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Dme Medical Director Jobs (NOW HIRING)

Cigna

Executive Medical Director DME/HH

The Medical Director DME & HH oversees intraday activities of EviCore's Durable Medical Equipment and Home Health management programs and services. Responsibilities include: * Serve as program ...

Cigna

Executive Medical Director DME/HH

The Medical Director DME & HH oversees intraday activities of EviCore's Durable Medical Equipment and Home Health management programs and services. Responsibilities include: * Serve as program ...

Cigna Health and Life Insurance Company

Medical Director DME/IRF Summary * Serve as program internal lead for DME clinical guideline and policy management * Work with Guideline Manager to create eviCore DME guidelines * Maintain and update ...

ORA Orthopedics

DME Specialist

Bettendorf, IA · On-site

In this role, you will be responsible for measuring and applying durable medical equipment (DME) to patients as directed by providers, ensuring proper fit. This role involves educating patients and ...

ORA Orthopedics

DME Specialist

Bettendorf, IA · On-site

In this role, you will be responsible for measuring and applying durable medical equipment (DME) to patients as directed by providers, ensuring proper fit. This role involves educating patients and ...

ORA Orthopedics

DME Specialist

Bettendorf, IA · On-site

In this role, you will be responsible for measuring and applying durable medical equipment (DME) to patients as directed by providers, ensuring proper fit. This role involves educating patients and ...

Wexford Health

Medical Director

Greenwood, WV

... care, DME utilization, provider prescriptive practice, laboratory, and x-ray services for their site in conjunction with the State-wide Medical Director, Regional Medical Director and Corporate ...

Wexford Health Sources, Inc.

... care, DME utilization, provider prescriptive practice, laboratory, and x-ray services for their site in conjunction with the State-wide Medical Director, Regional Medical Director and Corporate ...

ARC Group

Medical Director

Jacksonville, FL · Remote

MEDICAL DIRECTOR - REMOTE ARC Group has an immediate opportunity for a Medical Director! This ... Collaborate with CMS and other Medicare Contractors (e.g., A/B or DME MACs and others) to develop ...

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Dme Medical Director information

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$13K

$232.4K

$357K

How much do dme medical director jobs pay per year?

As of Sep 14, 2026, the average yearly pay for dme medical director in the United States is $232,369.00, according to ZipRecruiter salary data. Most workers in this role earn between $198,000.00 and $284,500.00 per year, depending on experience, location, and employer.

What is a DME Medical Director?

A DME (Durable Medical Equipment) Medical Director is a physician who oversees and manages the clinical aspects of DME services within a healthcare organization or insurance company. Their responsibilities typically include reviewing and approving medical necessity of DME requests, ensuring compliance with healthcare regulations, setting clinical policies, and providing guidance to staff and providers. They play a crucial role in balancing patient care needs with regulatory and cost considerations, ensuring that patients receive appropriate and effective medical equipment.

What are the key skills and qualifications needed to thrive as a DME Medical Director?

To thrive as a DME Medical Director, you need a medical degree (MD or DO), board certification, and expertise in durable medical equipment (DME) regulations and clinical standards. Familiarity with healthcare compliance software, electronic medical records (EMR), and Medicare/Medicaid billing systems is typically required. Strong leadership, decision-making, and communication skills help manage clinical teams and ensure adherence to regulatory guidelines. These skills and qualifications are crucial for delivering high-quality patient care, maintaining regulatory compliance, and efficiently overseeing DME operations.

What are some common challenges a DME Medical Director may face when coordinating with insurance providers and how can they be managed?

As a DME (Durable Medical Equipment) Medical Director, a common challenge is navigating the complex and ever-changing landscape of insurance policies and reimbursement criteria. Differences in guidelines between providers can lead to delays or denials in patient equipment approvals. Successful Medical Directors proactively stay updated on payer requirements, foster open lines of communication with case managers and insurance liaisons, and implement thorough documentation practices to support medical necessity. Building collaborative relationships and maintaining detailed, up-to-date knowledge of insurance protocols are key strategies for managing these challenges effectively.

What is the difference between Dme Medical Director vs Dme Provider?

AspectDme Medical DirectorDme Provider
CredentialsMedical license, often board-certified physicianLicensed healthcare professional, such as a therapist or technician
Work EnvironmentOversees clinical policies, reviews cases, ensures complianceProvides DME services, interacts directly with patients and suppliers
Employer & Industry UsageHospitals, clinics, DME companiesDME suppliers, retail stores, home health agencies

The Dme Medical Director primarily oversees clinical standards and compliance within DME organizations, ensuring quality care. In contrast, a Dme Provider directly delivers DME products and services to patients. Both roles are essential but differ in responsibilities and scope within the industry.

Is becoming a DME Medical Director hard?

Becoming a DME Medical Director requires medical licensure, experience in durable medical equipment, and often additional certifications. The role involves overseeing clinical aspects of DME services, which can require significant knowledge and leadership skills, but the difficulty varies based on individual background and experience.

What are popular job titles related to Dme Medical Director jobs?

For Dme Medical Director jobs, the most frequently searched job titles are:

Infographic showing various Dme Medical Director job openings in the United States as of September 2026, with employment types broken down into 86% Full Time, and 14% Part Time. Highlights an 86% In-person, and 14% Remote job distribution, with an average salary of $232,369 per year, or $111.7 per hour.

Executive Medical Director DME/HH

Remote

Cigna
Health Care and Social Assistance • 10K+ employees
Learn more about Cignaexternal

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 22 days ago

Cigna Healthcare rating

8.3

Company rating: 8.3 out of 10

Based on 241 frontline employees who took The Breakroom Quiz

Job description

Medical Director DME/HH
Summary:
The Medical Director DME & HH oversees intraday activities of EviCore's Durable Medical Equipment and Home Health management programs and services. Responsibilities include:
  • Serve as program internal lead for DME clinical guideline and policy management
    • Work with Guideline Manager to create EviCore DME guidelines
    • Maintain and update DME denial rationales
    • Represent EviCore in audits or case discussions specifically arranged around Medicare or Medicaid policies regarding DME and HH issues/decisions
  • Work with pathways team and provide clinical support for development of DME clinical pathways
  • Create quarterly DME quiz and hold quarterly debrief with physicians after quiz is completed
  • Assist in case audits to assess the accuracy of Associate Medical Directors' & Medical Directors' decision making and adherence to the EviCore criteria and processes
  • Hold regular 1:1 meetings (alternating with program chief) with DME/HH associate medical directors/medical directors
  • Provide weekend coverage to complete urgent DME & HH appeals that cannot be completed by the on call DME associate medical director/medical director
  • Testify at ALJ Hearings when your cases are being appealed or adjudicating Associate Medical Director is unavailable
  • Provide audit support for DME & HH cases reviewed during CMS and client audits
  • Assist with interviewing, onboarding, and training new DME/HH Associate Medical directors
  • Serve as a Subject Matter Expert and first point of contact for Associate Medical Directors who are seeking assistance with problematic case reviews, or escalated cases that deserve immediate review and attention
  • Respond to urgent, expedited, or escalated DME and HH cases and P2Ps
  • Assist in reviewing case determinations from clients responding to a provider or member complaint
  • Assist in responding to notifications and requests to amend incorrect reviews when the physician reviewer who initially reviewed the case is not available
  • Manage the day-to-day clinical activities of the EviCore DME/HH Program
  • Collaborate with leadership from Clinical Operations, Non-clinical Operations, and Program Operations to support and promote optimal program functioning and identify opportunities for improvement
  • Supervise and manage activities of the DME/HH program's Medical Directors and Associate Medical Directors to ensure effective and objective application of clinical guidelines, accurate determination of medical necessity, and efficient processing of clinical case review requests in accordance with legal and contractual obligations
  • Support the development and maintenance EviCore policies and procedures and criteria related to clinical certification
  • Coordinate the clinical development and education of the DME/IRF program's Medical Directors and Associate Medical Directors through collection/ circulation of educational materials, organization of quarterly educational sessions, and other activities as appropriate
  • Evaluate the performance of the DME/HH program's Medical Directors and Associate Medical Directors.
  • Serve as a coach, mentor, and/or clinical supervisor for specific Medical Directors and/or Associate Medical Directors
  • Support the review of EviCore clinical guidelines
  • Support sales and client management teams as clinical representative for designated program when requested by Program Chief
  • Provide timely expert medical review of medical necessity requests for clinical services and renders a clinical opinion about the medical service under review, including post-decision reviews, when necessary to support timely completion of clinical cases within the designated program
  • Maintain necessary credentials and immediately informs EviCore of any adverse actions relating to medical licenses and/or board certifications
  • Support and communicates EviCore policies and procedures to the provider community.
  • Participate in all required educational and quality improvement activities and maintain passing scores in all assessments
  • Other duties as assigned

Minimum Education, Licensure and Professional Certification requirement:
  • M.D. or D.O. degree from accredited institution.
  • Minimum of five (5) years of clinical practice experience after completion of all graduate medical education training, including residency and fellowship (when applicable)
  • Active board certification in Physical Medicine & Rehabilitation preferred.
  • Active unrestricted license to practice medicine in a state or territory of the United States as a utilization review doctor of medicine or doctor of osteopathic medicine.
  • Knowledge of applicable state and federal laws, URAC and NCQA standards, and utilization management

Minimum Experience required (number of years necessary to perform role):
  • Two (2) or more years of managed care experience
  • Supervisory and/or management experience strongly preferred
  • Familiarity with automated processes and computer applications and systems also required

Competencies:
  • Ensures Accountability
  • Drives Results
  • Manages Complexity
  • Drives Engagement
  • Develops Talent

If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload.
For this position, we anticipate offering an annual salary of 238,100 - 396,800 USD / yearly, depending on relevant factors, including experience and geographic location.
This role is also anticipated to be eligible to participate in an annual bonus and long term incentive plan.
At The Cigna Group, you'll enjoy a comprehensive range of benefits, with a focus on supporting your whole health. Starting on day one of your employment, you'll be offered several health-related benefits including medical, vision, dental, and well-being and behavioral health programs. We also offer 401(k), company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year, paid holidays, and leaves of absence. For more details on our employee benefits programs, click here.
About Evernorth Health Services
Evernorth Health Services, a division of The Cigna Group, creates pharmacy, care and benefit solutions to improve health and increase vitality. We relentlessly innovate to make the prediction, prevention and treatment of illness and disease more accessible to millions of people. Join us in driving growth and improving lives.
Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws.
If you need a reasonable accommodation to complete the online application process, please email seeyourself@thecignagroup.com for assistance. Please note that this email inbox is dedicated to accommodation requests only and cannot provide application updates or accept resumes.
Cigna has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State.
Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances.

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About Cigna

Sourced by ZipRecruiter

Cigna Corporation exists to improve lives. We are a global health service company dedicated to improving the health, well-being and peace of mind of those we serve. Together, with colleagues around the world, we aspire to transform health services, making them more affordable and accessible to millions. Through our unmatched expertise, bold action, fresh ideas and an unwavering commitment to patient-centered care, we are a force of health services innovation. When you work with us, or one of our subsidiaries, you'll enjoy meaningful career experiences that enrich people's lives.

Industry

Health care and social assistance

Company size

10,000+ Employees

Headquarters location

Bloomfield, CT, US

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