Remote Utilization Management Physician Reviewer
Oak Street Health
Oak Street Health is seeking a Full-Time Utilization Management Physician Reviewer to provide accurate coverage determinations for inpatient and outpatient services, applying UM criteria, clinical judgment, and internal policies. You will coordinate with care teams to ensure medically appropriate care is delivered in the right setting, at the right time. The role requires an active US medical license, MD/DO degree, and 3–5 years of primary care experience, with a focus on managed care and care #J-18808-Ljbffr
- ...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...Remote workFull timeWork from home
- ...IntePros is seeking a Physician Reviewer to provide remote support for a healthcare organization. The role involves reviewing medical necessity... ...a collaborative environment with opportunities to leverage clinical expertise in utilization management. #J-18808-Ljbffr...Remote work
- ...A healthcare management organization is seeking experienced Physician Reviewers to join their Medicare Utilization Management team in a remote position. Responsibilities include reviewing clinical service requests, applying evidence-based guidelines, and collaborating...Remote work
- ...A leading independent review organization is seeking a Utilization Management Physician Reviewer for a full-time remote role. Candidates must possess an active Nebraska medical license and have a minimum of 5 years clinical practice experience. Responsibilities include...Remote workFull timeCasual workMonday to Friday
- ...certified "Great Place to Work" company is seeking a Physician to provide utilization review services for the Group Health Department. This role... ...business background required Experience in Utilization Management with criteria review utilizing standard practice...Remote work
$219k - $286.9k
...Physician Reviewer - Utilization Management Hi, we're Oscar. We're hiring a Physician Reviewer to join our Utilization Management team. Oscar is... ..., Utilization Management. Work Location: This is a remote position, open to candidates who reside in the United...Remote workFull timeLocal areaWork from homeHome officeWeekend work$174.07k - $374.92k
...Full-Time Utilization Management Physician Reviewer We're building a world of health around every individual — shaping a more connected, convenient... ...at a time. Company: Oak Street Health Location: Remote/ Treehouse Role Description: This full-time role...Remote workHourly payFull time- ...Dual Occupational Medicine/Pain Management, Dual Internal Medicine/Pain... ...turnaround times. Our reviewers are compensated on a per-case... ...JOB SUMMARY As a Physician Reviewer/Advisor for Disability Peer Review, you will utilize clinical expertise to review...Remote workFor contractorsMonday to Friday
$204.76k - $292.52k
...Physician Reviewer We're unique. You should be, too. We're changing lives every day. For both our patients and our team members... ...Physician Reviewer is the primary physician reviewer for Utilization Management (UM) cases in our organization. Other duties include advising...Remote workHourly payFull timeWork at officeLocal area- ...Role Overview Our Utilization Management Reviewers evaluate medical necessity for inpatient and outpatient... ...escalate complex cases requiring physician review or additional intervention... ...Flexible work solutions include remote options, hybrid work schedules, competitive...Remote workMonday to FridayFlexible hoursWeekend work
$86k - $117.3k
...For roles that are 100% remote or hybrid, you must have access... ...most. We offer integrated managed care products,... ...direction of a supervisor, the Utilization Management Reviewer evaluates medical necessity... ...escalate complex cases requiring physician review or additional...Remote workHourly payContract workMonday to FridayFlexible hoursWeekend work$130 - $145 per hour
...Hi, we're Oscar. We're hiring a Behavioral Health Physician Reviewer to join our Utilization Management team. Oscar is the first health insurance company... ...Management. Work Location: This position is fully remote and open to candidates residing in the U.S.,...Remote workHourly payFull timePart timeWork from homeHome office$35 - $40 per hour
...service offerings for clinical, case management, member engagement, provider... ...containment, and analytics. Job Title RN Utilization Management Reviewer Responsibilities Conduct timely clinical... ...require weekends. Location: Fully remote work at home role. Secure, private area...Remote workHourly payTemporary workMonday to FridayFlexible hoursWeekend work- ChenMed is seeking a Physician Reviewer to lead Utilization Management review across multiple markets. The role requires medical training, IM/FP residency, and pain management certification, with experience in hospital medicine and utilization review preferred. The position...
- ...integrating, and monitoring the utilization of behavioral health (... ...Medical Director for review. Refer to and work closely with Case Management to address member needs... ...with the treating physician or other providers of... ...may be opportunity for remote work within all jobs posted...Remote workContract workWork at office
$248.5k - $373k
...internal medicine or family medicine physician to join our Utilization Management team. Optum is a clinician-led... ...'ll enjoy the flexibility to work remotely * from anywhere within the U.S. as... ...determination processesParticipates in case review and medical necessity...Remote workMinimum wageFull timeWork experience placementWork at officeLocal areaWork from home$248.5k - $373k
...Medical Director For Utilization ManagementWellMed, part of... ...medicine or family medicine physician to join our Utilization Management team. Optum is a... ...the flexibility to work remotely from anywhere within the... ...processesParticipates in case review and medical necessity...Remote workMinimum wageFull timeWork experience placementWork at officeLocal areaWork from home- ...About MMRO Managed Medical Review Organization (MMRO) is a nationally recognized... ...of experienced practicing physicians. MMRO is committed to... ...questions. Reviews are conducted remotely and do not require direct... ...turnaround times. Utilize MMRO review templates and ensure...Remote jobFull timeContract workFor contractorsFlexible hours
$240k
...Utilization Management Physician (UMP) Remote | Full-Time | Florida Compensation: $240,000 base + bonus Schedule: 40 hours/week Work Model: Remote... ...Management Physician to perform medical necessity reviews, peer-to-peer discussions, and clinical determinations...Remote jobFull timeRelocation- ...leading healthcare organization is seeking a RCS-Physician Advisor to join their Denial Management team. This full-time remote position requires a medical degree and board... ...to help optimize hospital services and resource utilization. #J-18808-Ljbffr Indiana University HealthRemote jobFull time
- ChenMed is seeking a Physician Reviewer to lead Utilization Management (UM) reviews across assigned markets and coordinate care for our patients. You will cover delegated UM, attend health plan and local calls, and participate in quality improvement within our growing UM...Local area
- ...A leading Independent Review Organization is seeking a Board-Certified Physical... ...Rehabilitation provider to perform Utilization Reviews. This fully remote role offers flexible scheduling and... ...Certification. Apply to join our Physician Review Panel and start earning based...Remote workExtra incomeFlexible hours
- ...Arizona Department Name: Utilization Mgmt Work Shift: Day... .... As an RN Utilization Management Care Reviewer, you will be an important... ...Networks Team. This 100% remote role manages a typical caseload... ...care and specialty physicians to provide the most comprehensive...Remote workFull timeMonday to FridayShift work
- ...Umpqua Health is seeking an Utilization Review Clinician to perform clinical reviews for mental... ...health and substance use services. This remote role may require on-site travel to... ...schedule. The URC collaborates with care management teams to ensure appropriate level of...Remote workFull time
- ...established industry player is seeking a Remote Physician Reviewer for a 3-year contract role. This... ...evaluating clinical service requests, utilizing clinical judgment to adjudicate requests... .... You will play a crucial role in managing members' clinical situations through...Remote workContract work
$155 - $165 per hour
...job poster from EPITEC As a Physician Reviewer, you'll play a critical role... ...experience Understanding of managed care and proficiency in PC (... ...Experience with managed care and utilization management Strong leadership... ...What We Offer Fully remote work arrangement (Weekends only...Remote workFull timeContract workWork at officeWeekend work- ...Role: Physician ED Claims Reviewer Duration: 12 months Required skills: Physician... ...coding (CPT/HCPCS) and managed care to conduct clinical review... ...: Experience/knowledge in utilization management is a plus.... ...a fast paced environment. This is a remote position....Remote work
- ...DRG Clinical Physician ReviewerWe are seeking a highly experienced DRG Clinical Physician Reviewer to join our growing clinical review team. This is a fully remote opportunity for a physician with a strong background in utilization review and clinical validation who thrives...Remote work
- ...searching for Board Certified Internal Medicine physicians to conduct Independent Medical Exams (IME) and Peer Reviews. This opportunity allows you to customize your... ...Alsip/South Chicago Area JOB SUMMARY: Utilizes clinical expertise, and reviews disability claims...Remote workFor contractorsMonday to Friday
- ...and more exclusive features. Location: Remote (Must reside in IL, MT, NM, OK, TN, or TX)... ...client is seeking experienced, board-certified physicians to join their Medicare Utilization Management team as Physician Reviewers. In this remote role, you will review clinical...Remote workFull timeWeekend work
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