing a specialised part... ...patient care, clinical monitoring, medication administration, clinical... ...for recruitment and opportunity matching in accordance with our Privacy Policy:Remote workPolicyHourly payWeekly payContract workPart timeFor contractorsFlexible hours24-MAG LLC
United States1 day ago- ...Specialty Health Incorporated is searching for a Clinical Review Support Specialist in the United States. This remote position involves supporting medical necessity reviews, making outreach calls, and collaborating on clinical policies. The ideal candidate will hold a Physical...Remote workPolicyWork from home
American Specialty Health Incorporated
New York, NY4 days ago - ...A company is looking for a Clinical Review Coordinator to support their... ...Specialty Infusion Pharmacy remotely. Key Responsibilities Complete... ...payer criteria to ensure medical necessity Review patient documentation... ...records that meet payer policy criteria Assist with denial...Remote workPolicy
Virtual Vocations Inc
United States2 days ago - ...The Outpatient Clinical Review team at BlueCross BlueShield... ...will serve as an expert in the clinical... ...to analyze medical claims and financial... ..., this is a fully remote role. The Clinical... ...of the Medical Director when appropriate, according to policy. Assists non-clinical...Remote workPolicyContract workCasual workWork at officeWork from homeRelocation package
BlueCross BlueShield of Tennessee
Chattanooga, TN20 hours ago
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Remote Medical Director - Clinical Policy & Review Expert. Be the first to apply!
Related searches
- senior manager clinical operations Frankfort, KY
- medical director utilization management Frankfort, KY
- clinical director Frankfort, KY
- medical director neurology Frankfort, KY
- clinical data manager remote Frankfort, KY
- director of health and wellness Frankfort, KY
- medicare medical director Frankfort, KY
- healthcare supervisor Frankfort, KY
- health insurance manager Frankfort, KY
- senior medical director medical affairs Frankfort, KY