Remote Medicaid Medical Director — Utilization

A leading health services company is seeking a Medical Director to oversee utilization management in the Medicaid market. This remote position requires strong analytical skills and extensive clinical experience, along with an MD or DO degree and active board certification. Responsibilities include medical determination of services, collaboration with...

Become a part of our caring community and help us put health first The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. The Medical Director actively uses...

Become a part of our caring community and help us put health first The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. The Medical Director actively uses...

At CVS Health, we’re building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. As the nation’s leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues –...

At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues - caring for...

At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues - caring for...

A leading health solutions company is seeking a Medical Director to support the Aetna Better Health of Kentucky. This primarily remote position involves ensuring timely responses regarding utilization management, prescreening, and appeals. Candidates must possess a Kentucky medical license and have at least five years of healthcare delivery experience. The...

A healthcare company is seeking a Medical Director to provide medical interpretations and determinations for health services. The role involves managing complex clinical scenarios and collaborating with internal teams while maintaining compliance. Candidates should possess an MD or DO degree, and at least 5 years of clinical experience. This remote position...

Medicaid Eligibility Delivery DirectorSchedule: M-F Traveling Required: 40%As a Medicaid Eligibility Delivery Director, you will make an impact by overseeing access, performance, and revenue security for all eligibility functions, leading a team of Directors, Managers, and Patient Advocates, who help uninsured patients find coverage by coordinating with...

Medicaid Eligibility Delivery DirectorSchedule: M-F Traveling Required: 40% As a Medicaid Eligibility Delivery Director, you will make an impact by overseeing access, performance, and revenue security for all eligibility functions, leading a team of Directors, Managers, and Patient Advocates, they help uninsured patients find coverage by coordinating with...