Sign up to access all features of our service.
  • Job search
  • Favorites
  • Create a CV
    New
  • Salaries
  • Subscriptions

Remote Medical Director - Utilization & Care Management

$223.8k - $313.1k

Humana

Humana Inc. in Trenton, NJ is seeking a Medical Director National OP Medicare to oversee complex clinical reviews. The ideal candidate will have an MD or DO degree along with 5+ years of experience in direct patient care. Responsibilities include determining authorization for services, conducting medical necessity reviews, and collaborating with physicians. This role requires strong analytical and communication skills and offers competitive benefits including a salary range of $223,800 to $313,100 per year. #J-18808-Ljbffr

Vacancy posted 1 day ago
Similar jobs that could be interesting for youBased on the Remote Medical Director - Utilization & Care Management in Ewing, NJ vacancy
  •  ...Crains Cleveland is seeking a Cardiovascular Utilization Management Reviewer to join their Utilization Management...  ...leverage your expertise in cardiology in a fully remote setting, contributing to case reviews and patient care improvement. Ideal candidates hold an MD/DO/... 
    Remote work
    Full time
    Part time
    Flexible hours

    Crains Cleveland

    New York, NY
    3 days ago
  • $248.5k - $373k

     ...Medical Director Oncology Optum is a global organization that delivers care, aided by technology to help millions...  ...Oncology will provide utilization review...  ...support case and disease management teams to achieve optimal...  ...flexibility to work remotely from anywhere... 
    Remote work
    Minimum wage
    Work experience placement
    Local area

    Reliant Medical Group

    United States
    3 days ago
  • $250k

     ...The Utilization Review Medical Director is responsible for conducting clinical reviews...  ...support Integra’s Utilization Management (UM) operations. This full...  ..., clinical standards of care, and regulatory updates relevant...  ...: Full-time remote role requiring consistent... 
    Remote work
    Full time
    Temporary work
    Local area

    Integra Partners

    Troy, MI
    5 days ago
  •  ...Molina Healthcare is seeking a Medical Director in Mississippi. This remote position involves providing medical...  ...and cost-effective member care. Key responsibilities include evaluating...  ...appropriateness, supporting utilization management, and collaborating with healthcare... 
    Remote work

    Molina Healthcare

    Jackson, MS
    1 day ago
  •  ...CenCal Health is seeking a Medical Director to oversee clinical management and ensure quality care for its members. Reporting to...  ...involves clinical oversight in utilization management and care strategies...  .... This role is hybrid or remote, and requires local residency... 
    Remote work
    Local area
    Relocation

    Cencal Health

    Santa Barbara, CA
    23 hours ago
  • $248.5k - $373k

     ...Medical Director For Utilization Management WellMed, part of the Optum family of businesses, is seeking an internal...  ...team. Optum is a clinician-led care organization that is changing the way...  ...'ll enjoy the flexibility to work remotely from anywhere within the U.S. as... 
    Remote work
    Minimum wage
    Full time
    Work experience placement
    Work at office
    Local area
    Work from home

    divvyDOSE

    United States
    3 days ago
  • $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

    SPECTRAFORCE

    Wausau, WI
    3 days ago
  •  ...position leads and oversees the team focusing on utilization management inpatient medical necessity reviews and transitions of care (TOC) efforts, including post-discharge...  ...goals are achieved. Collaborate with the Director of Clinical Utilization Management to develop... 
    Remote work
    Full time
    Temporary work
    Part time
    Work experience placement
    Work at office
    Trial period
    Flexible hours

    CHPW

    United States
    3 days ago
  •  ...A healthcare organization is seeking a Medical Director for Utilization Management to ensure compliant care decisions for Medicare Advantage members. This remote position requires expertise in clinical decision-making, particularly with MCG guidelines and utilization... 
    Remote work

    Appworkshub

    New York, NY
    4 days ago
  • $275k - $300k

     ...Oncology Institute of Hope and Innovation is seeking a Utilization Management Medical Director Oncology to work remotely from California, Nevada, Arizona, Oregon, or...  ...with healthcare providers to optimize patient care. Ideal candidates will possess a medical degree and... 
    Remote work

    The Oncology Institute of Hope and Innovation

    Los Angeles, CA
    4 days ago
  • $268k - $414k

     ...Capacity Path is seeking a Behavioral Medical Director to oversee the Utilization Management Program. This position involves...  ..., ensuring the quality of care and implementing evidence-based treatments...  ...offers the flexibility to work remotely and includes a competitive salary... 
    Remote work

    Capacity Path

    Houston, TX
    3 days ago
  •  ...Columbus, Ohio is seeking a Medical Director for National OP Medicare to...  ...service authorization and utilization management. This role requires strong...  ...on Medicare and post-acute care scenarios. The ideal candidate...  ...environment and may involve remote work. #J-18808-Ljbffr... 
    Remote work

    Humana

    Columbus, OH
    23 hours ago
  •  ...Availity is seeking a Medical Director to lead the Utilization Management team for their Auth AI platform. Responsibilities include overseeing a team, ensuring...  ..., analytic reasoning, and leadership skills. This remote role offers a competitive salary, benefits including... 
    Remote work

    Availity

    New York, NY
    4 days ago
  •  ...Medix™ is looking for experienced Utilization Management Medical Directors for a remote contract opportunity. This role is ideal for physicians with strong payer...  ..., and significant experience in this field, making a direct impact on care quality. #J-18808-Ljbffr... 
    Remote work
    Full time
    Contract work
    Flexible hours

    Medix

    New York, NY
    4 days ago
  • $250k - $350k

     ...Healthcare, an Essen Health Care company, is a specialized medical group dedicated to...  ...care, longitudinal care management, remote monitoring, and real‑...  ...quality, reduce avoidable utilization, and expand access for...  ...Title: Medical Director – Intention MA Location... 
    Remote work

    Essen Medical Associates

    Boston, MA
    1 day ago
  • $246.1k - $344.2k

     ...Become a part of our caring community As the associate medical director (AMD) reporting to the chief...  ...and clinical management to ensure patient care...  ..., focusing on quality, utilization, patient experience, and...  ...Travel: While this is a remote position, occasional travel... 
    Remote work
    Full time
    Contract work
    Temporary work
    Apprenticeship
    Work from home

    Humana

    Tallahassee, FL
    23 hours ago
  • $170 - $175 per hour

     ...CAI is seeking a qualified Medical Director to perform utilization management responsibilities in a remote role. The ideal candidate will have at least 5 years of clinical experience and strong decision-making skills. Responsibilities include reviewing escalated cases,... 
    Remote work
    Hourly pay

    CAI

    Juneau, AK
    10 days ago
  • $84k - $105k

     ...Transformcap is seeking a Medical Director to provide clinical support for its clinical utilization management programs. This position involves...  ...of 5 years of patient care experience and specialty in...  ...required. The position offers remote work with a salary range of... 
    Remote work

    Transformcap

    Jersey City, NJ
    1 day ago
  •  ...healthcare company in Washington, D.C. is seeking a Medical Director to oversee inpatient medical necessity reviews and utilization management. This role requires strong analytical and...  ...will have a dedication to quality care and enjoy working in a structured, team-oriented... 
    Remote work

    Humana

    Washington DC
    1 day ago
  • $110.88 - $124.74 per hour

     ...A community-based healthcare organization is seeking a Medical Director of Utilization Management to oversee and coordinate clinical management, ensuring...  ...experience and a current NY Physician license. The position is remote, allowing for a flexible schedule, and involves... 
    Remote work
    Hourly pay
    Daily paid
    Flexible hours

    Village Center for Care, Inc.

    New York, NY
    11 days ago
  •  ...Medical Director ID 2026-25149 Category...  ...Defense and Community Care Network/Department of...  ...Veterans Affairs. This remote-based civilian position...  ...years of experience in managed care environments....  ...management domains including Utilization Management, Case Management... 
    Remote work
    Weekday work

    Spectrum Healthcare Resources

    Las Vegas, NV
    4 days ago
  •  ...Medical Director-Ortho- CM & UR Brighton Health Plan Solutions REMOTE-100% PART TIME MANAGED CARE About The Role Brighton Health Plan Solutions, a full-service health plan administrator...  ...interest and experience in managed care utilization and case management to support our team... 
    Remote work
    Part time
    Work at office

    Brighton Health Plan Solutions

    New York, NY
    3 days ago
  • $275k

     ...Medical Director, Hematology/Oncology (Utilization Management & Clinical Strategy) Full-Time Remote (Post-Onboarding) U.S. Licensed MD/DO A nationally recognized healthcare organization...  ...on utilization management, oncology care determinations, and strategic program... 
    Remote work
    Full time
    Relocation package
    Monday to Friday

    Medix

    New York, NY
    4 days ago
  •  ...financial barriers and make care truly accessible: one...  ...and highly skilled Medical Director to join our growing...  ...and performing utilization reviews, prior authorizations...  .... This is a remote position requiring a...  ...optimize utilization management processes and improve... 
    Remote work
    Full time
    Flexible hours

    VALID8 Financial

    Austin, TX
    1 day ago
  • $221.6k - $277k

     ...Location Remote with ~50% domestic and international travel Shape the future of cancer care as a Medical Director, Skin/IO at Natera. In this strategic...  ...organizations on clinical utility, interpretation, and impact...  .... Effective project management and ability to balance multiple... 
    Remote work
    Immediate start
    Worldwide

    Natera

    New York, NY
    1 day ago
  • $240.12k - $315.16k

     ...Overview Oscar is hiring an Associate Medical Director to join the Utilization Management Team. This role determines the...  ...Director. Work Location This is a remote position, open to candidates with...  ...utilization review experience in a managed care plan (health care industry). Bonus... 
    Remote work
    Immediate start
    Work from home

    Namely

    New York, NY
    23 hours ago
  • $248.5k - $373k

     ...Medical Director Optum is a global organization that delivers care, aided by technology to help millions of...  ...flexibility to work remotely from anywhere within...  ...Provide daily utilization oversight and external...  ...guidance to maximize cost management through close coordination... 
    Remote work
    Minimum wage
    Work experience placement
    Local area
    Flexible hours
    Weekend work
    Afternoon shift

    Reliant Medical Group

    United States
    3 days ago
  • $275k - $325k

     ...Medical Director - Utilization Management Astrana is seeking a California-licensed Medical Director - Utilization...  ...appropriate, and cost-effective care. This is a critical, cross-functional...  ...Conditions This position is fully remote, with some travel to SoCal required... 
    Remote work

    Astrana Health

    United States
    1 day ago
  • $211.17k - $269.25k

     ...The Physical Health Medical Director plays a key role within the Physical Health Medical Management Team, providing clinical oversight...  ...to clinical quality, utilization management, and care coordination. This position...  ...to work primarily remote. While there is no expectation... 
    Remote work
    Full time
    Work at office
    Relocation
    Flexible hours
    Weekend work

    Alliance

    United States
    4 days ago
  •  ...Humana Inc. seeks a Medical Director for the National OP Medicare. This role involves using clinical expertise to determine authorization...  ...regulations, and support quality, coordination, and resource utilization. Ideal candidates will have an MD or DO degree, extensive... 
    Remote work

    Humana

    Richmond, VA
    1 day ago

Do you want to receive more vacancies?

Subscribe and receive similar vacancies to Remote Medical Director - Utilization & Care Management. Be the first to apply!