Managed Care Director Remote Jobs

The RN Care Manager at Strive Health plays a crucial role in supporting patient care for individuals with Chronic Kidney Disease and End-Stage Renal Disease. This position involves coordinating servic...

The Senior Director of Provider Relations is responsible for creating and implementing Network Transformation initiatives while leading a team to achieve provider performance and satisfaction metrics...

The Director of Health Policy will oversee the research of policy issues and communicate the company's positions to management and external stakeholders. This role involves developing state legislativ...

The Director of Payment Integrity Program Development at Devoted Health is responsible for identifying and researching new medical cost savings opportunities while ensuring accurate and timely payment...

The Executive Director, Operational Compliance will lead the development and implementation of compliance frameworks across all operational areas of the company. This role is responsible for ensuring...

The Medical Director for Specialty Pharmacy at Optum will provide utilization management services and clinical guidance for a comprehensive specialty pharmacy solution. This role involves collaboratin...

The Medical Director for Florida Medicaid will oversee Utilization Management, ensuring timely responses to members and providers regarding precertification and appeals. This role primarily supports t...

The HEDIS Project Manager IV is responsible for planning, organizing, and overseeing complex projects to meet strategic objectives while supporting HEDIS audit deliverables and compliance requirements...

The Medical Director - National Accounts at CVS Health is responsible for overseeing medical policy implementation and expanding medical management programs to meet member needs. This remote role invo...

The Medical Director of Radiation Oncology at eviCore is responsible for guiding strategic Utilization Review decisions and providing medical advice that impacts patient treatment. This role involves...

The Medical Director is responsible for overseeing the accuracy of clinical documentation and coding for inpatient charts, ensuring compliance with federal laws and healthcare privacy practices. This...

The Medical Director is responsible for reviewing inpatient charts to ensure accurate clinical documentation and coding compliance. This role involves collaborating with a DRG Integrity Specialist to...

The Medical Director is responsible for reviewing inpatient charts to ensure accurate clinical documentation and coding compliance. This role involves collaborating with a DRG Integrity Specialist to...

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

The Medical Director is responsible for overseeing audit and appeals decisions, analyzing medical policies, and guiding processes related to inpatient audits and documentation. This role also involves...

The Behavioral Health Medical Director is responsible for providing medical leadership in behavioral health, overseeing utilization management and case management programs for mental health and substa...

The Manager of Provider Contracts is responsible for overseeing the network strategy and development for Molina Health Plan, focusing on complex contracts and alternative payment methods. This role in...

The Senior Director of Audit, Monitoring and Oversight will lead internal audit activities and provide independent assurance and consulting services to enhance the control environment at WellCare. Thi...

The Regional Director at Clearway Health is responsible for overseeing the operations and financial performance of specialty pharmacy teams across assigned client sites. This role involves supporting...

The Manager, Government Clinical Services at Navitus provides strategic vision and operational oversight for the Clinical Program Management department. This role involves managing clinical staff, exe...

The Implementation Manager is responsible for managing the transition of new business into MedImpact, ensuring customer satisfaction during the implementation process. This role involves collaborating...

The Director Demand Partnership at HealthPlanOne is responsible for managing and growing monetization partners in the health and Medicare insurance sectors. This role involves prospecting new business...

The Associate Medical Director will assist in creating grants for funding and content for funded activities, collaborating with internal team members and external faculty. This role involves writing n...

The Senior Medical Director, Oncology Solutions, leads EviCore's Oncology management programs, providing mentorship and clinical supervision to Medical Directors. This role involves responding to esca...

The Senior Medical Director, Oncology Solutions, leads EviCore's Oncology management programs, providing mentorship and clinical supervision to Medical Directors. This role involves responding to esca...