Remote Rheumatology Physician Clinical Reviewer
Prime Therapeutics
- Remote job
A healthcare benefits company is seeking a Physician Clinical Reviewer specializing in Rheumatology, to provide crucial medical evaluations remotely. The role demands 5+ years of experience, effective communication skills, and a strong grasp of clinical review processes in accordance with established guidelines. Responsibilities include reviewing cases, collaborating with physicians, and ensuring compliance with policies. Competitive compensation based on experience is offered, along with a commitment to diversity and an inclusive work environment. #J-18808-Ljbffr Prime Therapeutics
$90.87 - $154.33 per hour
A national health services provider is seeking a Physician Clinical Reviewer for remote work. This role requires extensive experience in medical review, providing timely evaluations of service requests. Candidates must have a Doctor of Osteopathy, MBBS, or MD and at least...Remote job$90.87 - $154.33 per hour
A progressive healthcare organization is seeking a Physician Clinical Reviewer in Rheumatology. This remote role involves evaluating service requests, collaborating with healthcare providers, and ensuring compliance with medical review guidelines. Ideal candidates will...Remote jobHourly pay- ...Description Job Summary The purpose of this position is to utilize clinical expertise to review medical records against established criteria in accordance with contract requirements. Location: Remote (U.S.-based) Licensure Requirement: Must hold an active clinical...Remote workContract workWork at officeMonday to FridayWeekend workWeekday work
- ...Rheumatology physician employment in New York : An established hospital group in the upper Hudson Valley region of Upstate Region New York is... ...occasional telehealth services to improve accessibility for remote patients. !function () {var reb2b = window.reb2b = window...Remote workFull timePart timeWork visa
- ...passionate about using your clinical expertise to support quality... ...services? Do you enjoy critically reviewing clinical documentation,... ...are recruiting for 2 full-time remote/hybrid Clinical Reviewer positions... ...services. Consult with physician/practitioner consultants when...Remote workFull timeWork from homeMonday to Friday
- ...Overview We are seeking a clinically trained physician to provide targeted review and validation of HEOR and real-world evidence (RWE) outputs. This role ensures analyses are interpreted through a real-world clinical lens and are aligned with Medical Affairs...Remote work
- ...Behavioral Health Services Reviewer Are you passionate about improving... ...? Do you enjoy using your clinical expertise to evaluate needs,... ...on this team. This is a remote position based in Oregon and... ...designated systems Consult with physician or practitioner reviewers...Remote workFull timeContract workWork from home
$81.22k - $121.83k
...(UM) Clinician is responsible for conducting benefit coverage reviews and utilization management according to applicable regulatory... ...opportunities to improve service, reduce administrative cost, ensure clinically appropriate delivery of benefit covered services, and support...Remote workContract workWork at officeWork from home$185 per hour
...compliant AI platform that unifies intake, clinical documentation, coding, and quality... ...~ ~3+ years in home-health QA/OASIS review, utilization review, or clinical documentation... ...in a fast-moving startup environment and remote collaboration tools. Reliability counts...Remote workContract workReliefShift workWeekend work$55 - $75 per hour
...Per Diem, Non-Exempt (Hourly) Location: Sacramento, CA (Remote/Hybrid) Compensation : $55-$75 per hour, depending on experience... ...Under the direction of the Associate Director, the Licensed Clinical Reviewer supports clinical documentation review and quality assurance...Remote workHourly payDaily paid10 hours per week- ...Clinical Documentation Reviewer This is a remote position. Position Overview We are seeking a Clinical Documentation Reviewer to support TUWYN's contract... ...involves participating in daily huddles with VA physicians and interdisciplinary teams, prioritizing reviews for...Remote workContract workPart timeFor contractorsMonday to Friday
$115.44k - $173.16k
...Clinical Peer Reviewer Act as a leader and internal consultant to assigned department, committee and/or specialty section regarding peer... ...and performance improvement activities. Collaborates with physicians in determining peer review indicators, what quality measures...Remote workFull timeWork at officeShift work$40 - $45 per hour
...Pay Range: $40 - $45 per hour based on experience Work Hours : 20 hours per week (Mon - Fri) Location : Remote Summary : The Clinical Reviewer is responsible for conducting clinical reviews of submitted prior authorization (PA) requests and pre-payment...Remote workHourly payPart timeFor contractorsWork at officeLocal area$85k - $92k
...Job Title: CLINICAL QUALITY REVIEWER (RN or LCSW) Job ID: 87049 Location: USA- Remote in approved states Overview: We are partnering with a leading organization supporting a large-scale federal healthcare program to identify a Clinical Quality Reviewer. This role...Remote workHourly payWork at officeHome office- ...Clinical Reviewer - Pasrr Under the general supervision of the Associate Director, or designee, the Clinical Reviewer - PASRR is responsible... ...position does not include supervisory responsibilities. Remote position which requires working at computer for all tasks....Remote workWork experience placementWeekend work
- ...We are seeking a qualified SUD MD Reviewer to conduct a retrospective utilization... ...historically denied cases to determine if standard clinical criteria were appropriately applied.... ...Requirements Work is 100% remote and offers flexible hours. Benefits...Remote workTemporary workLocal areaFlexible hours
$28.37 - $35 per hour
...empower better health outcomes through technology, services, and clinical expertise. Our mission is to innovate health solutions that... ...Job Summary and Responsibilities Acentra seeks a Clinical Reviewer to join our growing team. Job Summary: The Clinical Reviewer...Remote workContract workWork at officeLocal areaMonday to FridayFlexible hoursShift workWeekend work- ...employees work. Our positions are classified as hybrid, onsite or remote. While the majority of our employees are hybrid, the following... ...Required Work Experience ~2 years of experience in clinical field of practice, health insurance, or other health care related...Remote workFull timeContract workWork experience placementWork at office1 day per week
- ...Clinical Appeals Reviewer (Licensed Healthcare Professional) Fully Remote-United States Job Type Full-time Description Overview Tanaq Support Services (TSS) delivers professional, scientific, and technical services and information technology (IT) solutions...Remote workFull timeContract workPart timeFor contractorsWork at officeLocal areaNight shift
$73.2k - $122k
...following: Laboratory molecular and genetic testing clinical case review activities. Evaluate telephone, fax, or web requests for... ...coverage of molecular and genetic laboratory requests from physician offices; comparing requests against established clinical protocols...Remote workLocal areaWork from homeFlexible hours$90.87 - $154.33 per hour
A healthcare management organization is seeking a remote Physician Clinical Reviewer specialized in Pediatric Rheumatology. The role entails reviewing clinical cases where medical necessity isn't initially met, consulting with healthcare providers, and ensuring proper...Remote job- A leading healthcare service provider in the United States is looking for a Clinical Appeals Reviewer. This fully remote position involves reviewing appeal cases and making independent decisions based on medical evidence. Candidates must be licensed healthcare professionals...Remote job
$90.87 - $154.33 per hour
A leading pharmacy benefit manager is looking for a remote Physician Clinical Reviewer specializing in Pediatric Rheumatology. This role involves collaborating with physicians to review service requests and ensure compliance with medical necessity guidelines. Candidates...Remote job$28.37 - $39.19 per hour
A healthcare technology firm is seeking a Clinical Reviewer for Substance Use on a PRN basis. The role involves reviewing patient records against... ...at least 3 years of clinical experience. The position is remote and offers a pay range of $28.37 to $39.19 per hour, along...Remote jobHourly payRelief$90.87 - $154.33 per hour
A leading pharmacy benefits manager is seeking a Physician Clinical Reviewer - Pediatric Rheumatology for a remote position. The ideal candidate will handle medical reviews and collaborate with healthcare professionals. Key requirements include a medical degree (DO, MBBS...Remote job$90.87 - $154.33 per hour
A healthcare solutions company is seeking a Physician Clinical Reviewer to evaluate service requests and ensure compliance with medical necessity... ...degree, along with 5 years of clinical experience. This remote role involves interaction with physicians and requires strong...Remote job- A leading pharmacy benefit manager is seeking a Physician Clinical Reviewer for Pediatric Rheumatology to work remotely. The role involves reviewing clinical requests that do not initially meet medical necessity guidelines and interacting with healthcare providers. Candidates...Remote job
- A leading pharmacy benefit management firm is looking for a Physician Clinical Reviewer specializing in Pediatric Rheumatology. This remote role requires 5+ years of clinical experience and involves reviewing service requests for medical necessity. You will work closely...Remote job
- A healthcare organization seeks a Physician Clinical Reviewer specializing in Pediatric Rheumatology for a remote role. This critical position involves timely medical review of service requests and interaction with physicians and health plan members. Candidates must hold...Remote job
- A healthcare consulting firm is looking for experienced Physical Therapists licensed in Colorado to provide clinical reviews remotely. In this independent contractor role, you will review medical records, prepare clinical summaries, and answer client inquiries on treatment...Remote jobFor contractors
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