Remote Physician Reviewer — Medicare Utilization Management
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- 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
$211.2k - $277.2k
...Physician Reviewer - Utilization Management You will determine the medical appropriateness of inpatient, outpatient, and pharmacy services by reviewing... ..., 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- 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
$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... ...least one year of Utilization Management experience in Medicare/Medicaid, a clinical license in the U.S., and effective...Remote jobFull time$174.07k - $374.92k
...divh2Full-Time Utilization Management Physician Reviewer/h2pWere building a world of health around every individual... ...: Oak Street Health/ppLocation: Remote/ Treehouse/ppRole Description:/ppThis... ...Management services to a Medicare and/or Medicaid line of business/liliExcellent...Remote workHourly payFull time- ...recognized Independent Review Organization (IRO), is 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...Remote workPrice workExtra incomeFor contractorsFlexible hours
- ...IDD Utilization Management Reviewer Competitive Compensation & Benefits Package! Position eligible for: ~ Annual incentive bonus plan... ...Forgiveness Qualifying Employer Office Location: Remote Option Available; Flexible for any of Partners' NC locations...Remote workWork at officeFlexible 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... ...escalate complex cases requiring physician review or additional... ...compliance with Medicaid and Medicare industry standards... ...Flexible work solutions include remote options, hybrid work...Remote workMonday to FridayFlexible hoursWeekend work
- 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 jobFor contractors
- 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 Dane Street Dane Street is a leading Independent Review Organization (IRO) and national provider of Utilization Review services. As we continue to expand our physician panel, we’re offering flexible, remote opportunities for board-certified physicians seeking supplemental...Remote workExtra incomeFor contractorsFlexible 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$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- 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
$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- Dane Street is seeking a Physician Reviewer based in Bellevue, WA, allowing for customized scheduling and caseloads. This independent contractor... ...a WA license or be willing to obtain one. The position is remote with some in-person exams starting in Bellevue. Dane Street compensates...Remote workFor contractorsFlexible hours
- 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
- 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
$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$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$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$331.41k - $373.44k
Providence Swedish Medical Center is seeking a Physician Advisor to provide leadership in Utilization Management. This fully remote role supports Washington ministries and... ...improving patient flow. Responsibilities include reviewing cases for medical necessity, leading denial...Remote job$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 MD...Remote job- ...provider in New Jersey is seeking a Physician Advisor to provide clinical... ...and conduct physician-to-physician reviews. The candidate will support utilization review and ensure adherence to medical... ...and proficiency in utilization management are essential. This role offers a...Remote job
- A healthcare solutions company is seeking a Physician Clinical Reviewer - Pediatric Gastroenterology to join its remote utilization management team. The role involves reviewing medical service requests, collaborating with physicians, and ensuring compliance with established...Remote job
$248.5k - $373k
...Medical Director For Utilization Management WellMed, part of the Optum family... ...or family medicine physician to join our Utilization Management... ...the flexibility to work remotely from anywhere within the U.... ...processes Participates in case review and medical necessity...Remote jobMinimum wageFull timeWork experience placementWork at officeLocal areaWork from home$90.87 - $154.33 per hour
A leading pharmaceutical service provider is seeking a Physician Clinical Reviewer in Pediatric Gastroenterology. This remote role focuses on utilization management, requiring expertise in clinical review and communication with physicians. Candidates must have a DO, MBBS...Remote job- ...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
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