Remote Medical Director - Utilization & Care Management
$223.8k - $313.1kHumana
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
- ...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 workFull timePart timeFlexible hours
$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 workMinimum wageWork experience placementLocal area$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 workFull timeTemporary workLocal area- ...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
- ...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 workLocal areaRelocation
$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 workMinimum wageFull timeWork experience placementWork at officeLocal areaWork from home$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- ...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 workFull timeTemporary workPart timeWork experience placementWork at officeTrial periodFlexible hours
- ...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
$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$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- ...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
- ...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
- ...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 workFull timeContract workFlexible hours
$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$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 workFull timeContract workTemporary workApprenticeshipWork from home$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 workHourly pay$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- ...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
$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 workHourly payDaily paidFlexible hours- ...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 workWeekday work
- ...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 workPart timeWork at office
$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 workFull timeRelocation packageMonday to Friday- ...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 workFull timeFlexible hours
$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 workImmediate startWorldwide$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 workImmediate startWork from home$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 workMinimum wageWork experience placementLocal areaFlexible hoursWeekend workAfternoon shift$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$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 workFull timeWork at officeRelocationFlexible hoursWeekend work- ...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
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