Medical Director, Utilization Management (Part Time - Weekends)

Clover Health(17 days ago)

RemotePart TimeSenior$144,060 - $202,614 (estimated)Medical/Utilization Management

About this role

Clover Health is seeking a part-time Medical Director in Utilization Management to evaluate outpatient and inpatient admissions for medical appropriateness. The role involves compliance with medical policies and regulations, with a focus on improving patient care and operational efficiency. The position offers a flexible, remote work environment dedicated to healthcare quality and innovation.

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Required Skills

Medical Policies
Utilization Management
Medical Necessity
Medicare Advantage
Clinical Review
Health Policy
Healthcare Regulations
Patient Care
Medical Certification
Medical Licensing

About Clover Health

cloverhealth.com

Clover Health is a Medicare Advantage provider offering HMO and PPO plans—many with $0 monthly premiums—bundling expanded benefits like dental, vision, and hearing. Headquartered in Jersey City, NJ, the company serves Medicare beneficiaries across multiple U.S. markets. Clover emphasizes a technology- and data-driven approach to care management, aiming to support providers, coordinate primary care, and improve member outcomes. It positions itself as a member-focused alternative designed to lower costs and simplify access to preventive and routine services.

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