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Added 2 mins ago
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Supply Chain Operations- Principal Supply Demand Planner 4
Oracle
Jefferson City, MO
- $102,300 to $209,500 USD / year
This is a highly visible role for a self-directed planner who can operate independently, lead cross-functional execution, and communicate forward-looking supply capability to senior…
Added 5 mins ago
FC
Catalytic Projects Associate (Management Analyst II)
Fairfax County
Fairfax, VA
- $33.73 to $59.02 USD / hour
This position works within our Catalytic Real Estate Division to support for innovative public-private partnership real estate projects. Also contributes to a portfolio of work that…
Added 5 mins ago
FC
Catalytic Redevelopment Manager (Management Analyst III)
Fairfax County
Fairfax, VA
- $38.84 to $67.96 USD / hour
…development efforts. Also leads the department's efforts to support place-based economic development. Focus will include strengthening business districts and commercial corridors within…
Added 5 mins ago
FC
Community Support Specialist (Management Analyst II)
Fairfax County
Fairfax, VA
- $33.73 to $59.02 USD / hour
Part of the Park Operation's Support Services Branch, under the general supervision of the Business Analyst III, this position is responsible for managing the division's community…
Added 5 mins ago
FC
HR Enterprise Strategic Initiative Program Manager
Fairfax County
Fairfax, VA
- $52.62 to $92.09 USD / hour
…leader to serve as the HR Enterprise Strategic Initiatives Program Manager. This role reports to Fairfax County’s Human Resources (HR) Director and leads high visibility, countywide human…
Added 5 mins ago
FC
Junior Associate, Economic Innovation & Strategy (Management Analyst I)
Fairfax County
Fairfax, VA
- $29.28 to $51.23 USD / hour
The Fairfax County Department of Economic Initiatives seeks a highly organized professional to support economic development and innovation projects. This entry-level role will be integral…
Added 5 mins ago
FC
Labor Relations Division Director (Human Resources Division Director)
Fairfax County
Fairfax, VA
- $57.04 to $108.38 USD / hour
This position manages and directs the labor relations division in the Department of Human Resources. Program activities include negotiation of collective bargaining agreements; contract…
Added 6 mins ago
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Part-Time Sales Lead - Famous Footwear
Famous Footwear
RIVERTON, UT
- Part-time
As a Famous Footwear Sales Lead, you are passionate about providing the best shoe store experience for every customer. You do this by creating a welcoming environment and in-store culture…
Added 10 mins ago
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Group Account Director
Publicis Groupe Holdings B.V
Arlington, VA
- $121,315 to $185,920 USD / year
Lead internal and client QBR activities, looks for opportunities to cross sell and drive organic growth with clients. Owns and coordinates sections of annual growth/innovation workshop with…
Added 10 mins ago
PG
Senior Vice President, Transformation Lead (Freelance)
Publicis Groupe Holdings B.V
New York, NY
- $86.64 to $144.06 USD / hour
…sub-divisions within their respective brands to provide dedicated support for the client. By acting as a unified interface, Constellation eliminates operational silos and presents a single…
Added 10 mins ago
Senior Project Coordinator - Digital Content
Denver, CO
…501(c)(3) nonprofit organization, through grants and membership support, we work with federal partners such as the EPA, CDC, and FDA on critical and diverse issues such as climate change,…
Added 10 mins ago
Senior Director, Learning & Development
Indeed
Saint Louis, MO
…field leadership to shape how we enable our teams to sell and support clients at scale, across every…
Added 21 mins ago
Senior Finance Manager, Americas Sales Finance
Palo Alto Networks, Inc.
CA
- Support the analysis, approval and execution of key operational activities such as headcount requisitions, program spend, purchase requisitions, and time and expenses
Added 24 mins ago
National Oncology Sales Training Manager - United States Field
Amgen
Sioux Falls, SD
In this high-impact role, you will lead a team of six Oncology Sales Training Managers and shape the New Hire and Advanced Training curricula for Amgen’s U.S. Oncology Business Unit. You’ll…
Added 24 mins ago
SkillBridge - Network / Principal Network Communications Engineer
Northrop Grumman
Ellsworth AFB, SD
Support and lead air crew engagement for proper techniques in solving complex analysis of technical problems that arise during operations.
Added 24 mins ago
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Program Manager
Eliassen Group
Pierre, SD
- $75 to $80 USD / hour
Lead and mentor Technical Program Managers and Scrum Masters while ensuring adherence to best practices and proper facilitation of ceremonies.
Added 24 mins ago
EG
Cloud Engineer
Eliassen Group
Pierre, SD
- $70 to $88 USD / hour
Lead technical strategy for cloud initiatives and mentor developers building scalable platforms that support regulatory needs.
Added 24 mins ago
Senior Manager, Internal and External Reporting
Eliassen Group
Pierre, SD
The Senior Manager will have significant exposure to senior finance leadership and external auditors and will lead a team of accounting and reporting professionals. The ideal candidate…
Added 25 mins ago
SC
Licensed Salon Manager
Sport Clips
Johnston, IA
- $31 to $38 USD / hour
Sport Clips Haircuts of Johnston is hiring a Salon Manager to lead a high-performing men’s and boys’ hair salon. This role is ideal for a licensed cosmetologist or barber who enjoys hair…
Added 25 mins ago
SC
Licensed Salon Manager
Sport Clips
Ames, IA
- $31 to $38 USD / hour
Sport Clips Haircuts of Ames is hiring a Salon Manager to lead a high-performing men’s and boys’ hair salon. This role is ideal for a licensed cosmetologist or barber who enjoys hair…
Added 25 mins ago
SC
Licensed Salon Manager
Sport Clips
Olathe, KS
- $31 to $38 USD / hour
Sport Clips Haircuts of Olathe is hiring a Salon Manager to lead a high-performing men’s and boys’ hair salon. This role is ideal for a licensed cosmetologist or barber who enjoys hair…
Added 25 mins ago
SC
Licensed Salon Manager
Sport Clips
Shawnee, KS
- $31 to $38 USD / hour
Sport Clips Haircuts of Shawnee Station West is hiring a Salon Manager to lead a high-performing men’s and boys’ hair salon. This role is ideal for a licensed cosmetologist or barber who…
Added 25 mins ago
SC
Licensed Salon Manager
Sport Clips
Topeka, KS
- $31 to $38 USD / hour
Sport Clips Haircuts of Wanamaker Crossing in Topeka is hiring a Salon Manager to lead a high-performing men’s and boys’ hair salon. This role is ideal for a licensed cosmetologist or…
Added 25 mins ago
SC
Licensed Salon Manager
Sport Clips
Bloomington, MN
- $34 to $41 USD / hour
Sport Clips Haircuts of Bloomington - Southtown is hiring a Salon Manager to lead a high-performing men’s and boys’ hair salon. This role is ideal for a licensed cosmetologist or barber who…
Added 25 mins ago
SC
Licensed Salon Manager
Sport Clips
Burnsville, MN
- $34 to $41 USD / hour
Sport Clips Haircuts of Burnsville is hiring a Salon Manager to lead a high-performing men’s and boys’ hair salon. This role is ideal for a licensed cosmetologist or barber who enjoys hair…

Jobgether

Lead Medical Director, Utilization Management

Remote, United States

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Job details

Posting language: English
Posted: Nov 6, 2026

Original job description

This position is listed on behalf of a partner company, who manages all applications and next steps. Our partner is looking for a Lead Medical Director, Utilization Management based in the United States.

This is a senior physician leadership opportunity focused on ensuring members receive appropriate, timely, and evidence-based healthcare. You will oversee utilization management activities, providing clinical direction for medical necessity reviews across outpatient referrals, inpatient admissions, and other care requests. Alongside managing a team of Utilization Management Medical Directors, you will help shape clinical policies, strengthen review consistency, and guide complex or escalated cases. You will play a key role in multidisciplinary committees, collaborating with clinical, quality, compliance, pharmacy, and operational teams. By using clinical evidence, case trends, and performance data, you will identify opportunities to improve care quality, access, and outcomes. This remote-first role combines hands-on clinical judgment, strategic leadership, and a strong commitment to member-centered care.

Accountabilities:

• Complete assigned prior authorization, concurrent, retrospective, and other utilization management reviews, applying sound clinical judgment and meeting established turnaround expectations.

• Ensure medical necessity decisions are consistent with applicable evidence-based criteria, coverage policies, and clinical standards.

• Lead and manage a team of Utilization Management Medical Directors, supporting performance, clinical consistency, and effective decision-making.

• Review complex and escalated cases, seeking specialty consultation when appropriate.

• Develop, review, and maintain clinical policies, pharmacy policies, medical necessity criteria, and utilization management procedures in collaboration with clinical experts and operational teams.

• Monitor emerging clinical evidence and recommend policy updates to maintain current, appropriate, and consistent review standards.

• Chair the Utilization Management Committee by preparing agendas, presenting policy recommendations and utilization trends, documenting decisions, and ensuring follow-through on committee actions.

• Serve on the Credentialing Committee, providing physician expertise on provider qualifications, credentialing matters, and clinical concerns.

• Contribute to the Quality Committee by identifying trends in care quality, access, and outcomes and recommending improvement opportunities.

• Participate in physician peer-to-peer discussions, appeals, and provider education, communicating clinical decisions clearly and respectfully.

• Analyze audit findings, case reviews, appeals, complaints, and utilization management performance data to identify variation and improve policies, clinical practices, and workflows.

• Partner with care management, quality, compliance, network, pharmacy, and operations teams to address issues that span clinical programs.

• Support regulatory and accreditation readiness through appropriate clinical documentation, committee records, and corrective actions within the role's scope.

• Advise organizational leaders on utilization management strategy, clinical risks, and opportunities to improve member and provider experiences.

Requirements:

• MD or DO degree.

• Active, unrestricted medical license.

• Board certification in a relevant clinical specialty.

• At least 5 years of clinical practice experience in utilization management or medical necessity review.

• At least 5 years of direct leadership experience managing a clinical team.

• Strong understanding of evidence-based clinical guidelines, medical necessity criteria, and healthcare coverage policies.

• Knowledge of applicable regulatory and accreditation requirements relevant to utilization management.

• Demonstrated clinical judgment and the ability to assess complex cases, interpret medical evidence, and make consistent, defensible decisions.

• Strong leadership and team management capabilities, including the ability to guide physician reviewers and support high-quality clinical performance.

• Excellent communication and conflict-resolution skills, particularly in peer-to-peer discussions, appeals, and interactions with providers.

• Ability to contribute effectively to multidisciplinary committees, communicate policy recommendations, and drive follow-through on decisions.

• Experience using case reviews, audits, and performance data to identify trends and support continuous improvement.

Benefits:

• Base salary range: $320,000–$340,000 USD, with final compensation determined by factors such as experience, education, certifications, market data, and internal equity.

• Equity opportunities and a performance-based bonus program.

• 401(k) matching.

• Regular compensation reviews.

• Comprehensive medical, dental, and vision coverage.

• Flexible time-off policy.

• Remote-first work culture.

• No-Meeting Fridays and monthly company holidays.

• Mental health resources and initiatives supporting employee well-being.

• Paid parental leave for all new parents.

• Employee Stock Purchase Plan (ESPP) with discounted equity opportunities.

• Office setup expense reimbursement.

• Monthly cell phone and internet stipend.

• Learning programs, mentorship, professional development funding, and regular performance feedback.

• Collaborative, mission-driven environment focused on improving healthcare quality and member outcomes.

How Jobgether works:

We use an AI-powered matching process to ensure your application is reviewed quickly, objectively, and fairly against the role's core requirements. Our system identifies the top-fitting candidates, and this shortlist is then shared directly with the hiring company. The final decision and next steps (interviews, assessments) are managed by their internal team.

We appreciate your interest and wish you the best!

Why Apply Through Jobgether?

Data Privacy Notice: By submitting your application, you acknowledge that Jobgether will process your personal data to evaluate your candidacy and share relevant information with the hiring employer. This processing is based on legitimate interest and pre-contractual measures under applicable data protection laws (including GDPR). You may exercise your rights (access, rectification, erasure, objection) at any time.

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