Remote Physician Reviewer — Medicare Utilization Management
Solving IT
- Remote job
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 to ensure quality care for members. Candidates must be board-certified physicians with a minimum of 5 years of clinical experience. A comprehensive benefits package including health plans and 401(k) is offered, promoting equality and diversity in the workplace. #J-18808-Ljbffr Solving IT
- ...Working fully remote in a full-time capacity, the Utilization Management Physician Reviewer will be responsible for making accurate coverage determinations for inpatient... ...providing Utilization Management services to Medicare and/or Medicaid populations A current,...Remote workFull time
- ...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
- ...Place to Work” company is seeking a Physician to provide utilization review services for the Group Health... ...required Experience in Utilization Management with criteria review utilizing standard... ...practice guidelines Medicaid/Medicare experience preferred JOB...Remote work
$174.07k - $374.92k
...Full-Time Utilization Management Physician Reviewer We're building a world of health around every individual... ...Company: Oak Street Health Location: Remote/ Treehouse Role Description:... ...Utilization Management services to a Medicare and/or Medicaid line of business...Remote workHourly payFull time- Oak Street Health is seeking a Full-Time Utilization Management Physician Reviewer to ensure accurate coverage determinations for inpatient and outpatient... ...a license to practice in the US. This position offers remote work options and competitive compensation packages,...Remote jobFull time
$130 - $145 per hour
Hi, we’re Oscar. We’re hiring a part-time Physician Reviewer to join our Utilization Management team. Oscar is the first health insurance company built around... ..., Utilization Management. Work Location This is a remote position, open to candidates who reside in the United...Remote workHourly payFull timePart timeLocal areaWork from homeHome officeWeekend 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 workFor contractorsMonday to FridayFlexible hours
- ...Working remotely on a full-time basis, the State Licensed Utilization Reviewer will perform utilization reviews on workers' compensation treatment referrals, ensuring... ...necessity and contributing to effective claims management. Key responsibilities: Utilize clinical...Remote workFull time
$204.76k - $292.52k
...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-RemoteRemote workHourly payFull timeReliefWork at officeLocal area- ...and monitoring the utilization of behavioral... ...Medical Director for review. Refer to and... ...closely with Case Management to address member... ...with the treating physician or other providers... ...contracts (Medicare and Medicaid) and... ...opportunity for remote work within all jobs...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$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- 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
- ...organization. Identifies opportunities to manage members' clinical situations with a... ...service requests. Participates in the Physician Review Units' appeal process of service denials... ...patient care or medical diagnosis.) Remote 20 - 40 hours/week and possible weekend...Remote workContract workWeekend work
- ...job and more exclusive features. Location: Remote (Must reside in IL, MT, NM, OK, TN, or TX) Position... ...is seeking experienced, board-certified physicians to join their Medicare Utilization Management team as Physician Reviewers. In this remote role, you will review...Remote workFull timeWeekend 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
- ## Reviewer I, MedicalApplyremote type: Hybridlocations: Myrtle Beach, South Carolinatime... ...criteria sets and/or performs utilization management of professional, inpatient or outpatient... ...through Friday. **This position will be remote after 6 months of onsite training.****...Remote workFull timeContract workFor contractorsWork at officeLocal areaMonday to Friday
$42.18 - $51.56 per hour
...healthcare? Bring your true colors to blue. The Physical Therapy Utilization Management Reviewer is responsible for evaluating the appropriateness and... ...Test. Interact with treating providers, PCPs, physicians, therapists, and facilities as needed to gather clinical...Hourly payFull timeWork at officeFlexible hoursShift 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 jobContract work
$32 per hour
...an ongoing need for Document Reviewers. Document Reviewers will review... ...litigation! Position Details Remote work-from-home opportunity... ...is required. Proficiency in utilizing modern technology, especially... ...investigation and data recovery and management needs of our clients. Serving...Remote workHourly payTemporary workWork from homeHome officeMonday to ThursdayFlexible hours- ...Job Description Job Description Physician Peer Reviewer – Multiple Specialties in Texas and/... ...Review Organization (IRO) with Health Utilization Management (HUM) accreditation. For the past 30... ...external reviews Job Type Contract Work Location Remote...Remote workContract workWork experience placementWork at office
$87k - $115k
...Utilities Right of Way Document Specialist Manager - Texas - (1790) Location : Texas (candidate will have the flexibility to work out of their home office but... ...and other documents within approved systems. Review documents to prepare reports detailing ownership information...Daily paidFull timeWork from homeRelocationHome office- ...Utilization Management Reviewer Mental Health Resource Center is a not-for-profit Florida corporation that provides a wide range of mental health and behavioral health care services to the community such as 24-hour emergency services, inpatient psychiatric services...Full timeWork at officeMonday to Friday
- Beyond Blue Job Posting Title: Utilization Management Reviewer Requisition Number: R-000002878 Department Name: Supervisor, Utilization Review Work... ...certifications and authorizations. Coordinates with physicians, care teams, and ancillary staff to support effective discharge...Full timePart timeWork experience placementReliefInternshipShift work
- ..., seeks BC/BE Internal Medicine physicians to join our expanding Department... ...transform health care across the state utilizing a clinically integrated network,... ...of Digital Health services Remote Patient Monitoring for chronic disease management Centralized Call Center and...Remote workRelocationRelocation packageFlexible hours
$87.7k - $157.8k
...clinical professional on our Medical Management/Health Services team. Centene is a... ...workplace flexibility. Centene is Hiring - Remote Psychologist Reviewers (ABA) Centene is seeking Remote... ...on best practice models and utilization management processes Interact with...Remote workFull timePart timeWork at officeFlexible hours$50 per hour
...and Jack Dorsey . Position: Energy/Utilities — Visual Document Understanding Type:... ...Compensation: $50/hour Location: Remote Commitment: 15–20 hours/week Role... ...-truth outputs and objective rubrics. Review and improve AI model outputs to ensure...Remote workContract workSummer work$35 - $37 per hour
...Lead RN Reviewer Cohere's Service Operations team is responsible... ...~5+ years in healthcare, managed care, or insurance-related roles... ...license (BSN preferred) ~ Utilization Management experience required... ...leadership style suited for a remote, fast-paced environment...Remote workHourly payFlexible hours$7.5k
...LPN Licensed Practical Nurse - Utilization Mgmt Reviewer - Case Management - Full Time Cortland, NY, United States Job Description This position is eligible... ...with Care Coordination, Guthrie Clinic offices, other physician offices, and the Robert Packer Hospital Business...Full timeWork at officeRelocation packageShift work$120k - $150k
...Overview As the Senior Design Manager / Document Controller will... ...Conduct and coordinate design reviews to ensure compliance with specifications... ...document control systems: utilize document management platforms... ..., TX. Will also consider remote candidates. EEO and...Remote workWork at office
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