Remote Utilization Management Physician Reviewer
Hispanic Alliance for Career Enhancement
Oak Street Health is seeking a Full-Time Utilization Management Physician Reviewer to ensure accurate coverage determinations for inpatient and outpatient services. The role involves collaborating with care teams and making utilization management decisions based on clinical judgment. Candidates must have a medical degree, at least one year of utilization management experience, and a license to practice in the US. This position offers remote work options and competitive compensation packages, reflecting Oak Street's commitment to quality care. #J-18808-Ljbffr
- ...A leading health insurance company is hiring a remote Physician Reviewer to join their Utilization Management team. This role involves determining the medical appropriateness of services based on clinical information and evidence-based guidelines. Candidates should have...Remote work
$174.07k - $374.92k
Oak Street Health, part of CVS Health, is seeking a Full-Time Utilization Management Physician Reviewer to ensure accurate coverage determinations for inpatient and outpatient services. This role requires at least one year of Utilization Management experience in Medicare...Remote workFull time- 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 jobFull timeWork from home
- 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 job
$211.2k - $277.2k
...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- ...Orthopedic Surgeon Utilization Review Opportunity Dane Street, a nationally... ...is expanding its panel of Physician Reviewers. We are currently... .... This is a fully remote, non-clinical role offering... ...portal and streamlined case management Full onboarding and ongoing...Remote workPrice workExtra incomeFor contractorsFlexible hours
- ...Specialty Health System (StarCare) is seeking a full time Utilization Management (UM) Reviewer to join its outstanding Utilization Management team... ...will work in a hybrid work environment (combination of remote and on-site) and must be able to work on-site when job duties...Remote workFull timeWork at officeMonday to Friday
- ...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
- ...certified “Great Place to Work” company is seeking a Physician to provide utilization review services for the Group Health Department. This role requires... ...background required Experience in Utilization Management with criteria review utilizing standard practice guidelines...
- ...additional details. Office Location: Remote Option Available; Flexible for any of... ...position is responsible for facilitating the review of service plans and service... ...appropriate services at a given time. The IDD Utilization Management Reviewer screens authorization...Remote workWork at officeFlexible hours
$150 - $170 per hour
...CareCentrix is seeking a Part-Time Physician Reviewer to conduct utilization reviews, ensuring medical necessity across various services. This role involves... ...at least 3 years of clinical practice and utilization management experience. The position offers flexible hours, paying...Hourly payPart timeFlexible hoursWeekday work- 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
- Position: Licensed Physician Reviewer - Ortho (remote) - ChenMed, Miami, FL The Physician Reviewer is the primary reviewer for Utilization Management/Clinical Appropriateness cases within our organization. The role requires advising other physician reviewers, attending...Remote jobWork at officeLocal area
$90.87 - $154.33 per hour
A healthcare management company is seeking a remote Physician Clinical Reviewer specializing in Dermatology. This role involves reviewing cases that require clinical expertise, interacting with physicians, and providing clinical rationale for appeals. Candidates must hold...Remote job- Overview Medical Review Institute of America (MRIoA) is a nationally... ...organization specializing in utilization management and clinical review services.... ...medical determinations. Position Physician Advisor (UM Medical Director) - Full‑time, remote (United States) Role Summary...Remote workFull timeFlexible hoursShift workWeekend work
- ...Dane Street, LLC is seeking a remote Physician Reviewer for full-time work from home. The role requires an MD or DO, board-certified in Internal or Family Medicine, to perform utilization reviews, including preauthorization and appeals. Ideal candidates will have prior...Remote workFull timeWork from home
$110k - $203.51k
...scientists, digital innovators, program and construction managers and other professionals delivering projects that... ...**AECOM** is seeking an **Assistant Project Manager - Utility Design Reviewer** to work **remotely** . However, the client is located in Sacramento, CA and...Remote workFor contractorsFor subcontractorLocal areaWorldwideRelocationVisa sponsorshipFlexible hours$90.87 - $154.33 per hour
A healthcare company is seeking a remote Physician Clinical Reviewer in Gastroenterology to join their utilization management team. This role requires 5+ years of clinical experience and strong communication skills for effective interaction with medical professionals. The...Remote work- ...A leading pharmacy benefits manager is seeking a Physician Clinical Reviewer specialized in Dermatology for a remote role. This position involves reviewing clinical requests... ...an opportunity to contribute to effective utilization management processes while working within...Remote work
$90.87 - $154.33 per hour
A leading healthcare organization is seeking a Physician Clinical Reviewer specializing in Gastroenterology for a remote role. This position is crucial to the utilization management team, responsible for timely medical reviews of service requests needing clinical evaluation...Remote work$331.41k - $373.44k
...Wapa is seeking a Physician Advisor to provide leadership within Utilization Management. This fully remote position supports Washington ministries, enhancing medical necessity practices and optimizing patient flow through data-driven strategies. Ideal candidates are...Remote work- ...Alignment Healthcare USA, LLC is hiring a Utilization Management Physician Advisor to optimize inpatient and... ...conducting medical necessity reviews and leading utilization management strategies... ...role offers the flexibility of a remote position, ideal for dedicated professionals...Remote work
- ...Job Posting: Medical Director – Utilization Management (Remote) Pay: up to $200 an hour Position: Medical... ...and structural balance many physicians look for when transitioning to payer... ...cases, ensuring high-quality, compliant review processe s.Conduct utilization management...Remote workFull timeContract work
- ...A healthcare company is seeking a Physician Clinical Reviewer specializing in Pediatric Gastroenterology to join their remote utilization management team. This role involves reviewing service requests, collaborating with physicians, and ensuring compliance with medical...Remote work
- Overview Dane Street is an Independent Review Organization and a national provider of Utilization Review services. We are expanding our physician panel with opportunities for non-... ...physicians who are board certified in Pain Management with active California licenses and...Remote workExtra incomeContract work
- ...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 workFull timeContract workLive inWork at office
$240k
...Job Description Job Description Utilization Management Physician (UMP) Remote | Full-Time | Florida Compensation: $240,000 base + bonus Schedule... ...Management Physician to perform medical necessity reviews, peer-to-peer discussions, and clinical determinations...Remote jobFull timeRelocation- A healthcare services company is seeking a full-time remote Utilization Management Physician Reviewer. The role requires a board-certified physician to perform thorough reviews of utilization management cases ensuring high standards of patient care. Responsibilities include...Remote jobFull time
$90.87 - $154.33 per hour
...Prime Therapeutics is seeking a Physician Clinical Reviewer in Pediatric Gastroenterology to join our utilization management team. This fully remote position requires a DO, MBBS, or MD, with at least 5 years of clinical experience. The role involves reviewing medical...Remote work$172.36k - $258.55k
A leading healthcare company is seeking a Physician Advisor for Utilization Management. The role requires a California license and significant experience... ...utilization management. Responsibilities include processing reviews, liaising with medical staff, and overseeing case...Remote job
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