Remote Medical Director - Surgical Claims Review
$248.5k - $373kCrains Cleveland
Eden Prairie, MN
- Remote job
Cruains Cleveland is seeking a Medical Director to provide physician support for Enterprise Clinical Services. This role includes conducting coverage reviews and ensuring quality medical care for members. The position is remote and requires a strong understanding of Evidence Based Medicine, with responsibilities including documentation and collaboration with providers. The salary ranges from $248,500 to $373,000 based on experience and qualifications. #J-18808-Ljbffr Crains Cleveland
Vacancy posted 5 days ago
Similar jobs that could be interesting for youBased on the Remote Medical Director - Surgical Claims Review in Eden Prairie, MN vacancy
$248.5k - $373k
Stryker Corporation is looking for a Medical Director who will provide physician support to Enterprise Clinical Services. The role includes conducting medical coverage reviews and working collaboratively with internal partners and providers. Candidates should have an M...Remote jobClaims$248.5k - $373k
Salem Health Hospitals & Clinics is seeking a Medical Director responsible for providing physician support to Enterprise Clinical Services operations. This role is fully remote and focuses on managing clinical reviews and benefit coverage determinations. Required qualifications...Remote jobClaimsFull time$248.5k - $373k
The Texas Health Institute is seeking a Medical Director to provide physician support and oversee clinical operations. The position involves conducting coverage reviews, engaging with providers, and ensuring quality medical care. With a salary range of $248,500 to $373...Remote jobClaims$373k
Wisconsin Psychiatric Association Inc is looking for a Medical Director to provide essential physician support to Enterprise Clinical Services operations. The position includes remote work flexibility and involves collaborative processes regarding benefit coverage and...Remote jobClaims- ...healthcare company in Michigan is seeking a Medical Director to oversee clinical decisions and ensure compliance... .... This position allows for occasional remote work, with responsibilities primarily involving medical reviews and teamwork within a regulated environment....Remote workClaimsCasual work
Humana
Lansing, MI1 day ago - ...leading U.S. healthcare company is seeking a Medical Director to provide medical interpretation and... ...and Medicaid. Responsibilities include reviewing clinical scenarios and collaborating... ...delivery. This role is mostly remote but may require occasional travel to company...Remote workClaims
Humana
Santa Fe, NM5 days ago $248.5k - $373k
...Medical Director Optum is a global organization that delivers care, aided by technology to... ...deliver clinical coverage and medical claims reviews. Our role is to empower providers and... ...You'll enjoy the flexibility to work remotely from anywhere within the U.S. as you take...Remote jobClaimsMinimum wageFull timeWork experience placementLocal area- A leading healthcare provider is seeking a Medical Director to review health claims and ensure compliance with clinical standards. The ideal candidate... ...salary and is based in Sacramento, CA, with standard hours and some remote work flexibility. #J-18808-Ljbffr Humana IncRemote jobClaims
$223.8k - $313.1k
...Become a part of our caring community The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve moderately... ...HIPAA information. Travel: While this is a remote position, occasional travel to Humana's offices...Remote workClaimsBi-weekly payFull timeTemporary workApprenticeshipWork at officeLocal areaWork from homeHome officeMonday to FridayWeekend workHumana, Inc.
Charleston, WV2 days ago- Optum is seeking a Medical Director to oversee clinical review operations and collaborate with a multidisciplinary team on benefit determinations. This... ...clinical practice. The position offers flexibility to work remotely from anywhere in the U.S. and focuses on improving...Remote jobClaims
$122.44k
...develop staff in the administration of the Medical Review and Prior Authorization programs for... ...liaison between program partners. Location Remote position. Typical work hours: 8:30am - 5... ...Experience with pricing large stop‑loss claims in coordination with clinical staff and...Remote workClaimsFor contractorsWork at officeMonday to Friday$248.5k - $373k
...Medical Director Optum is a global organization that delivers care, aided by technology to... ...deliver clinical coverage and medical claims reviews. Our role is to empower providers and... ...You'll enjoy the flexibility to work remotely from anywhere within the U.S. as you take...Remote jobClaimsMinimum wageWork experience placementLocal area$248.5k - $373k
...Medical Director Optum is a global organization that delivers care,... ...together. As part of the Focus Claims Review team at Optum, the Medical... ...the flexibility to work remotely from anywhere within the U.... ...: Reviews surgical and other professional claims...Remote jobClaimsMinimum wageWork experience placementLocal area$240k - $250k
...Medical Director Utilization Management We are looking for... ...including medical and surgical clinical areas to deliver... ...of services by reviewing clinical information and... ...perspectives. This is a remote-first role that may... ...data with post-service claims validation, we're...Remote workClaimsFlexible hours- ...and benefits, including medical, dental, vision, long-... ...Work-life balance. ~ Remote setting ROLE DESCRIPTION... ...to a second level reviewer. This individual... ...review. General Medical-Surgical nursing is sufficient to... ...’s status, benefit and claim concerns, and validation...Remote workClaimsTemporary workWork at officeWork from homeMonday to FridayFlexible hours
Hines & Associates Inc Careers
Rockford, IL2 days ago $220k - $230k
...Position Summary The Clinical Review Medical Director is primarily responsible for reviewing hospital... ..., DRG review, peer review, and claim review experience is desirable. Active... ...necessary to perform assigned tasks. Remote Work Requirements: High speed...Remote workClaimsFull timeWork at office- ...Title: Utilization Review Nurse Location: Remote in IL, TX, NM, MT or... ...benefits, evaluate medical necessity and promote... ...outpatient services, surgical and diagnostic procedures... ...with Medical Directors when services do not... ...ICD-10), and overall claims process a plus • Knowledge...Remote workClaimsContract workLocal area
Innovative Systems Group
Richardson, TX2 days ago - ...Title: Utilization Review Nurse Location: Remote in IL, TX, NM, MT or... ...benefits, evaluate medical necessity and promote... ...outpatient services, surgical and diagnostic procedures... ...with Medical Directors when services do not... ...ICD-10), and overall claims process a plus • Knowledge...Remote workClaimsContract workLocal area
Innovative Systems Group
Chicago, IL4 minutes ago $248.5k - $373k
...Medical Director Optum is a global organization that delivers care,... ...together. As part of the Focus Claims Review team at Optum, the Medical... ...per week. This can be remote work from home anywhere in... ...Responsibilities: Reviews surgical and other professional...Remote jobClaimsMinimum wagePart timeWork experience placementLocal areaWork from home- Optum is seeking a Medical Director in Phoenix, Arizona to provide physician support for clinical claims reviews and promote improved health outcomes. The role emphasizes collaboration... .... The successful candidate will work remotely and enjoy comprehensive benefits. #J-188...Remote jobClaims
$248.5k - $373k
UnitedHealth Group is looking for a part-time Medical Director to provide leadership for the claims review program. This position allows you to work remotely from anywhere within the United States with a commitment of 20 hours per week. The ideal candidate will hold an...Remote jobClaimsPart time- ...mandated turnaround times. Our reviewers are compensated on a per-case... ...Responsibilities Reviews all medical records and addresses each... ...media stipend is provided for remote workspace. Come up to speed quickly... ...over 200,000 insurance claims annually for leading national...Remote workClaimsFor contractorsWork experience placement
Dane Street
Wausau, WI4 days ago $29.05 - $67.97 per hour
...experience, responsible for review of documentation to ensure medical necessity and appropriate... ...the medical record and claim submitted support correct... ...criteria with medical directors on denial decisions. Supplies... ...medicine, medical/surgical or pediatrics. Billing and...Remote jobClaimsHourly payWork experience placementWork at office$260k - $280k
...Medical Director Spine Surgery United States Opportunity Overview:... ...appropriateness of services by reviewing clinical information and... ...Pay & Perks: Fully remote opportunity with about 5% travel... ...authorization data with post-service claims validation, we're creating a...Remote workClaimsFlexible hours$100k - $300k
...Description New: Part-Time Medical Director Opportunity in Michigan Position... ...se. The medical director reviews a variety of cases weekly to... ...in Mich., and may be partly remote. It is a Michigan-based nonprofit... ...of medical and disability claims and preauthorization...Remote workClaimsHourly payTemporary workPart timeFor contractorsImmediate startDOCTORS CHOICE PLACEMENT SERVICES, INC.
United States19 hours ago$67.7k
...your trusted partner in innovation. Medical Claims Reviewer Overall Purpose of the Position: Broadway... ..., Ambulance, Physical Therapy and Surgical. Performs medical reviews using... ...Monday to Friday Work Location: remote within three hour driving radius of Augusta...Remote workClaimsFull timeContract workFor contractorsLive inWork at officeWork from homeHome officeMonday to FridayFlexible hoursShift workGrabJobs
United States2 days ago- ...partner in innovation. Location : Remote (U.S. - Work from home)... ...Registered Nurse (RN) to join our Medical Review team. This role involves... ...Responsibilities Review medically complex claims, pre‑authorization requests,... ..., and/or medical‑surgical settings. Ability to...Remote jobClaimsFor contractorsWork at officeWork from homeHome office
- ...Claims Reviewer Location: Phoenix AZ 85053 (REMOTE) Duration: 6+ Months Pay Range: $28.00/hr on W2 Shift:... ...Conducts retrospective review of medical/surgical claims and behavioral health... ...related information to medical director, providers, peer reviewers, Claims...Remote workClaimsContract workFor subcontractorInterim roleShift work
$83.2k
...Clinical Review Coordinator At Commence, we're the start of a new... ...review process. The role is remote work, but you must reside in the... ..., providers, and other medical personnel. Protects the confidentiality... ...performing pre- and post-pay claims reviews, and utilization...Remote workClaimsContract workFor contractorsWork at officeShift work$50k - $55k
...Remote Case Manager, Clinical Review & Care Optimization Fully Remote Allied Benefit Systems Overview... ...Salary Position Type Full Time Category Medical Management Description... ...ESSENTIAL FUNCTIONS: Review clinicals, claims and baseline case information for health...Remote jobClaimsFull timeWork experience placementWork at officeWork from home
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Remote Medical Director - Surgical Claims Review. Be the first to apply!
Related searches
- health insurance manager Eden Prairie, MN
- medical director neurology Eden Prairie, MN
- senior director clinical operations Eden Prairie, MN
- healthcare consulting manager Eden Prairie, MN
- health services director Eden Prairie, MN
- remote medical billing manager Eden Prairie, MN
- health services manager Eden Prairie, MN
- public health director Eden Prairie, MN
- director of health information management Eden Prairie, MN
- medicare medical director Eden Prairie, MN