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
- A healthcare consulting firm is seeking Peer Reviewers (MDs/DOs/DDS) for a full-time remote position. The role involves providing clinical expertise for peer reviews of patient care, making informed clinical judgments, and documenting all reviews per instructions. Applicants...SuggestedRemote jobFull time
$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$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- ...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
$62k - $70k
...position is to ensure that the utilization process is thorough,... ...timely manner Completes peer to peer reviews with insurance MDs to advocate... ...credentials include: Physicians: MD or DO (typically Board Certified... ...review processes, medical necessity criteria, and healthcare...SuggestedFull timeLocal areaRemote work- ...Orthopedic Spine Surgeon Reviewer Dane Street, a nationally recognized... ...with an active New York medical license and Workers'... ...Board Certification to conduct Utilization Reviews. This is a fully remote... ...business days) Participate in peer-to-peer calls as needed (...Price workExtra incomeFor contractorsRemote workFlexible hours
$130 - $145 per hour
...Behavioral Health Physician Reviewer to join our Utilization Management team. Oscar is... ...: The Behavioral Health Medical Director oversees behavioral... ...initial denials, peer-to-peers (including giving... ...practice as a psychiatrist. - MD or DO with a current unrestricted...Hourly payFull timePart timeRemote workWork from homeHome office- ...wants you to join our dynamic team of expert reviewers! In this role, you will have the opportunity to utilize your medical expertise to conduct thorough reviews of clinical... ..., provide clinical summaries, engage in peer communications, and answer specific questions...For contractorsRemote work
- ...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
- 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
- ...outcomes. Key Responsibilities Review medical records to ensure complete and... ...documentation integrity. Utilize EPIC for chart review and data... ...Friday, 8:00 AM - 5:00 PM PST (40 hrs/week). Schedule can be... ...FMG (Foreign Medical Graduate), MD, or RN required. Certifications...Remote jobMonday to FridayFlexible hours
$53.05k
...PEER SPECIALIST QUEENS SUPERVISED RELEASE PROGRAM Posted: 12/29/2025 CJA's work seeks to reduce jail overcrowding and unnecessary detention... ...operations, pilot projects, and research under one roof. CJA utilizes procedural justice practices to provide pretrial services to...Work at officeImmediate startRemote workTrial periodNight shiftAfternoon shift$45k
...Description Ohel is seeking Peer Specialist to be a part of a field‑based team that serves... ...the community. The role will involve utilizing one's lived experience to bridge the care... ...employment laws. For further information, please review the Know Your Rights notice from the...Full time- ...experiences, and abilities. The Peer Specialist working within a... ...trainings. Present issues/cases for review at Clinical Team Meetings and... ...with participants and utilize supervision to address conflicts... ...to appointments for benefits, medical, etc. Must be able to utilize...
- ...providers. Position Overview The Peer Specialist will provide... ...transportation to and from scheduled PCP Medical Appointments. Lead as well as... ...CMA worker is unavailable. Utilize personal lived experience with... .../Recovery Plans will be reviewed and signed by Team Leader and...Work at officeLocal areaTrial period
$21.97 - $25.56 per hour
...Overview Peer Specialist Healthcare staff can work anywhere….The BEST work with US! $21.97-$25.56 per hour A nationally recognized comprehensive Health and Human Services Agency, with over 60 programs across New York City and greater New York Area. Samaritan Daytop Village...Hourly payWork experience placementWork at office- ...Scope of the Role Utilize experience as a recipient of behavioral health services with a... ...informed, recovery‑oriented, and intentional peer support approaches. Promote a safe,... ...employees comprehensive healthcare coverage (medical, dental, and vision plans), supplemental...Temporary workLocal areaFlexible hoursNight shiftAfternoon shift
$55.1k - $99k
1 day ago Be among the first 25 applicants This range is provided by TalentPlug LLC... ...for 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 CIC...Full timeRemote work- ...candidates for the following position: Position: Peer Specialist (Part Time/24hrs Weekly) The... ...Life experience with the service systems utilized by the target population. Peer Specialist... ...growth. Full-time employees enjoy: Medical, Dental, & Vision Coverage Prescription Coverage...Full timePart time
- ...Job Title: Peer Specialist Job Summary: CASES is a New York City agency at the forefront of the intersection... ...to support you and your family, including: Medical Dental Vision Vacation and Paid Time Off – starting at 25 days-off annually 12 Paid Holidays per year Retirement...Full timeWork experience placementWork at officeRemote workMonday to FridayFlexible hoursShift workDay shift
- ...Overview Provide peer counseling and advocacy to men, women and children who receive... ...consequences of drug use and not taking medication for mental illness. Promotes problem-solving... ...socialization, symptom management, etc. utilizing Motivational Interviewing skills....Work at office
- ...Recruiting Certified Peer Specialist for Manhattan Psychiatric Center Manhattan Psychiatric... ...advancement & professional growth NYS medical, dental, and vision insurance Paid time... ...unique attributes and skills are valued and utilized to support the mission of the Agency. OMH...Work at officeMonday to FridayWeekend work
$51.5k - $53.05k
...Peer Specialist CASES is a New York City agency working at the forefront of the intersection... ...treatment planning, crisis intervention, medication management, medication assisted treatment,... ...Vacation and Paid Time Off – starting at 25 days-off annually ~12 Paid Holidays per...Full timeWork at officeRemote workTrial periodMonday to FridayFlexible hoursShift workDay shift- ...working towards stability. This position will utilize their recovery expertise, lived... ...counseling and education in areas such as medication management, symptom management and developing... ...housing agencies, social services, self-helper/peer-run services, natural community supports,...Local area
$20 per hour
...Description Concern Housing is seeking a certified Peer Specialist to work with our Crisis... ...our consulting psychiatrist from Janian Medical to provide additional peer support to... ...responded to in ways that fully develop and utilize each person's talent and strengths. EOE...Daily paidInternshipLive inLocal areaFlexible hoursDay shiftAfternoon shift$20.98 - $26.23 per hour
...Overview VNS Health Peer Specialists/ Advocates are living... ...for you and your loved ones, Medical, Dental, Vision, Life and Disability... ...their recovery process Reviews service plans with clients/... ...department and inpatient utilization, helping them access treatment...Temporary workFlexible hours$27.48 per hour
...Title: Peer Specialist Unit: Congregate Housing - Castle III Reports to: Program Director Status: Full-Time; Regular... ...and supervision for development, Knowledgeable in utilizing motivational interviewing and trauma-informed techniques Must...Hourly payPermanent employmentFull timeLocal areaAfternoon shift$32.97 per hour
...Salary Range: $32.97 - $32.97Hourly, Title: Peer Specialist Unit: NYS OMH Scattered Site... ...clients to and from appointments (e.g., medical, social service, housing). Participate in... ...regulations. Collect urinary specimens (e.g., utilizing multi-drug panel and submission of urine...Hourly payPermanent employmentFull timeWork experience placementLocal areaWeekend work- ...employee must occasionally lift or move up to 25 pounds. Specific vision abilities... ...three years’ experience in clinical quality, utilization management, case management, nursing,... ...academic health system # Audit experience and review of quality initiatives (PSI, Mortality)...Full timeWork at officeRemote workHome officeMonday to FridayWeekend work
$34k
...performs a wide range of tasks to assist peers of all ages, from young adult to old age... ...and other written materials will be utilized by the Peer Specialist in the provision... ...strengths, overcoming job-related anxiety by reviewing job applications, and providing...Work at officeLocal area
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