Remote Medical Director: Appeals & Grievances Leader
Stryker Orthopaedics
UnitedHealthcare is seeking a clinician to review appeals and grievances across PPO, HMO, MAPD and PDP products. The role involves regulatory responses and collaboration with medical directors and network staff.
We offer remote work from anywhere in the U.S. The successful candidate will bring MD/DO credentials, 5+ years’ clinical practice, and strong leadership, communication, and project-management skills to help improve care access and outcomes.
#J-18808-Ljbffr$248.5k - $373k
...$248,500.00 - $373,000.00Job Area: Medical & Clinical OperationsCompany: UnitedHealth... ...'ll enjoy the flexibility to work remotely * from anywhere within the U.S. as... .... Primary Responsibilities:The Appeals and Grievances Medical Director is responsible for ongoing clinical...Remote workMinimum wageWork experience placementLocal areaWork from home$236.5k
...clinical professional on our Medical Management/Health Services team... ...Purpose: Supervisory Medical Director at Centene provides medical... ...actively participates in the appeals process, ensuring that appeals... ...approach to work with remote, hybrid, field or office work...Remote workFull timePart timeWork at officeFlexible hours$280k - $310k
A distinguished behavioral health organization seeks a Medical Director to lead psychiatric consultation and clinical innovation within the... ...extensive clinical experience and proven leadership skills. A fully remote position with a competitive salary range of $280,000 to $310,...Remote work- ...To support a growing remote team, the full-time Appeals and Grievance Specialist will manage and resolve complaints, grievances, and appeals from members and providers while ensuring compliance with applicable requirements. Key responsibilities Manage and resolve complaints...Remote workFull time
- A healthcare service provider is seeking an Appeals and Grievances Clinical Specialist to manage member complaints and clinical case resolutions. This is a 100% remote role requiring an RN, LPN, or Dental Hygienist license. Responsibilities include developing cases, researching...Remote job
- ...Appeals And Grievances Lead 3 Key Consulting is recruiting an Appeals and Grievances Lead for a... ...DMHC, and DHCS regulations. Must know Medical Terminology. Must have excellent written... ...but not limited to members, peers, leaders, physicians, executives, and regulatory...Flexible hoursWeekend work
$280.84k - $393.18k
...Health Services, the Senior Medical Director Policy & Outcomes (Sr.... ...clinical requirements. This leader serves as the accountable medical... ...quality management, grievance and appeals, delegation oversight, and... ...work schedule. (Mon & Fri - remote, Tues - Thurs onsite in Rancho...Remote workTemporary workLocal area- ...Job Title Job Description Process appeals and grievances, analyze, research, and provide comprehensive responses in accordance with established... ...and applying contract and regulatory provisions. This is a Remote Role Experience Experience handling a large load of work in...Remote workContract workApprenticeshipLocal area
- Banner Health seeks a remote Grievance & Appeals Coordinator in Arizona to support members and providers through the grievance, appeal, and claim-dispute process. This part-time role requires experience with AHCCCS, CMS regulations, and strong communication. You will manage...Remote jobPart timeMonday to FridayShift work
- L.A. Care Health Plan is seeking an Appeals and Grievances Specialist II in Los Angeles, CA. The role involves investigating member and provider... ...include at least 2 years in Managed Care, knowledge of medical terminology, and excellent communication skills. This full-...Remote jobFull time
$23.22 - $34.84 per hour
A leading health insurance provider is seeking a Grievance & Appeals Coordinator to work virtually full-time, with responsibilities including summarizing complaints, ensuring resolution of grievances, and documenting interactions. The ideal candidate should possess a high...Remote jobHourly payFull time$21.16 - $38.37 per hour
...Join to apply for the Medicare Appeals & Grievances Specialist (PST Hours) role at Molina Healthcare . This position is remote and will be working Pacific Standard hours.... ...grievance outcomes. Requests and reviews medical records, notes, and/or detailed bills as...Remote workHourly payFull timeContract workWork experience placementWork at office$320k - $350k
...teams drive groundbreaking medical discoveries and invite all... ...SummaryThe Senior Medical Director serves as a key clinical executive... ...or escalated cases, appeals, and grievances, and ensure UM policies align... ...Job Details (if applicable)Remote TypeRemoteWork Location399...Remote workFull time$286.07k - $353.38k
....Position SummaryThe Vice President, Medical Director, Health Plan provides senior clinical... ...program requirements, including clinical appeals and grievances, using sound clinical evidence and... ..., Care Management, and physician leaders.Represent the organization with regulatory...Remote workFull timeHome office$22 - $23 per hour
...Immediate need for a Grievance & Appeals Coordinator . This is a 12+ Month Contract opportunity... ...with long-term potential and is US ( Remote ). Please review the job description below... ...are not limited to, health insurance (medical, dental, vision), 401(k) plan, and paid...Remote workContract workWork at officeLocal areaImmediate start$83.1k - $120.36k
...Position Summary: The Appeals & Grievances (A&G) unit manages Healthfirst member... ...providers. This is either a remote or on-site position located... ...Conditions, Prior Approval, Medical Necessity, Pre-certification... ...Prepare cases for Medical Director Review ensuring that all pertinent...Remote workContract workTemporary workWork experience placementLocal area- ...Medical Director Utilization Management Location: Remote Preference EST or nearby Pittsburgh PA, NY, WV Duration: 6+ Months Contract Role with possible... .... Complete initial determinations, appeals, grievances, and other reviews as assigned. Compose clear...Remote workContract workPrivate practice
- Strategic Staffing Solutions is currently looking for a Grievance & Appeals Coordinator, a W2 contract engagement with one of our largest clients in Detroit, MI! REMOTE!! Title: Grievance & Appeals Coordinator Location : Detroit, MI (Fully Remote) Duration: 12+ Months...Remote workContract work
$22.84 per hour
...written claims and authorization appeals from providers and pursue resolution of formal grievances from members. Education/... ...Experienced Randstad is a world leader in matching great people with great... ...benefits package, including: medical, prescription, dental, vision,...Remote workHourly payPermanent employmentTemporary workWork experience placementWork at officeShift work- ...Medical Director Utilization Management (Payer Side Experience Required)- (Remote) Duration: 30 Weeks with possible extension Location:... ...medical necessity reviews, appeals, and escalated case evaluations... ...determinations, appeals, grievances, and additional assigned utilization...Remote workFull timeContract workPart timePrivate practiceMonday to FridayFlexible hours
- ...and highly organized Manager of Clinical Appeals to lead our clinical appeals operations across... ...a strong background in clinical review, medical necessity denials, payer appeal processes... ...commercial plans. Experience managing remote and/or offshore teams (Philippines...Remote work
$45.9k - $78.6k
...norm and every member feels valued. The Appeals & Grievances Specialist plays a vital role in... ...authorizations, concurrent and retrospective medical necessity reviews, and complex provider... ...Excel, and Outlook This position is a Remote role.To be eligible for consideration,...Remote workWork experience placement$81.1k - $116.48k
Appeals and Grievances Clinical Specialist - RN, LPN or Dental Hygienist - 100% Remote Join to apply for the Appeals and Grievances Clinical Specialist - RN, LPN or Dental Hygienist... ...pre-existing conditions, prior approval, medical necessity, pre-certification, continued...Remote jobFull timeMonday to FridayShift work$60.78k
...Appeals and Grievances Specialist II Job Category: Customer Service Department: Appeals & Grievances... ...Health Care (DMHC), Managed Risk Medical Insurance Board (MBMIB) and National... ...hours, on weekends, holidays, a hybrid remote schedule, occasional flexibility in...Remote workFull timeLocal areaShift workWeekend work- ...Community Health Plan Remote PRIMARY PURPOSE Oversees medical coordination required... ...for Managed Care Medical Directors. Board... ...service and post-service appeals request for medical necessity and resolves grievances related to medical quality...Remote workContract workWork at officeLocal area
$97.33k - $114.5k
...Spring Health, a global leader in mental health, is seeking a Clinical Manager to lead its remote clinical team delivering EAP mental health services. This full-time role involves overseeing operational health, ensuring quality service delivery, and mentoring team members...Remote workFull time- ...Centene Corp. is seeking a Remote Medical Director, Appeals to lead medical management, utilization review, and quality improvement for our national program. You will provide medical leadership across utilization management, cost containment, and clinical quality initiatives...Remote work
- Behavioral Health in Baltimore, Maryland is looking for a Clinical Director/Supervisor (LCSW-C) to lead their clinical team effectively.... ...and a strong background in trauma-informed care. This is a remote position that offers comprehensive professional development and...Remote work
- ...A leading executive search firm is seeking an experienced Medical Director for a remote position in the United States. The role includes providing medical and scientific leadership for clinical trials, ensuring patient safety, and regulatory compliance. Candidates must...Remote work
- ...Thermo Fisher Scientific is seeking a Medical Director/Clinical Trial Physician (FSP) for a fully remote role in the United States with 10-20% travel. The candidate will provide medical leadership to study teams, develop protocols, and ensure regulatory compliance while...Remote work
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Remote Medical Director: Appeals & Grievances Leader. Be the first to apply!
- medical director oncology Cypress, CA
- health manager Cypress, CA
- public health director Cypress, CA
- clinical manager Cypress, CA
- clinical data manager remote Cypress, CA
- health services manager Cypress, CA
- hospice medical director Cypress, CA
- clinical director Cypress, CA
- occupational health manager Cypress, CA
- director clinical pharmacology Cypress, CA

