Henderson, NV (100% Fully Remote Opportunity) Reporting To: Chief Medical Officer Start Date ... policy development, and UM committee activities. * Documentation & Compliance: Maintain precise ...
Henderson, NV (100% Fully Remote Opportunity) Reporting To: Chief Medical Officer Start Date ... policy development, and UM committee activities. * Documentation & Compliance: Maintain precise ...
Business Document AI Trainer - Remote
Las Vegas, NV · Remote
$35 - $50/hr
Document findings and provide actionable feedback to inform the ongoing development of AI systems ... Direct experience supporting or driving projects in strategy, operations, sales, marketing, finance ...
Business Document AI Trainer - Remote
Las Vegas, NV · Remote
$35 - $50/hr
Document findings and provide actionable feedback to inform the ongoing development of AI systems ... Direct experience supporting or driving projects in strategy, operations, sales, marketing, finance ...
Assistant Department Director, Cultural Resources
Reno, NV · On-site +1
$130K - $145K/yr
Responsibilities include project delivery oversight, business development, client relations, staff ... Flexible work schedules and remote/hybrid options for most roles. * Multidisciplinary environment:
New
Assistant Department Director, Cultural Resources
Reno, NV · On-site +1
$130K - $145K/yr
Responsibilities include project delivery oversight, business development, client relations, staff ... Flexible work schedules and remote/hybrid options for most roles. * Multidisciplinary environment:
New
AI Data Trainer - MS Suite - Remote
Las Vegas, NV · Remote
$35 - $50/hr
Document findings and provide actionable feedback to inform the ongoing development of AI systems ... Direct experience supporting or driving projects in strategy, operations, sales, marketing, finance ...
AI Data Trainer - MS Suite - Remote
Las Vegas, NV · Remote
$35 - $50/hr
Document findings and provide actionable feedback to inform the ongoing development of AI systems ... Direct experience supporting or driving projects in strategy, operations, sales, marketing, finance ...
Senior Data Team Lead (Remote)
Las Vegas, NV · Remote
$86K - $217K/yr
No less than 7 years of direct clinical data management experience * 5+ years in a Lead Clinical ... We create intelligent connections to accelerate the development and commercialization of innovative ...
Senior Data Team Lead (Remote)
Las Vegas, NV · Remote
$86K - $217K/yr
No less than 7 years of direct clinical data management experience * 5+ years in a Lead Clinical ... We create intelligent connections to accelerate the development and commercialization of innovative ...
... Director) * Strong ability to engage prospects and their assistants in dialogue, quickly build ... During a period of time when gaining new customers has become almost impossible, Kopp has developed ...
Quick apply
... Director) * Strong ability to engage prospects and their assistants in dialogue, quickly build ... During a period of time when gaining new customers has become almost impossible, Kopp has developed ...
Senior Data Team Lead (Remote)
Las Vegas, NV · Remote
$86K - $217K/yr
No less than 7 years of direct clinical data management experience * 5+ years in a Lead Clinical ... We create intelligent connections to accelerate the development and commercialization of innovative ...
Senior Data Team Lead (Remote)
Las Vegas, NV · Remote
$86K - $217K/yr
No less than 7 years of direct clinical data management experience * 5+ years in a Lead Clinical ... We create intelligent connections to accelerate the development and commercialization of innovative ...
... Director) * Strong ability to engage prospects and their assistants in dialogue, quickly build ... During a period of time when gaining new customers has become almost impossible, Kopp has developed ...
Quick apply
... Director) * Strong ability to engage prospects and their assistants in dialogue, quickly build ... During a period of time when gaining new customers has become almost impossible, Kopp has developed ...
Remote BCBA
Las Vegas, NV · On-site +1
$80K - $95K/yr
... development initiatives • Partner with Regional Directors and Operations teams on initiatives, quality, compliance, and more What Excellence Looks Like • High-quality, data-driven clinical ...
Remote BCBA
Las Vegas, NV · On-site +1
$80K - $95K/yr
... development initiatives • Partner with Regional Directors and Operations teams on initiatives, quality, compliance, and more What Excellence Looks Like • High-quality, data-driven clinical ...
Remote BCBA
Las Vegas, NV · Remote
$80K - $95K/yr
... development initiatives Partner with Regional Directors and Operations teams on initiatives, quality, compliance, and more What Excellence Looks Like High-quality, data-driven clinical programs ...
Remote BCBA
Las Vegas, NV · Remote
$80K - $95K/yr
... development initiatives Partner with Regional Directors and Operations teams on initiatives, quality, compliance, and more What Excellence Looks Like High-quality, data-driven clinical programs ...
Remote BCBA
Tonopah, NV · Remote
$80K - $95K/yr
... development initiatives Partner with Regional Directors and Operations teams on initiatives, quality, compliance, and more What Excellence Looks Like High-quality, data-driven clinical programs ...
Remote BCBA
Tonopah, NV · Remote
$80K - $95K/yr
... development initiatives Partner with Regional Directors and Operations teams on initiatives, quality, compliance, and more What Excellence Looks Like High-quality, data-driven clinical programs ...
Participate in the development of field clinicians that routinely perform OASIS assessments and of ... Direct staff toward the appropriate use of community resources. * Assist leaders with appraising ...
New
Participate in the development of field clinicians that routinely perform OASIS assessments and of ... Direct staff toward the appropriate use of community resources. * Assist leaders with appraising ...
New
... business development activities. * Develop and manage a robust pipeline of new opportunities to ... Direct prospects through consultative sales process to identify need, provide proof of concept by ...
... business development activities. * Develop and manage a robust pipeline of new opportunities to ... Direct prospects through consultative sales process to identify need, provide proof of concept by ...
Agent CSR Entry Level WFH
Las Vegas, NV · On-site +1
$14.75 - $19.75/hr
Requirements / Responsibilities / Rewards We've fully embraced a remote-first work environment ... In this position, you'll work from wherever you're most productive, gain direct mentorship from ...
Agent CSR Entry Level WFH
Las Vegas, NV · On-site +1
$14.75 - $19.75/hr
Requirements / Responsibilities / Rewards We've fully embraced a remote-first work environment ... In this position, you'll work from wherever you're most productive, gain direct mentorship from ...
$166K - $191K/yr
You'll have a direct influence on the iOS team's product roadmap and plenty of opportunities to ... Create tools and infrastructure to enable rapid development of the Poe mobile experience
$166K - $191K/yr
You'll have a direct influence on the iOS team's product roadmap and plenty of opportunities to ... Create tools and infrastructure to enable rapid development of the Poe mobile experience
$166K - $191K/yr
You'll have a direct influence on the iOS team's product roadmap and plenty of opportunities to ... Create tools and infrastructure to enable rapid development of the Poe mobile experience
$166K - $191K/yr
You'll have a direct influence on the iOS team's product roadmap and plenty of opportunities to ... Create tools and infrastructure to enable rapid development of the Poe mobile experience
$166K - $191K/yr
You'll have a direct influence on the iOS team's product roadmap and plenty of opportunities to ... Create tools and infrastructure to enable rapid development of the Poe mobile experience
$166K - $191K/yr
You'll have a direct influence on the iOS team's product roadmap and plenty of opportunities to ... Create tools and infrastructure to enable rapid development of the Poe mobile experience
$166K - $191K/yr
You'll have a direct influence on the iOS team's product roadmap and plenty of opportunities to ... Create tools and infrastructure to enable rapid development of the Poe mobile experience
$166K - $191K/yr
You'll have a direct influence on the iOS team's product roadmap and plenty of opportunities to ... Create tools and infrastructure to enable rapid development of the Poe mobile experience
Virtual Customer Service Representative - Entry-Level
Reno, NV · On-site +1
$90K - $120K/yr
... professional development designed to help professionals succeed in a remote setting. Key ... Weekly pay via direct deposit * Full training and licensing support * Monthly and quarterly ...
Virtual Customer Service Representative - Entry-Level
Reno, NV · On-site +1
$90K - $120K/yr
... professional development designed to help professionals succeed in a remote setting. Key ... Weekly pay via direct deposit * Full training and licensing support * Monthly and quarterly ...
$115K - $150K/yr
Position Overview The Manager of Business Reporting Development leads a team of Business Report Developers responsible for designing, developing and delivering reporting tools that support the ...
$115K - $150K/yr
Position Overview The Manager of Business Reporting Development leads a team of Business Report Developers responsible for designing, developing and delivering reporting tools that support the ...
Remote Director Development information
What are the key skills and qualifications needed to thrive as a Remote Director of Development, and why are they important?
What is a Remote Director of Development?
How does a Remote Director of Development effectively lead and support a geographically dispersed team?

Full-time
Medical
Posted 3 days ago
Job description
We are seeking a Medical Director of Utilization Management to lead and support the clinical integrity of our utilization management (UM) functions, with a primary focus on inpatient and post-acute care reviews.
In this role, you will ensure timely, consistent, and appropriate care determinations for Commercial and Medicare Advantage members. By leveraging evidence-based practices, CMS regulations, and health plan benefit structures, you will evaluate the medical necessity of care, participate in peer-to-peer consultations, and collaborate with multidisciplinary teams to drive optimal clinical outcomes, regulatory compliance, and cost efficiency.
Duration: August 10, 2026 - February 10, 2027
Location: Henderson, NV (100% Fully Remote Opportunity)
Reporting To: Chief Medical Officer
Start Date: Immediate Need
Key Responsibilities- Utilization Review & Medical Necessity: Conduct timely medical necessity determinations for inpatient admissions, continued stays, and post-acute care settings (SNF, IRF, LTACH, Home Health) for Commercial and Medicare Advantage populations.
- Evidence-Based Evaluation: Apply nationally recognized guidelines (MCG, InterQual), CMS coverage criteria, and health plan policies to ensure appropriate level-of-care determinations.
- Complex Case Escalation: Serve as the lead physician reviewer for complex, high-risk, or potentially adverse UM cases requiring clinical judgment.
- Peer-to-Peer Engagement: Conduct peer-to-peer discussions with attending and treating physicians to clarify documentation, discuss options, and align on appropriate care plans.
- Cross-Functional Collaboration: Partner with Care Management and UM teams to identify utilization trends, reduce avoidable readmissions/extended stays, and streamline care transitions.
- Policy & Quality Support: Offer clinical expertise to support quality improvement initiatives, regulatory audit preparedness (CMS/NCQA), policy development, and UM committee activities.
- Documentation & Compliance: Maintain precise, compliant, and timely documentation of all reviews and rationales in accordance with federal, state, and organizational guidelines.
- Education & Licensure: Active M.D. or D.O. degree with an active, unrestricted medical license in good standing (in state of residence).
- Board Certification: Current Board Certification in an appropriate medical specialty.
- Clinical & Leadership Experience: Minimum of 5 years of clinical practice, including at least 3 years of direct experience in utilization management, physician review, or medical leadership within a managed care or health plan setting.
- Population Expertise: Demonstrated physician-level experience supporting Commercial and/or Medicare Advantage lines of business.
- Criteria Proficiency: Advanced expertise with MCG guidelines and strong working knowledge of InterQual and CMS criteria.
- Regulatory Knowledge: Deep understanding of Medicare Advantage regulations, Commercial health plan benefit structures, and state/federal UM mandates.
- Technical Skills: Experience navigating medical management platforms, enterprise applications, and Microsoft Office products.
- Communication & Negotiation: Exceptional written and oral communication skills, with a proven ability to handle delicate peer-to-peer discussions and articulate complex clinical rationales clearly.
- Analytical Mindset: Strong problem-solving abilities, attention to detail, and a data-driven approach to identifying utilization trends and quality gaps.
- Master's degree in Public Health, Business Administration, or Health Administration (MPH, MBA, or MHA).
- Certification by the American Board of Quality Assurance and Utilization Review Physicians (ABQAURP).
This is a 100% remote, high-impact contract opportunity starting immediately, offering you the flexibility of working from home while managing key clinical determinations for a dynamic health plan environment.
Employment Type: FULL_TIME