Managed Care Director Remote Jobs

The Medical Director - Medicaid position at CVS Health involves overseeing Utilization Management for the Aetna Better Health Plan of Louisiana, ensuring timely responses to members and providers rega...

The Project Manager III is responsible for managing medium to high complexity projects, ensuring successful delivery and adherence to project milestones. This role involves collaboration with stakehol...

The Director of Medication Adherence Operations at Devoted Health will lead the strategic and operational aspects of the Pharmacy Guide team, focusing on designing and scaling innovative solutions for...

The Medical Director at Highmark Inc. is responsible for ensuring utilization management is performed according to the highest clinical standards. The role involves reviewing escalated cases, advising...

The Senior Director of Compliance Advisory for Medicare is responsible for ensuring regulatory compliance with federal and state legal requirements related to Medicare. This role involves overseeing c...

The Director of Member Services is responsible for providing exceptional service to members regarding billing inquiries, service requests, and complaints. This role involves overseeing the Member and...

The Senior Care Manager (RN) is responsible for assessing, planning, and implementing complex care management activities to ensure quality and cost-effective healthcare outcomes for members. This role...

The Medical Director for the Aetna Duals Center of Excellence will oversee utilization management, including concurrent and prior authorization reviews, appeals, and pharmacy coverage. This remote pos...

The CDI Manager oversees the daily activities of the Clinical Documentation Integrity program, ensuring accurate and efficient performance of clinical documentation duties. This role involves collabor...

The Medical Director for Post-Acute Care Management at Optum Care Transitions will oversee utilization and communication with network physicians and hospitals, ensuring effective care transitions for...

The Workforce Management Director at HealthPlanOne is responsible for developing and leading a workforce planning team in a dynamic environment. This role involves partnering with executive leadership...

The Manager of Compliance is responsible for overseeing the organization's compliance program, ensuring adherence to federal and state laws, and managing audits and corrective action plans. This role...

The Director of Care Management at Aetna Better Health of Texas is responsible for overseeing the implementation and execution of clinical operations and care coordination services. This role involves...

Vheda Health is seeking a Senior Medical Director to provide strategic leadership and clinical oversight for its chronic care and maternal health programs. The role involves clinical leadership, stake...

The Director I, Product Line Management is responsible for implementing companywide initiatives for revenue cycle processes within a specific product line. This role involves leading a team, collabora...

The Credentialing and Enrollment Manager is responsible for overseeing the processing of applications and reapplications for medical staff and allied health professionals, ensuring compliance with acc...

The Credentialing and Enrollment Manager is responsible for overseeing the processing of applications and reapplications for medical staff and allied health professionals, ensuring compliance with acc...

The Credentialing and Enrollment Manager is responsible for overseeing the application and reapplication processes for medical staff and allied health professionals, ensuring compliance with accredita...

The Credentialing and Enrollment Manager is responsible for overseeing the application and reapplication processes for medical staff and allied health professionals, ensuring compliance with accredita...

The Credentialing and Enrollment Manager is responsible for overseeing the processing of applications and reapplications for medical staff and allied health professionals, ensuring compliance with acc...

The Credentialing and Enrollment Manager is responsible for overseeing the processing of applications and reapplications for medical staff and allied health professionals, ensuring compliance with acc...

The Medical Director will lead a team of UM RN Analysts in developing Availity's Auth AI platform, focusing on the interpretation of payer medical policy guidelines and clinical validation. This role...

The Medical Director will lead a team of UM RN Analysts to oversee the development of Availity's Auth AI platform, focusing on the interpretation of payer medical policy guidelines and clinical valida...

The Care Manager is responsible for planning and managing behavioral and physical care for members, collaborating with healthcare teams to enhance member experiences and health outcomes. This role inv...

The Credentialing and Enrollment Manager is responsible for overseeing the processing of applications and reapplications for medical staff and allied health professionals, ensuring compliance with acc...