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
- ...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
...time. Company: Oak Street Health Title: Full-Time Utilization Management Physician Reviewer Location: Remote/ Treehouse Role Description This full-time role is... ...experience providing Utilization Management services to a Medicare and/or Medicaid line of business Excellent verbal...Remote workHourly payFull timeLocal area$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
- ...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 ongoing...Remote workPrice workExtra incomeFor contractorsFlexible hours
- ...we 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-Remote...Remote workHourly payFull timeLocal area
$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... ...processes Participates in case review and medical necessity determination...Remote workMinimum wageFull timeWork experience placementWork at officeLocal areaWork from home- 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
- ...Swedish Medical Group is looking for a Physician Advisor to provide leadership within Utilization Management. This fully remote role targets Washington ministries, emphasizing high-value care and effective medical necessity practices. The ideal candidate will have...Remote work
$285.23k - $332.26k
...Mso Physician Reviewer Burlingame, CA 94010 Overview Salary Range... ...for ensuring the appropriate utilization of healthcare services... ...UM team members, and case managers to facilitate efficient and... ...payer guidelines, including Medicare and Medicaid benefit coverage...Full time$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- ...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 workContract work
- A healthcare services company is seeking a physician reviewer to utilize clinical expertise in reviewing insurance appeals and claims. This telework opportunity allows for a customizable schedule while ensuring compliance with client-specific policies. Candidates must hold...Remote workContract workFor contractors
- ...healthcare organization is seeking qualified physicians for contract work conducting prior authorizations and retrospective reviews. The role requires an active medical... ...substantial patient care experience. Physicians will utilize a review platform and need a reliable high-...Remote workContract workFlexible hours
- ...Can work remotely in any state except CA, NY, HI or AK 20 - 40 hours/week and possible... .... Identifies opportunities to manage members' clinical situations with a view... ...service requests. Participates in the Physician Review Units' appeal process of service denials...Remote workWeekend work
- ...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
- ...Medical Reviewer Pay rate is ***/hour fully remote, but must reside in one of our plan states: IL, TX, NM, OK,... ...organization. Identifies opportunities to manage members' clinical situations with... ...managers. Participates in the Physician Review Units' appeal process of...Remote workMonday to FridayShift workWeekend 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
- ...searching for Board Certified Internal Medicine physicians to conduct Independent Medical Exams (IME) and Peer Reviews. This opportunity allows you to customize your... ...Alsip/South Chicago Area JOB SUMMARY: Utilizes clinical expertise, and reviews disability claims...Remote workFor contractorsMonday to Friday
- ...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
- ## 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- ...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
$42.18 - $51.56 per hour
Role Overview The Physical Therapy Utilization Management Reviewer is responsible for evaluating the appropriateness and medical necessity of outpatient... ...Test. Interact with treating providers, PCPs, physicians, therapists, and facilities as needed to gather clinical...Hourly payFull timeWork at officeFlexible hoursShift work- ...Physician Advisor The Physician Advisor... ...physician-to-physician reviews, clinical... ...appropriate resource utilization. Key Responsibilities... ...review and case management teams with... ...of Participation, Medicare regulations, and... ...Experience in a remote or consulting healthcare...Remote work
$70.97 - $125 per hour
...Psychiatrist Physician Reviewer - PRN - Remote (Within Illinois) Acentra Health exists... ...the peer review process, utilization review activities, and... ...in Utilization Management, Case and Disease Management... ...knowledge of Medicaid and Medicare program Knowledge of standards...Remote jobHourly payReliefLocal area- ...A leading payment management solutions provider seeks an Offsite Invoice Payment Specialist to manage utility invoice entries in a work-from-home setup. The role requires high typing speed and self-motivation along with the ability to work independently. Candidates must...Remote workWork from home
- ...Physician Advisor, Quality Utilization Management The Physician Advisor, Utilization Management (UM), provides clinical and management guidance to enhance... ...testing/treatments. Lead the hospital’s Utilization Review Committee, identifying trends and implementing...Full time
- ...Translators and Reviewers, Localization Group (Volunteer) The Translation Commons Localization Group is looking for remote volunteerTranslators and Reviewers to help us translate... ...in Smartcat, the translation management system utilized for the project; Joining...Remote work
$120k - $150k
...Senior Design Manager / Document Controller About this position Fleet... ...and coordinate design reviews to ensure compliance with specifications... ...document control systems utilizing document management platforms... ...safety protocols. Location & Remote Options Location: Denver, CO,...Remote workWork at office
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