Remote Medical Director, Utilization & Coverage
Optum
Optum seeks an UM Medical Director, DME, remotely available within the United States. The role leads initial clinical reviews for benefit coverage determinations and collaborates with leadership to implement clinical and operational processes across lines of business.
The position involves utilization management activities, peer-to-peer discussions with providers, and coordination with internal partners to ensure timely, cost-effective, high-quality care. Travel may be required.
#J-18808-Ljbffr- ...UnitedHealth Group is seeking a Medical Director to provide physician support to Enterprise Clinical Services and oversee clinical coverage reviews and medical necessity determinations... ...benefit language interpretation, with flex remote work across the U.S. This full-time...Remote jobFull timeFlexible hours
$275k - $325k
...growing, TOI is changing oncology for the better. Utilization Management Medical Director OncologyWork Location: REMOTE (work from home)California Nevada Arizona... ...patients to clarify and discuss treatment options and coverage. Evaluate clinical and utilization data to...Remote workWork from home- ...Medical DirectorCurative is seeking an enthusiastic... ...highly skilled Medical Director to join our growing team... ...and performing utilization reviews, prior authorizations... .... This is a remote position requiring a "... ...premiums for you and 50% coverage for dependents on the...Remote workFull time
- ...Judi Health is seeking a Medical Director for the Clinical Enterprise team to oversee utilization management, prior authorizations, and appeals for commercial and government... ...and prescribers to support evidence-based coverage decisions. Qualified candidates hold an MD/DO...Remote work
- ...Description Job Description Medical Director of Prior Authorization and Utilization Management - Palm Springs, California... ...can be structured as a hybrid remote role - you would not necessarily... ...bonus ~ Paid malpractice with tail coverage Requirements: MD or DO...Remote workPermanent employmentTemporary workRelocation package
- ...steps. Our partner is looking for a Medical Director (Utilization Management) based in United States.... ...program development. This is a fully remote, full-time leadership opportunity operating... ..., CMS regulations, and applicable coverage criteria. Extensive experience...Remote workFull timeWork at officeMonday to Friday
$248.5k - $373k
...Medical Director Oncology Optum is a global organization that delivers... ...Oncology will provide utilization review determinations and support... ...the flexibility to work remotely from anywhere within the U.... ...rotational holiday and call coverage Preferred...Remote jobMinimum wageWork experience placementLocal area$240.12k - $315.16k
Hi, we're Oscar. We're hiring an Associate Medical Director to join our Utilization Management Team. Oscar is the first health insurance company built... ...into the Senior Medical Director.Work Location: This is a remote position, open to candidates holding an active medical...Remote workFull timeImmediate startWork from homeHome office- ...Beacon Hill is seeking a Medical Director (MD/DO) for Raleigh, North Carolina, with a strong focus on physical health utilization management and clinical leadership. The role collaborates... ...functions while accommodating primarily remote work with a North #J-18808-Ljbffr...Remote work
- ...CAI is seeking a Medical Director to oversee utilization management with adherence to top clinical standards. This full-time, remote position requires board-certified MD/DO and active state licensure in PA, NY, or WV, with 5+ years of direct patient care experience. You...Remote workFull time
- ...UnitedHealth Group is seeking a Medical Director to lead clinical coverage reviews for Enterprise Clinical Services, collaborating with leadership to ensure... ...with providers to educate on medical policy. Remote work is available from anywhere in the U.S. The position...Remote work
- ...UnitedHealth Group is seeking a Medical Director to provide physician support for Enterprise Clinical Services, guiding clinical coverage determinations and cost-effective care decisions... ...quality improvement initiatives. Remote work is available nationwide, with in-office...Remote workWork at office
- ...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
$248.5k - $373k
...- $373,000.00/yearJob Area: Medical & Clinical OperationsCompany:... ...medicine physician to join our Utilization Management team. Optum is a... ...clinicians work and live.The Medical Director for Utilization Management... ...the flexibility to work remotely * from anywhere within the U....Remote workMinimum wageFull timeWork experience placementWork at officeLocal areaWork from home$275k - $325k
...Description Description Astrana is seeking a California-licensed Medical Director - Utilization (UM) to provide clinical oversight and strategic... ...Requirements and Working Conditions This position is fully remote, with some travel to SoCal required as needed. Candidates...Remote workFull timePart timeShift work- ...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 health plan companies with experience in imaging cases. Must be board-...Remote jobFull timeImmediate start
- ...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
- ...Oscar Health is hiring an Associate Medical Director to lead the Utilization Management Team and determine the medical appropriateness of inpatient, outpatient... ...reporting to the Senior Medical Director. This remote role is open to physicians with licenses in Florida,...Remote job
- 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 organizational standards in a fully remote role based in the United States. You will collaborate...Remote jobPart time
- WPS Health Solutions seeks a Contractor Medical Director to lead clinical review for Local Coverage Determinations and medical policy development. You will collaborate... ...work is available with some travel and potential remote options in approved states. #J-18808-Ljbffr WPS...Remote workFor contractorsLocal area
- ...Medical Director Utilization Management Location: Remote Preference EST or nearby Pittsburgh PA, NY, WV Duration: 6+ Months Contract Role with possible extension. Position Overview As part of a physician team, the Medical Director ensures utilization management...Remote workContract workPrivate practice
$248.5k - $373k
...Medical Director For Utilization ManagementWellMed, part of the Optum family of businesses, is seeking an internal medicine or family medicine physician... .... Growing together.You'll enjoy the flexibility to work remotely from anywhere within the U.S. as you take on some tough...Remote workMinimum wageFull timeWork experience placementWork at officeLocal areaWork from home- ...Description Job Description Medical Director of Prior Authorization and Utilization Management - Palm Springs, California... ...can be structured as a hybrid remote role - you would not necessarily... ...bonus ~ Paid malpractice with tail coverage Requirements: MD or DO...Remote workRelocation package
$110 - $130 per hour
A healthcare staffing company is seeking a Medical Director to lead utilization management and quality improvement for Medicare inpatient care. This remote role requires board-certified physicians with active medical licenses in FL and TX. Key responsibilities include...Remote work$248.5k - $373k
...373,000/yearJob Area: Medical & Clinical OperationsCompany... ...we deliver clinical coverage and medical claims... ...care costs.The Medical Director provides physician... ...knowledge in various utilization management activities... ...the flexibility to work remotely * from anywhere within...Remote workMinimum wageFull timeWork experience placementLocal area- ...MetroPlus in New York seeks a Medical Director focused on health care utilization management. The position involves overseeing medical necessity reviews, conducting peer discussions, and guiding policy implementation. Candidates should possess a Doctor of Medicine or Doctor...Remote job
- ...Altais is seeking a Medical Director of Utilization and Medical Management for a remote, one-month opportunity. The role reports to Senior Medical Director and collaborates with the One Altais clinical leadership team to ensure high-quality, cost-efficient care across...Remote job
- 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
- ## Medical DirectorApplylocations: Kansastime type:... ...Summary**The Medical Director will serve as a clinical... ...for supporting the plan utilization management, medical... ...position is eligible to work remotely, hybrid or onsite in... ...guidelines, and coverage determinations based on...Remote workWork at officeImmediate startRelocation
$248.5k - $373k
...UM Medical Director, DME – Remote (Pacific or Mountain Time Zone preferred) – Optum Optum is a global... ...processes related to benefit coverage determinations, quality improvement,... ...include applying clinical knowledge in utilization management activities, primarily pre...Remote workWork at officeLocal areaMonday to Friday
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Remote Medical Director, Utilization & Coverage. Be the first to apply!
- health account manager Phoenix, AZ
- home health manager Phoenix, AZ
- hospital account manager Phoenix, AZ
- senior manager clinical operations Phoenix, AZ
- regional director of clinical operations Phoenix, AZ
- public health project manager Phoenix, AZ
- director population health Phoenix, AZ
- medical director oncology Phoenix, AZ
- health manager Phoenix, AZ
- remote medical billing manager Phoenix, AZ



