Remote Medical Director, DRG & Clinical Review
$269.5k - $425.5kOptum
A leading healthcare organization is seeking a Medical Director to oversee Clinical Review efforts. This role involves providing expertise in DRG coding and collaborating with diverse teams to improve health outcomes. Candidates must possess an MD or DO, board certification, and relevant clinical experience. This full-time position offers a competitive salary range of $269,500 to $425,500 annually, with comprehensive benefits and a commitment to diversity and equity. #J-18808-Ljbffr
$174.07k - $374.92k
...outstanding opportunity for a Medical Director. Ready to take your... ...6 company? This is a remote Work at Home position... ...for providing clinical expertise to promote the... ...include transactional reviews in support of the appeal... ...subject matter expert in DRG reviews and ICD-10...Remote workHourly payFull timeTemporary workLocal areaWork from home- ...senior leader to manage advanced, complex medical claim reviews. You will provide strategic direction,... ...ICD-10, CPT/HCPCS coding, and clinical guidelines to shape operational strategies... ...standardize review methodologies across a remote team with travel up to 25%. #J-18808-...Remote job
$190k - $200k
...healthcare management organization is seeking a Medical Director for a remote position. The role involves reviewing medical records, making decisions on service requests... .... Candidates must have an MD or DO, 5+ years of clinical experience, and a valid medical license. This...Remote workContract workTemporary work$248.5k - $373k
...0.00 - $373,000.00Job Area: Medical & Clinical OperationsCompany: UnitedHealth... ...coverage and medical claims reviews. Our role is to empower... ...health care costs.The Medical Director provides physician support to... ...the flexibility to work remotely * from anywhere within the U...Remote workMinimum wageWork experience placementLocal area$223.8k - $313.1k
...of our caring community The Medical Director relies on medical background and reviews health claims. The Medical Director... ...of inpatient care through clinical expertise and thoughtful medical... ...information.Travel: While this is a remote position, occasional travel to Humana...Remote workBi-weekly payFull timeTemporary workApprenticeshipWork at officeLocal areaWork from homeHome officeMonday to FridayWeekend work- ...enthusiastic and highly skilled Medical Director to join our growing team.... ...and performing utilization reviews, prior authorizations, and making... ...will serve as a key clinical expert, ensuring appropriate... ...peer discussions. This is a remote position requiring a "roll up...Remote workFull timeFlexible hours
- ...MedCAREERS seeks an Associate Medical Director Board Certified in Medical Oncology... ...(or Hematology/Oncology) for a remote role across the USA. You will perform chart review and utilization review for... ...active license and 5+ years of clinical work. No patient contact; start...Remote jobFull timeImmediate start
$191.5k - $355.6k
...seeking a Physician (M.D. or D.O) to handle medical policy responsibilities and perform medical reviews while interacting with provider... ...license, board certification, and 5 years of clinical experience. The position is 100% remote, with a competitive compensation package...Remote job- ...a nonprofit health plan serving multiple states, seeks a Medical Director - Clinical Operations for a part-time, 8-hour Friday schedule. This role... ...and business mind. Responsibilities include leading reviews, committee participation, and guiding medical policy to balance...Remote jobPart time
- Molina Healthcare is seeking a registered nurse with inpatient claim review experience to ensure diagnoses, procedures, revenue codes, and DRG assignments accurately reflect the documented care and billed charges. You will apply ICD-10, DRG and revenue code guidelines,...Remote job
$248.5k - $373k
...exceed expectations as we deliver clinical coverage and medical claims reviews. Our role is to empower providers... ...health care costs. The Medical Director provides physician support to Enterprise... ...’ll enjoy the flexibility to work remotely from anywhere within the U.S. as...Remote workMinimum wageFull timeWork experience placementLocal area- ...The Medical Director is a key clinical leader responsible for driving excellence in documentation... .... By partnering with DRG Validation Auditors, the... ...requirements. Analytics & Strategy: Review performance metrics,... ...Paid time off Location Remote with limited travel to client...Remote workWork at office
$31.15 - $55.77 per hour
...to manage patients, improve clinical and financial outcomes, and share... ...is responsible for reviewing pre-authorization requests for... ...determining if requests meet medical necessity for the requested level... ...reviews with naviHealth Medical Directors. Notify hospitals and SNFs of...Remote workContract workWork experience placementLive inWork at officeFlexible hoursAfternoon shiftEarly shift$85k - $90k
...accuracy, accountability, and clinical excellence to healthcare... ...solutions, including DRG Validation, Cost Outlier, and Readmission Reviews. Under the direction... .... This is a fully remote position. Candidates must... ...College level courses in medical terminology, anatomy,...Remote workFull time$45 - $50 per hour
...Clinical Documentation Consultant (CDI) DRG Validation / Auditor Immediate need for a talented... ...and is located in US(Remote). Pay Range: $45 - $50... ...retrospective inpatient chart reviews Review provider... ...BSN, MSN, MD or Foreign Medical Graduate Minimum 4 years...Remote workContract workLocal areaImmediate start- ...Position Summary The DRG Validator/Reviewer is responsible for reviewing... ...ICD-10 coding to analyze medical records, determine coding accuracy... ...record documentation, clinical coding guidelines, and DRG... ...primarily office-based or remote, depending on company policy...Remote workFull time
$248.5k - $373k
...,500.00 - $373,000.00Job Area: Medical & Clinical OperationsCompany: UnitedHealth... ...enjoy the flexibility to work remotely * from anywhere within the U.S.... ...Appeals and Grievances Medical Director is responsible for ongoing clinical review and adjudication of appeals and...Remote workMinimum wageWork experience placementLocal areaWork from home- ...delivery and patient outcomes. Our talented remote workforce spans the country and plays a... ...s why we offer benefits that include: Medical, dental and vision insurance Paid time... ...and based in Alabama. The Supervisor, Clinical Review plays a critical role in providing...Remote workContract work
- Job SummaryWe are seeking a Medical Director with clinical specialization (varying therapeutic areas including... ...serve as a medical resource for the review, presentation, and interpretation of... ...also has the ability to be fully remote with the right experience**.ResponsibilitiesProvide...Remote workContract workWork from home
- ...you to shine? Join us as a Medical Director, Gastrointestinal & Inflammation... ...sources including non-clinical, clinical, post-marketing and... ...expertise, medical interpretation, review, and authorship of... ...is currently classified as “ remote” in accordance with Takeda’s...Remote workWork at officeLocal areaWorldwide
$85k - $109.2k
...It takes great medical minds to create powerful solutions that solve some of healthcare... ...Associate Manager, Inpatient/Outpatient Coding Review who is responsible for supervising a... ...team of Certified Coders, Clinical DRG Auditors, and Nurse Reviewers to audit inpatient...Remote workFull timeContract workWork from homeFlexible hours$212k - $287k
...job title for this position is Medical Sr. Consultant*Position... ...DO) who is excited to apply clinical expertise in a dynamic, collaborative... ...week). The position is fully remote, with travel to our St. Paul,... ...relevant for claims and UW reviews, provide advanced medical...Remote workFull timeHome officeFlexible hours- We are looking for a Medical Director, who will be the clinical leader of our expansion into Arizona as a third market... ...(CCM) visits are completed and reviewed Run regular huddles and provide... ...management, 'checklist' management, remote monitoring, etc.) used together to...Remote work1 day per week
$275k - $325k
...approximately 1.9 million patients, including clinical trials, transfusions, and other... ...better. Utilization Management Medical Director OncologyWork Location: REMOTE (work from home)California Nevada... ...utilization management for case review and clinical decision making. In...Remote workWork from home$78.7k - $134.9k
.... The Supervisor, Quality Reviewers is responsible for leading day-to-day clinical review and medical record operations supporting... ...record retrieval work including remote electronic health record (EHR... ...discussions Assists Director and Manager as needed to develop...Remote workWork experience placement$213k - $304k
The Opportunity:As a Medical Director at Relay Tx, you will help advance our clinical pipeline from IND to proof of concept to... ...committees. Provide expert medical review, assessment, and interpretation... ...for patients. We are open to remote employeesEstimated Salary Range...Remote workImmediate start- ...Optum division seeks an Inpatient Care Management Medical Director to oversee acute level of care reviews for medical necessity across payer networks. The role... ...market, or national levels. The position offers remote work from anywhere in Florida, competitive salary,...Remote work
$79k - $99.75k
...pay comprehensive inpatient DRG reviews based on industry standard inpatient... ...and rules, evidence based clinical criteria plan, and policy... ...claims as they compare with medical records ICD-10 Official Coding... ...India. We foster a hybrid and remote friendly culture, and all our...Remote workFull timeWork at officeLocal areaVisa sponsorshipFlexible hours$145k - $165k
...more human.About the Role:As a Medical Director, you will provide scientific... ...for incorporation of clinical, medical and scientific relevance... .... You will be a remote employee reporting to a Senior... ...visual representations of data Review content for medical and scientific...Remote workFlexible hours- ...1347Remote100% Remote100% Remote in the 28 states - North Carolina... ...cases have you typically reviewed in a day? Top 3-4 Required... ...MD or DO from accredited medical school Industry Specific... ...application of a Medical Director’s knowledge and clinical skills will vary across...Remote work
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