Remote Physician Advisor: Utilization Management & Quality
$198.22k - $297.33kE2E Alignment Healthcare USA, LLC
E2E Alignment Healthcare USA, LLC is seeking a Physician Advisor to collaborate with medical officers and the healthcare services team. You will optimize institutional and outpatient services while ensuring quality of care. The ideal candidate has a minimum of 3 years experience in a clinical setting and must be licensed in California. Your responsibilities include overseeing staff, liaising with payers, and improving clinical outcomes. Compensation is competitive, with a range of $198,219 to $297,329 based on experience and qualifications. #J-18808-Ljbffr
Vacancy posted 3 days ago
Similar jobs that could be interesting for youBased on the Remote Physician Advisor: Utilization Management & Quality in California, MO vacancy
$198.22k - $297.33k
...Position Overview The Physician Advisor works with Senior Medical Officers... ...while ensuring the quality of care provided. Key Responsibilities... ...between the medical staff, utilization review and 3rd party payers... ...Team to develop case management protocols and provide oversight...Remote workQualityE2E Alignment Healthcare USA, LLC
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Fort Myers, FL3 days ago - ...Corewell Health is expanding its Utilization Management team and is seeking a collaborative and clinically driven Physician Advisor to support our East Region. Position Overview... ...ensure appropriate, efficient, and high-quality patient care across the continuum. Essential...QualityWeekend work
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Southfield, MI3 days ago - ...The Physician Advisor (PA-Utilization Management) serves as the physician leader in matters relating to patient care... ...utilization management, sustain quality goals, and act as a consultant to physicians... ...position you are interested in is remote or on-site. Individuals who reside...QualityFor contractorsLocal areaImmediate start
Ochsner LSU Health System
Shreveport, LA2 days ago - ...: THIS IS A 1099 POSITION The Physician Advisor serves as a physician leader responsible... ...CMI), medical necessity compliance, utilization management, and hospital throughput. The... ...clinical documentation integrity (CDI), quality, and revenue cycle teams to ensure...QualityFull timeLocal areaShift workNight shift
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Athens, GA4 days ago - ...A peer review organization is seeking a full-time remote Utilization Management Physician Reviewer. Ideal candidates must hold an MD, DO, or DPM degree... .... This is a unique opportunity to work from home while contributing to quality medical reviews. #J-18808-Ljbffr...Remote workQualityFull timeWork from home
ExamWorks
New York, NY2 days ago - ...A healthcare services company is seeking a full-time remote Utilization Management Physician Reviewer. The role requires a board-certified physician... ...and senior management, communication with clients, and quality assurance processes. Candidates must possess an MD, DO,...Remote workQualityFull time
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New York, NY2 days ago $250k - $410k
...Associate Medical Director, Physician Advisor The Associate Medical Director, Physician Advisor supports Utilization Management by providing clinical oversight, education, and guidance... ...length of stay, and ensure high-quality, cost-effective care. As a key member of...QualityRelocation packageCedars-Sinai
Encino, CA1 day ago- ...A healthcare management organization is seeking experienced Physician Reviewers to join their Medicare Utilization Management team in a remote position. Responsibilities include reviewing clinical... ...guidelines, and collaborating to ensure quality care for members. Candidates must...Remote workQuality
Solving IT
New York, NY2 days ago $174.07k - $374.92k
...Street Health, part of CVS Health, is seeking a Full-Time Utilization Management Physician Reviewer to ensure accurate coverage determinations for... ...personalized primary care for older adults, emphasizing on quality care. The typical pay range for this role is between $174...Remote workQualityFull timeOak Street Health, part of CVS Health
Chicago, IL1 day ago- ...ChenMed is looking for a Licensed Physician Reviewer – Ortho for a remote role based in Miami, FL. This position involves conducting Utilization Management reviews and advising other physician reviewers while participating in quality improvement efforts. The ideal candidate...Remote workQuality
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Doral, FL1 day ago - ...Remote Physician Reviewer – Utilization Management ****This Person Needs to sit in PA, NJ, or Delaware**** IntePros is seeking a Physician Reviewer to support... ...with clinical and operational teams to ensure high-quality, evidence-based utilization management practices....Remote workQuality
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New York, NY3 days ago - ...expanding its panel of Physician Reviewers. We are currently... ...to conduct Utilization Reviews. This is a fully remote, non-clinical role offering... ...portal and streamlined case management Full onboarding and ongoing... ...physicians to ensure high-quality, evidence-based clinical...Remote workQualityPrice workExtra incomeFor contractorsFlexible hours
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New York, NY5 days ago - ...FL408D – Utilization Management Physician Utilization Management Physician (UMP) Before we talk mission... ...(UMP) Full-time. 40 hours. Remote structure. Based out of Edgewater, Florida... ...your clinical judgment • Help guide quality and outcomes No floor rounding...Remote workQualityFull time
Fsc Corporation
United States1 day ago - Greenkey Resources LLC is hiring a remote Clinical Reviewer based in Arizona. In this role... ...you hold an MD and have experience in utilization review, this position invites you to be... ...continuous improvement while supporting high-quality health standards. #J-18808-Ljbffr...Remote jobQuality
- ...seeking a high-performing Physician Reviewer to join our... ...timely, defensible utilization review determinations... ...operational teams to ensure quality and compliance Reviews... ...to manage short-TAT and urgent cases... ...systems Work Environment Remote work from home Full-time...Remote workQualityFull timeTemporary workWork at officeWork from homeMonday to FridayNight shift
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New York, NY1 day ago $260k - $275k
...every 16 weeks Position Type: Full-time | Remote | Non-clinical We are seeking a Board-Certified Physician to join a Utilization Management team in a fully remote, non-clinical role... ...regulatory, accreditation, and internal quality standards Accurately document decisions within...Remote workQualityFull timeWeekend workMedix
New York, NY2 days ago$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... ...organizational confidentiality Provides quality assurance and education of current...Remote workQualityMinimum wageFull timeWork experience placementWork at officeLocal areaWork from homeOptum
San Antonio, TX2 days ago$105 - $115 per hour
EPITEC is seeking a Physician Reviewer to evaluate clinical service requests and utilize medical expertise for decision... ...supporting utilization management processes and participating in quality improvement initiatives.... ...flexible hours, fully remote work (excluding CA, NY,...Remote jobQualityHourly payFlexible hours$211.2k - $277.2k
...Physician Reviewer - Utilization Management You will determine the medical appropriateness of inpatient, outpatient... .... Work Location: This is a remote position, open to candidates who reside... ...that meet Oscar's stringent quality parameters. Provide clinical determinations...Remote workQualityFull timeLocal areaWork from homeHome officeWeekend workOscar Health
United States1 day ago$26.01 - $56.14 per hour
...accountable and prioritize safety and quality in everything we do. Join us... ...Health, specific to ABA. Utilizes clinical experience and... ...of the utilization/benefit management function. Required Qualifications... ...business needs ~ This is a remote position Preferred...Remote workQualityHourly payFull timeTemporary workMonday to FridayOak St. Health
United States3 days ago$80.17 - $119.26 per hour
CommonSpirit Health is seeking a System Physician Advisor to conduct clinical case reviews in a remote capacity. This role entails ensuring effective utilization of healthcare services, communicating with medical staff, and making recommendations regarding patient care....Remote jobHourly pay$174.07k - $374.92k
...ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something... ...Company: Oak Street Health Title: Full-Time Utilization Management Physician Reviewer Location: Remote/ Treehouse Role Description: This...Remote workQualityHourly payFull timeLocal areaCVS Health
United States1 day ago- Corewell Health in Southfield, Michigan, is seeking a full-time Physician Advisor to join their Care Management team. The role involves supporting clinical operations and ensuring high-quality care across patient interactions. Responsibilities include developing relationships...QualityFull time
$29.1 - $62.32 per hour
...ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of... ...schedules will be determined in collaboration with management to ensure adequate weekend coverage. Position Summary: Utilize your clinical experience and skills in a...Remote workQualityHourly payFull timeTemporary workWork at officeWork from homeShift workWeekend workOak St. Health
United States2 days ago$29.1 - $62.32 per hour
4062 Aetna Resources, LLC is seeking a Utilization Management Nurse Consultant Clinical Precertification RN (Medicare) to support healthcare quality and care coordination. This full-time remote position requires an active RN license and at least 3 years of RN experience...Remote jobQualityHourly payFull time$26.01 - $68.55 per hour
...ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something... ..., one family and one community at a time. Utilization Management (UM) Nurse Consultant (RN) Location: Remote (based on business needs) Schedule: Monday-...Remote workQualityHourly payFull timeTemporary workWork at officeLocal areaMonday to FridayShift workCVS Health
Rock Hill, SC1 day ago$26.01 - $68.55 per hour
...Resources, LLC is seeking a Medicare Precertification Utilization Management Nurse Consultant to work remotely. The role requires an active RN license and a... ...determinations, and collaborating with providers for quality care. This full-time position offers a pay range of...Remote jobQualityHourly payFull time$26.01 - $62.32 per hour
...hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of... ...one community at a time. Medicare Precertification Utilization Management Nurse Consultant (RN) Remote | Full-Time | Weekends Are you a detail-oriented...Remote workQualityHourly payFull timeTemporary workWork at officeLocal areaMonday to FridayShift workWeekend workAfternoon shiftCVS Health
Mountain Home, TX6 days ago$250k - $410k
...Beverly Hills is seeking an Associate Medical Director, Physician Advisor, to lead Utilization Management. This position involves ensuring compliance with... ...team through complex case reviews, and enhancing care quality. Candidates should be licensed physicians with at least...Quality
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