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Medical Management Jobs (NOW HIRING)

Elevance Health

Med Mgmt Clinician Sr

Las Vegas, NV · On-site

$70 - $100/hr

Does not issue medical necessity non-certifications. * Collaborates with leadership in enhancing training and orientation materials. * May complete quality audits and assist management with ...

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Elevance Health

Med Mgmt Nurse CA (US)

Costa Mesa, CA

$41.38 - $69.02/hr

The Medical Management Nurse for California HMO is responsible for review of the most complex or challenging cases that require nursing judgment, critical thinking, and holistic assessment of member ...

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How much do medical management jobs pay per hour?

As of Sep 4, 2026, the average hourly pay for medical management in the United States is $44.26, according to ZipRecruiter salary data. Most workers in this role earn between $28.85 and $57.69 per hour, depending on experience, location, and employer.

What is medical management?

Medical management refers to the process of overseeing and coordinating healthcare services to ensure patients receive appropriate, cost-effective, and high-quality care. It often involves tasks such as evaluating medical necessity, coordinating care plans, managing healthcare resources, and working with providers and insurance companies. Professionals in medical management may focus on case management, utilization review, quality assurance, and compliance with healthcare regulations. The goal is to optimize patient outcomes while controlling healthcare costs.

What are the key skills and qualifications needed to thrive in medical management?

To thrive in Medical Management, you need a strong background in healthcare administration, clinical operations, and a relevant degree such as healthcare management or nursing. Familiarity with healthcare information systems, regulatory compliance tools, and certifications like Certified Medical Manager (CMM) are often required. Leadership, problem-solving, and effective communication are standout soft skills for this role. These skills and qualifications are crucial for ensuring efficient operations, regulatory adherence, and high-quality patient care in healthcare organizations.

How does a medical management professional typically collaborate with healthcare providers and insurance teams?

Medical Management professionals work closely with both healthcare providers and insurance teams to ensure patients receive appropriate, cost-effective care. They review patient cases, coordinate utilization management, and often act as liaisons to facilitate communication between clinical staff and payers. This collaboration involves regular meetings, detailed documentation, and working with multidisciplinary teams to optimize care plans and adhere to regulatory guidelines. Effective teamwork and strong communication skills are essential for success in this role.

What is the difference between Medical Management vs Medical Coding?

AspectMedical ManagementMedical Coding
Required CredentialsHealthcare administration, certifications like CCM or CPHQCertified Professional Coder (CPC), CPC-H, or CCS
Work EnvironmentHospitals, clinics, healthcare organizations, office settingsMedical offices, billing companies, remote work
Employer & Industry UsageHealthcare management companies, hospitals, insurance firmsMedical billing companies, healthcare providers, insurance companies

Medical Management focuses on overseeing healthcare operations, policy implementation, and patient care coordination. Medical Coding involves translating medical diagnoses and procedures into standardized codes for billing and record-keeping. While both roles are essential in healthcare, Medical Management emphasizes administrative leadership, whereas Medical Coding centers on accurate documentation for billing purposes.

What can I do with a medical management degree?

A medical management degree prepares individuals for roles such as healthcare administrator, medical office manager, or health services manager. These positions involve overseeing healthcare operations, managing staff, and ensuring compliance with regulations, often requiring strong organizational and leadership skills.

What degree do you need to be a medical management?

Medical management roles typically require a bachelor's degree in healthcare administration, health services management, or a related field. Advanced positions may require a master's degree such as a Master of Healthcare Administration (MHA) or Master of Business Administration (MBA) with a focus on healthcare. Relevant certifications and experience in healthcare settings can also enhance job prospects.
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What cities are hiring for Medical Management jobs?

Cities with the most Medical Management job openings:

What are the most commonly searched types of Medical Management jobs?

The most popular types of Medical Management jobs are:

What states have the most Medical Management jobs?

States with the most job openings for Medical Management jobs include:

Medical Management jobs near you
Infographic showing various Medical Management job openings in the United States as of August 2026, with employment types broken down into 1% As Needed, 79% Full Time, 14% Part Time, and 6% Contract. Highlights an 87% Physical, 1% Hybrid, and 12% Remote job distribution, with an average salary of $92,054 per year, or $44.3 per hour.

Sr. Med Dir, Med Mgmt

University of Massachusetts Medical School

Boston, MA • On-site

$220K - $260K/yr

Full-time

Re-posted 10 days ago

Job description

Overview
The Senior Medical Director for Medical Management will lead medical management strategy and operations for the MassHealth Office of Clinical Affairs to ensure the delivery of medically necessary, cost-effective, and high quality care for MassHealth members. Working closely with clinical and operational leaders within the Office of Clinical Affairs, this leader will oversee program initiatives related to utilization management (including prior authorizations), medical coverage policy, and care management.
Responsibilities
Medical Management Strategy and Policy
• Leads development and implementation of Office of Clinical Affairs strategy for medical management to ensure appropriate, efficient, and high quality care delivery
• Collects, analyzes and reports on medical management metrics to identify trends and recommend interventions
• Accountable to improving efficiency, cost-effectiveness, and quality in OCA's medical management programs, including through use of new technology as appropriate
• Contributes to MassHealth's cross-agency medical management strategy
Medical Management Programs
• Oversees Office of Clinical Affairs Medical Management Programs and functions
• Oversees and contributes to OCA utilization management initiatives, including related to prior authorization, concurrent review, and retrospective review
• Oversees and contributes to development and implementation of clinical coverage policies, including assessment of new and existing technologies.
• Oversees and contributes to clinical reviews of providers
• Reviews, analyzes, and responds to quality and safety data
• Ensures high-performing medical management programs that adhere to all relevant regulatory and other requirements, including those set forth by CMS and other oversight entities
Stakeholder Engagement
• Advises and collaborates with the Chief Medical Officer (CMO) and Medical Directors on
strategic issues involving medical management programs
• Serves as a lead interface for OCA medical management programs with other teams throughout the agency
• Leads and/or supports external stakeholder engagements regarding coverage and medical management of services for MassHealth members
Leadership
• Manages clinical and non-clinical staff who are directly responsible for executing on OCA's medical management initiatives
• Ensures Medical Management staff maintain up-to-date knowledge, skills and abilities
related to the administration of assigned responsibilities and functions
• Oversees relevant contractors performing utilization management reviews on behalf of OCA/MassHealth
Other
• May engage in other clinical policies and program work within the MassHealth portfolio
• Other duties as assigned
Qualifications
LICENSURE/CERTIFICATION
• Current, unrestricted physician license in Massachusetts throughout employment with OCA
REQUIRED EDUCATION
• M.D. or D.O. degree required
• Board Certified in specialty recognized by the American Board of Medical Specialties or the American Osteopathic Association Specialty Certifying Boards; Internal Medicine or Family Medicine preferred
REQUIRED QUALIFICATIONS
• At least 5 years experience in direct patient care post-residency
• At least 5 years experience in utilization management in a managed care organization/health plan
• In active clinical practice throughout employment with the Office of Clinical Affairs; internal medicine or family medicine preferred
• Thorough knowledge of the principles and practices of medical management including utilization management
• Excellent oral and written communication and presentation skills
• Must work two days per week on site in Boston and/or Quincy during normal business hours
Additional Information
Preferred Qualifications:
PREFERRED EDUCATION
  • Master of Health Administration (MHA), Master of Public Health (MPH), or Master of Business Administration (MBA) in Healthcare Management preferred

PREFERRED QUALIFICATIONS
  • Demonstrated commitment to serving Medicaid patients
  • Thorough knowledge of Medicaid and related regulations

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