Medical Director
7 days ago
Be among the first 25 applicantsOverviewThe Utilization Management (UM) Medical Director provides clinical leadership for the UM program, ensuring members receive appropriate, high-quality care. You will oversee review guidelines, collaborate with internal teams and external partners, and drive compliance with regulatory and accreditation standards.Key ResponsibilitiesLead the development, implementation, and periodic review of UM policies and clinical criteriaProvide physician oversight for concurrent and retrospective review activitiesApprove and interpret clinical guidelines, pathways, and criteria for admission, continued stay, and dischargeServe as the primary clinical liaison with payers, providers, and regulatory bodiesMentor and educate UM nurses, physician reviewers, and other staff on best practicesAnalyze utilization data and quality metrics to identify trends and areas for improvementParticipate in appeals and peer-to-peer discussions to resolve clinical disputesMaintain compliance with NCQA, URAC, CMS, state regulations, and organizational standardsQualificationsMedical degree (MD or DO) from an accredited institutionActive, unrestricted medical license in the applicable state/regionBoard certification in an acute-care specialty (e.g., Internal Medicine, Family Medicine, Pediatrics)Minimum of 5 years clinical practice experience, with 2+ years in utilization management or managed careCompensation: $263,488 - $329,360 and bonus eligibleSeniority levelDirectorEmployment typeFull-timeJob functionHealth Care ProviderIndustries: Hospitals and Health Care #J-18808-Ljbffr
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Medical Director
7 days ago
California, United States Caminar, Inc. Full time1 day ago Be among the first 25 applicantsThis range is provided by Caminar, Inc.. Your actual pay will be based on your skills and experience — talk with your recruiter to learn more.Base pay range$410,000.00/yr - $410,000.00/yrAbout Us: Caminar is a leading behavioral health organization that supports youth and adults across multiple counties in Northern...
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Medical Director
3 weeks ago
California, United States Oklahoma Complete Health Full timeMedical Director page is loaded## Medical Directorlocations: Remote-ORtime type: Full timeposted on: Posted Todayjob requisition id: 1617853You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering...
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Medical Director
7 days ago
California, United States The Jacobson Group Full time2 days ago Be among the first 25 applicants This range is provided by The Jacobson Group. Your actual pay will be based on your skills and experience — talk with your recruiter to learn more. Base pay range $150.00/hr - $180.00/hr Direct message the job poster from The Jacobson Group Recruiter @ The Jacobson Group | Insurance Talent Acquisition Must be...
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Medical Director
7 days ago
California, United States Morgan Consulting Resources, Inc. - Healthcare Executive Search Full timeJoin to apply for the Medical Director role at Morgan Consulting Resources, Inc. - Healthcare Executive Search Be among the first 25 applicants Morgan Consulting Resources, Inc. - Healthcare Executive Search provided pay range This range is provided by Morgan Consulting Resources, Inc. - Healthcare Executive Search. Your actual pay will be based on your...
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Medical Director
3 weeks ago
California, United States Ami Network Full timeCompensation: $300,000 to $350,000 per yearRequired Qualifications:City/State: Orange County, CALead with Heart. Build a Legacy. Create Lasting Change.Imagine leading a clinic where every patient feels seen, celebrated, and where your leadership shapes the future of LGBTQ+ health in Orange County.At Radiant Health Centers, we're more than just a health...
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Medical Director
3 weeks ago
California, United States Corebridge Financial Full timeJoin to apply for the Medical Director role at Corebridge Financial5 days ago Be among the first 25 applicantsJoin to apply for the Medical Director role at Corebridge FinancialWho We AreAt Corebridge Financial, we believe action is everything. That’s why every day we partner with financial professionals and institutions to make it possible for more people...
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Remote Medical Director
3 weeks ago
California, United States Centene Corporation Full time2 days ago Be among the first 25 applicants You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility. We’re Hiring Remote Medical...
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Medical Director
2 weeks ago
California, United States AMN Healthcare Full timeMedical Director UC Merced Seeks a Medical Director | Dynamic Leadership Opportunity | Work Alongside a Mission-Driven Student Health Team | Work in Merced, CA UC Merced seeks a Medical Director to guide a close-knit, multidisciplinary team, and oversee AAAHC reaccreditation in 2028. While also advancing quality improvement and risk assessment, the role...
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Remote Medical Director
7 days ago
California, United States Centene Corp. Full timeYou could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility.**Position Purpose:** Assist the Chief Medical Director to direct and coordinate...
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Remote- Medical Director Arizona
3 weeks ago
California, United States Centene Corporation Full timeOverview Join to apply for the Remote- Medical Director Arizona role at Centene Corporation. You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace...
