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
- ...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
- ...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
$219k - $286.9k
...Job Description Hi, we're Oscar. We're hiring a Physician Reviewer to join our Utilization Management team. Oscar is the first health insurance company... ...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
...health care one person, one family and one community at a time. Company: Oak Street Health Title: Utilization Management Physician Reviewer Location: Fully Remote Hours: full time, Monday - Friday, 8am -5pm Salary: $230k per year Role Description:...Remote workHourly payFull timeLocal areaMonday to Friday- ChenMed is seeking a Physician Reviewer to lead Utilization Management (UM) case reviews and collaborate with health plans and local teams to coordinate care for patients. The role supports process and quality improvements in delegated UM operations. The position requires...Remote jobLocal area
- ...ezURs is seeking board-certified Pain Management Physicians for fully remote Physician Consultant positions. As a URAC accredited Independent Review Organization, our physicians perform utilization reviews, disability, and peer reviews across multiple lines of business...Remote workFor contractors
$204.76k - $292.52k
...we need great people to join our team. The Physician Reviewer is the primary physician reviewer for Utilization Management (UM) cases in our organization. Other duties... ...please click HERE ( Current Contingent Worker please see job aid HERE to apply #LI-Remote...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 work2 days per week- ...Orthopedic Spine Surgeon Reviewer Dane Street, a... ...expanding its panel of Physician Reviewers. We are currently... ...Certification to conduct Utilization Reviews. This is a fully remote, non-clinical role offering... ...portal and streamlined case management Full onboarding and...Remote workPrice workExtra incomeFor contractorsFlexible hours
- A recognized healthcare provider is seeking a Board Certified Orthopaedic Spine Surgeon to conduct utilization reviews. This telework position allows for a flexible schedule within a standard Monday - Friday work week. Responsibilities include reviewing medical records,...Remote jobFor contractorsMonday to FridayFlexible hours
- ...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 workFull timeTemporary workFor contractorsFlexible hours
$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- ChenMed is seeking a Physician Reviewer for Utilization Management to lead UM case reviews across multiple markets. You will participate in daily health plan calls and coordinate care for our patients. The role emphasizes process and quality improvement, with opportunities...
- ChenMed is seeking a Physician Reviewer to serve as the primary reviewer for Utilization Management (UM) cases across the assigned markets. You will advise other physician reviewers and participate in daily health plan calls to coordinate care for patients. This role supports...Local area
- Coastal Care Services, Inc. is seeking an LPN licensed Utilization Management Nurse Reviewer for a work-from-home opportunity serving the Miami, FL... ...Equipment, reviews medical necessity, collaborates with physicians, patients and families to assure cost-effective, high-quality...Remote jobWeekday work
$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- ...Medicine) looking for a full-time, remote job in a nonclinical setting? Then... ...! ExamWorks is seeking a physician board-certified in either Family Medicine... ...to join the team full-time as a Utilization Management Physician Reviewer. This position is 100% remote...Remote workFull timeMonday to FridayWeekend work
$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... ...processes Participates in case review and medical necessity determination...Remote workMinimum wageFull timeWork experience placementWork at officeLocal areaWork from home- ...join our dynamic team of expert reviewers! In this role, you will have the opportunity to utilize your medical expertise to conduct... ...clients. We are looking for Physicians in the following area: ~ Internal Medicine/Pain Management Be a part of a team that values...Remote workFor contractors
- ...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
$134.6k - $230.8k
...quality organization supporting utilization management operations across a large,... ...across utilization management, physician advisor functions, peer-to-peer review support, and appeals operations... ...enjoy the flexibility to work remotely * from anywhere within the U.S....Remote workMinimum wageFull timeWork experience placementWork at officeLocal area$213.1k - $383.58k
...communities we serve. The Job The Utilization Management (UM) Physician Medical Director provides physician-... ...organization’s prior authorization, concurrent review, and appeals programs. This role... ...83,580 per year Work Mode - Mostly Remote: Employees who reside outside the...Remote workFor contractorsWork at officeLocal areaRelocation- ...the organization. Identifies opportunities to manage members' clinical situations with a view toward... ...management for members whose cases come for review, in partnership with case managers. Participates in the Physician Review Units' appeal process of service denials...Remote work
- ...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
- ...AmeriHealth Caritas is seeking a BHUM Reviewer to conduct medical necessity reviews for inpatient and outpatient... ...nursing or social work credentials, experience in utilization management, and the ability to work remotely within the US; remote options and weekday schedule...Remote workWeekday work
- ...DRG Clinical Physician Reviewer We are seeking a highly experienced DRG Clinical Physician Reviewer to... ...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 in...Remote work
- ...Behavioral Health Utilization Reviewer The Behavioral Health Utilization Reviewer is responsible for conducting clinical reviews of behavioral... ...clinical decisions and rationale in the utilization management system. Communicate determinations to providers and members...Remote workWork at office
- ...Comagine Health in Oregon seeks a Clinical Reviewer to evaluate medical necessity and... ...review clinical documentation, perform utilization reviews, and document determinations in... ...across children, youth, and adults. This remote, Oregon-based role requires active licensure...Remote work
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Remote Utilization Management Physician Reviewer. Be the first to apply!
- supervising physician Richmond, VA
- doctors office nurse Richmond, VA
- anesthesia physician Richmond, VA
- physician-geriatric medicine Richmond, VA
- lpn doctors office Richmond, VA
- internal medicine primary care physician Richmond, VA
- doctor work from home Richmond, VA
- physician neurology Richmond, VA
- remote physician reviewer Richmond, VA
- permanent doctor Richmond, VA




