Medical Peer Reviewer (MD/DO) - 25 hrs/wk, Utilization Mgmt
Healthfirst
Healthfirst in New Jersey is seeking a Medical Peer Reviewer to support the CMO Administration by assessing requests for authorization and claims payments based on medical records and internal Healthfirst data. The role requires board-certified physicians, strong clinical judgment, and the ability to work within regulatory timelines, with 25 hours per week and paid time off; the team collaborates across Utilization Management, Care Management, and medical departments. #J-18808-Ljbffr Healthfirst
$140 - $145 per hour
...re hiring a Physician Reviewer to join our Utilization Management Team.... ...You will determine the medical appropriateness of inpatient... ...commitment of 20-25 hours per week is... ...reviews. Conduct timely peer-to-peer discussions... ...certification as an MD or DO ~ Licensed in one...SuggestedHourly payFull timePart timeLocal areaRemote workWork from homeHome officeWeekend work$122.91k - $188.02k
Healthfirst is seeking a Medical Peer Reviewer based in Pennsylvania to evaluate medical necessity as part of utilization management. The role requires collaboration with various medical departments and demands flexibility in workload. The hiring range is $122,907 to $...Suggested$122.91k - $188.02k
...role of the CMO Administration team, the Medical Peer Reviewer plays a critical role in consulting on medical necessity in the context of utilization management and ensuring adherence to... ...Requirements The Medical reviewer requires 25 hours a week of coverage. The...SuggestedRemote jobTemporary workPart timeWork experience placementFlexible hoursWeekend work3 days per weekWeekday work- ...A peer review organization is seeking a full-time remote Utilization Management Physician Reviewer. Ideal candidates must hold an MD, DO, or DPM degree with active board certification and unrestricted medical license in relevant states. The role involves performing detailed...SuggestedFull timeRemote workWork from home
- ...IntePros is seeking a Physician Reviewer to provide remote support for... ...The role involves reviewing medical necessity determinations and... .... Candidates should have an MD or DO, active board certification,... ...leverage clinical expertise in utilization management. #J-18808-Ljbffr...SuggestedRemote work
- ...seeking physicians with a minimum of 5 years clinical experience, preferably in Family Medicine, for a peer review role. Responsibilities include reviewing medical records and making standard of care determinations while working from home with a flexible schedule. Applicants...Remote jobWork from homeFlexible hours
- ...researchers, retired researchers, and former researchers who can perform peer reviews for journals and publishers. Note: You should be able to... ...with the publishers. Qualifications Doctorate (PhD/MD) or equivalent advanced degree in the subject area. At least two...Freelance
- ...looking for researchers, retired researchers, and former researchers in the United States who can perform peer reviews for journals. Candidates should have a PhD/MD or equivalent, at least two publications in the last two years, and strong analytical and communication...
$20 per hour
Join to apply for the Peer Specialist Non-Driving - REN011 - Fri... ...5 days ago Be among the first 25 applicants Join to apply for... ...documentation of all incidents, utilizing the chain of command, within 2... ...benefits package that includes medical, vision, and dental insurance,...Full timeSummer workFlexible hoursShift work- ...3, USA Posted Tuesday, August 25, 2026 at 4:00 AM PURPOSE: The... ...communities. POSITION OVERVIEW: The Peer Specialist engages... ...their needs. The Peer Specialist utilizes a peer relationship to foster... ...; activities of daily living; medication management; and independent living...Hourly payFull timePart timeWork at officeLocal area
$10k
## Utilization Review RN - PT - Day - Utilization Resource Mgmt Pennington NJApplylocations: Pennington, NJtime type: Part timeposted on: Posted Todayjob requisition... ...of primary and specialty care. Capital Health Medical Group is made up of more than 600 physicians and other...Full timeTemporary workPart timeWork at officeLocal areaImmediate startFlexible hoursNight shift- ...Our programs are spread across 25 locations and include over 12... ...the Harp Advocacy Center, Peer‑driven Crisis Respite Center,... ...based on participant goals. Utilize strategies for collaborating with... ...systems, including behavioral and medical health, criminal justice,...Permanent employmentInternshipFlexible hoursWeekend workDay shiftAfternoon shift
$54.64k
...will directly help reduce the utilization of jails and prisons. Shift Hours... ...deliver case management and peer support services that address... ..., income support, treatment, medical care, civil legal services, self... ...Paid Time Off - starting at 25 days-off annually 12 Paid Holidays...Hourly payFull timeWork experience placementWork at officeImmediate startRemote workMonday to FridayFlexible hoursShift workDay shift$91.7k - $163.7k
...find a culture guided by inclusion, talented peers, comprehensive benefits and career... ...together. The role of the Psychologist Peer Review involves applying clinical criteria and benefit... ...by the reviewer's manager * Conduct Non-MD clinical reviews of the following type...Remote jobMinimum wagePermanent employmentFull timeWork experience placementLocal areaWork from home$45 - $50 per hour
...Greenlife Healthcare Staffing is looking for a dedicated Registered Nurse Clinical Reviewer for a fully remote position in New York. This role involves conducting utilization and quality reviews and contributing to clinical studies. With a competitive pay of $45 - $50...Hourly payRemote work$130 - $145 per hour
...Behavioral Health Physician Reviewer to join our Utilization Management team. Oscar... ...The Behavioral Health Medical Director oversees behavioral... ...including initial denials, peer-to-peers (including giving... ...practice as a psychiatrist. ~ MD or DO with a current...Hourly payFull timePart timeRemote workWork from homeHome office$55.1k - $99k
1 day ago Be among the first 25 applicants This range is provided by TalentPlug LLC... ...the Diagnosis Related Group (DRG) and Medical Record Audit Programs for Fidelis Care.... ...travel to New York twice a year ~ RN, PA, MD, APRN, DO, or MBBS license ~ Valid/Current CPC or...Full timeRemote work- ...Physician Reviewer Opportunity Dane Street, a nationally recognized... ...with an active New York medical license and Workers' Compensation... ...Certification to conduct Utilization Reviews. This is a fully remote... ...days) Participate in peer-to-peer calls as needed (coordinated...Price workExtra incomeFor contractorsRemote workFlexible hours
- ...are applying. Only reasonable accommodation requests related to applying for a position within HF Management Services, LLC will be reviewed at the e-mail address and phone number supplied. Thank you for considering a career with HF Management Services, LLC. Know Your...
- ChenMed LLC is seeking a Physician Reviewer to lead Utilization Management (UM) cases across multiple markets. The role includes coordinating with... ...growing delegated UM program. The ideal candidate holds an MD with Internal Medicine or Family Practice training, a Pain...Local area
- Cactus Communications is seeking experienced peer reviewers capable of assessing academic manuscripts. Candidates should have a Doctorate (PhD/MD) and at least two recent publications in their field. The role involves evaluating research methodologies, providing constructive...
- ...experienced Radiologists to join our growing team of expert medical reviewers. In this role, you will apply your expertise to conduct comprehensive... ...supporting high-quality, defensible medical determinations. MD/DO with completion of an accredited Radiology residency program...For contractorsRemote work
- Cincinnatus LLC is seeking licensed MD professionals to join a flexible, remote, part-time engagement. The role involves reviewing clinical content and AI-generated responses, answering... ...experience, ability to engage with medical literature, and comfort using AI tools....Remote jobPart time10 hours per weekFlexible hours
$31.3 - $47 per hour
...Specialist (SDS) performs final reviews of the Bank’s commercial loans... ...Managers (RM), and peer documenters on commercial documentation... ...paced environment. Ability to utilize computer applications associated... ...May be required to lift up to 25 pounds. Company Profile...Hourly payPermanent employmentLocal area- A healthcare company is seeking a Remote Medical Case Reviewer to evaluate vaccine and countermeasure-related injury claims. Responsibilities... ...and consulting with medical experts. Candidates must hold an MD/DO or relevant advanced degree, with several years of related experience...Remote jobContract work
- Remote Medical Case Reviewer (Contract) Location: Remote About the Opportunity PsyPhyCare is seeking Medical Case Reviewers to support a federal... ...under federal travel guidelines). Qualifications For MD/DO Medical Case Reviewers: Doctor of Medicine (MD) or Doctor of...Remote jobHourly payContract work
$275k - $325k
...delivery by providing guidance on medical necessity, utilization management, and quality... ...Duties Utilization Review: Review medical records and... ...outcomes. Clinical duties: up to 25% of the position Perform... ...Medical degree (MD or DO) Medical license Knowledge...Full timePart timeWork at office- SME Careers seeks a Medical Doctor (Specialist) Subject Matter Expert to work remotely. This role involves reviewing AI-generated clinical responses and creating expert medical content... .... Ideal candidates will possess an MD/DO with specialty training and 5+ years of clinical...Remote job
- ...inviting Board Certified Physicians to join their Disability Peer Review team. This telework opportunity allows you to evaluate and review... ...a doctor/patient relationship. Requirements include board certification in OB/GYN and a current medical license. #J-18808-LjbffrFor contractorsRemote workFlexible hours
- ...(H+H) is responsible for the delivery of medical care, mental health care, and discharge planning in the jail system. Approximately 25% of new admissions per year to the NYC jail... ...record or databases (when applicable) Utilize the Inmate Inquiry System (IIS) in order to...Full timeImmediate startFlexible hours
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Medical Peer Reviewer (MD/DO) - 25 hrs/wk, Utilization Mgmt. Be the first to apply!
- clinical reviewer New York, NY
- medical reviewer work from home New York, NY
- health records assistant New York, NY
- medical records administrator New York, NY
- medical records reviewer New York, NY
- medical records reviewer remote New York, NY
- medical record assistant New York, NY
- medical records clerk part time New York, NY
- medical records clerk New York, NY
- clinical documentation specialist New York, NY


