Remote Medical Director - Clinical Coverage & Utilization
Jobleads-US
- Remote job
UnitedHealth Group is seeking a Medical Director to provide physician support to Enterprise Clinical Services and oversee clinical coverage reviews and medical necessity determinations. You will collaborate with network and non-network physicians, document findings, participate in clinical rounds, and help guide benefit language interpretation, with flex remote work across the U.S.
This full-time role requires MD/DO, board certification, and 3+ years of practice and offers a comprehensive
#J-18808-Ljbffr Jobleads-US- ...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... .... The position involves utilization management activities, peer-to-peer...Remote work
$275k - $325k
...9 million patients, including clinical trials, transfusions, and other... ...oncology for the better. Utilization Management Medical Director OncologyWork Location: REMOTE (work from home)California Nevada... ...discuss treatment options and coverage. Evaluate clinical and utilization...Remote workWork from home- ...Medical DirectorCurative is seeking an enthusiastic... ...skilled Medical Director to join our... ...overseeing and performing utilization reviews, prior... ...serve as a key clinical expert, ensuring appropriate... .... This is a remote position requiring... ...for you and 50% coverage for dependents on...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... ...: No direct clinical responsibilities, allowing... ...structured as a hybrid remote role - you would not necessarily... ...malpractice with tail coverage Requirements:...Remote workPermanent employmentTemporary workRelocation package
- ...partner is looking for a Medical Director (Utilization Management) based in United... ...responsible for ensuring clinically appropriate, evidence-based... ...development. This is a fully remote, full-time leadership... ..., and applicable coverage criteria. Extensive experience...Remote workFull timeWork at officeMonday to Friday
$248.5k - $373k
...Medical Director Oncology Optum is a global organization... ...Oncology will provide utilization review determinations... ...to achieve optimal clinical outcomes. You'll enjoy... ...flexibility to work remotely from anywhere within... ...holiday and call coverage Preferred Qualification...Remote jobMinimum wageWork experience placementLocal area$240.12k - $315.16k
...re Oscar. We're hiring an Associate Medical Director to join our Utilization Management Team. Oscar is the first... ...and pharmacy services by reviewing clinical information and applying evidence-... ...Director.Work Location: This is a remote position, open to candidates holding...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 with medical... ...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
$248.5k - $373k
...$373,000.00/yearJob Area: Medical & Clinical OperationsCompany: UnitedHealth... ...physician to join our Utilization Management team. Optum is a... ...work and live.The Medical Director for Utilization Management... ...enjoy the flexibility to work remotely * from anywhere within the...Remote workMinimum wageFull timeWork experience placementWork at officeLocal areaWork from home$275k - $325k
...Description Astrana is seeking a California-licensed Medical Director - Utilization (UM) to provide clinical oversight and strategic leadership through our... ...Requirements and Working Conditions This position is fully remote, with some travel to SoCal required as needed....Remote workFull timePart timeShift work- ...MedCAREERS seeks an Associate Medical Director Board Certified in Medical... ...Hematology/Oncology) for a remote role across the USA. You will perform chart review and utilization review for health plan companies... ...license and 5+ years of clinical work. No patient contact; start...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 policies with... ...organizational standards in a fully remote role based in the United States....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... ...in accordance with the highest and most current clinical standards. The incumbent reviews escalated cases...Remote workContract workPrivate practice
$248.5k - $373k
...Medical Director For Utilization ManagementWellMed, part of the Optum family of businesses, is seeking an... ...management program.At Optum, you'll have the clinical resources, data and support of a... ...'ll enjoy the flexibility to work remotely from anywhere within the U.S. as you...Remote workMinimum wageFull timeWork experience placementWork at officeLocal areaWork from home- ...Description Job Description Medical Director of Prior Authorization and Utilization Management - Palm... ...: No direct clinical responsibilities, allowing... ...structured as a hybrid remote role - you would not necessarily... ...malpractice with tail coverage Requirements:...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
...73,000/yearJob Area: Medical & Clinical OperationsCompany: UnitedHealth... ...we deliver clinical coverage and medical claims... ...costs.The Medical Director provides physician... ...knowledge in various utilization management activities... ...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... ...Summary**The Medical Director will serve as a clinical subject matter... ...supporting the plan utilization management, medical... ...is eligible to work remotely, hybrid or onsite in... ...clinical guidelines, and coverage determinations...Remote workWork at officeImmediate startRelocation
$248.5k - $373k
...UM Medical Director, DME – Remote (Pacific or Mountain Time Zone preferred) – Optum... ...physician support to Enterprise Clinical Services operations,... ...processes related to benefit coverage determinations, quality... ...applying clinical knowledge in utilization management activities,...Remote workWork at officeLocal areaMonday to Friday- ...Hampshire seeks a Full-time Medical Director to lead medical management, quality... ...health plan. You will direct utilization management, drive cost... ...board certification, and recent clinical practice, with a flexible work model including remote/hybrid options and...Remote workFull timeFlexible hours
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Remote Medical Director - Clinical Coverage & Utilization. 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



