Sign up to access all features of our service.
  • Job search
  • Favorites
  • Create a CV
    New
  • Salaries
  • Subscriptions

Remote Physician Reviewer — Medicare Utilization Management

Solving IT

New York, NY
  • 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

Vacancy posted 4 days ago
Similar jobs that could be interesting for youBased on the Remote Physician Reviewer — Medicare Utilization Management in New York, NY vacancy
  •  ...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

    Dane Street

    United States
    23 hours ago
  • $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 work
    Hourly pay
    Full time
    Local area

    Hispanic Alliance for Career Enhancement

    Springfield, IL
    23 hours ago
  • $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 work
    Hourly pay
    Full time
    Part time
    Local area
    Work from home
    Home office
    Weekend work

    Oscar Health

    New York, NY
    1 day ago
  • 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 work
    For contractors
    Monday to Friday
    Flexible hours

    Dane Street

    Washington DC
    1 day ago
  •  ...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 work
    Price work
    Extra income
    For contractors
    Flexible hours

    Dane Street

    New York, NY
    1 day ago
  •  ...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 work
    Hourly pay
    Full time
    Local area

    ChenMed

    United States
    8 days ago
  • $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 work
    Minimum wage
    Full time
    Work experience placement
    Work at office
    Local area
    Work from home

    UnitedHealth Group

    San Antonio, TX
    1 day ago
  • 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 work
    Extra income
    Contract work

    Dane Street

    California, MO
    23 hours ago
  •  ...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

    Swedish Medical Group

    Seattle, WA
    23 hours ago
  • $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

    North East Medical Services

    Burlingame, CA
    1 day ago
  • $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 job
    Full time
    Relocation

    HealthPlus Staffing

    Daytona Beach, FL
    18 days ago
  •  ...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 work
    Contract work

    The Judge Group, LLC

    New York, NY
    4 days ago
  • 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 work
    Contract work
    For contractors

    Dane Street

    Washington DC
    1 day ago
  •  ...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 work
    Contract work
    Flexible hours

    AFMC

    Fort Smith, AR
    1 day ago
  •  ...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 work
    Weekend work

    Integrated Resources

    United States
    2 days ago
  •  ...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 work
    Contract work
    Weekend work

    VIVA

    United States
    4 days ago
  •  ...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 work
    Monday to Friday
    Shift work
    Weekend work

    Mindlance

    United States
    3 days ago
  •  ..., 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 work
    Relocation
    Relocation package
    Flexible hours

    Prisma Health

    Columbia, SC
    6 days ago
  •  ...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 work
    For contractors
    Monday to Friday

    Dane Street

    United States
    2 days ago
  •  ...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 work
    Full time
    Weekend work

    Solving IT

    New York, NY
    3 days ago
  • ## 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 work
    Full time
    Contract work
    For contractors
    Work at office
    Local area
    Monday to Friday

    Southcarolinablues

    Myrtle Beach, SC
    2 days ago
  • $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 pay
    Full time
    Work at office
    Flexible hours
    Shift work

    Blue Cross Blue Shield of Massachusetts

    Hingham, MA
    1 day ago
  •  ...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 work
    Contract work
    Work experience placement
    Work at office

    Federal Hearings And Appeals

    Wilkes Barre, PA
    4 days ago
  • $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 pay
    Full time
    Work at office
    Flexible hours
    Shift work

    Blue Cross and Blue Shield of Massachusetts, Inc.

    Hingham, MA
    1 day ago
  •  ...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

    HURC Healthcare Solutions

    Short Hills, NJ
    1 day ago
  • $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 job
    Hourly pay
    Relief
    Local area

    Acentra Health

    Downers Grove, IL
    3 days ago
  •  ...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 work
    Work from home

    Remote Jobs Solutions

    San Jose, CA
    1 day ago
  •  ...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

    UPMC Southwestern PA

    Monroeville, PA
    1 day ago
  •  ...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

    Translation Commons

    Cupertino, CA
    2 days ago
  • $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 work
    Work at office

    Tract Capital Management, LP

    Alexandria, VA
    23 hours ago

Do you want to receive more vacancies?

Subscribe and receive similar vacancies to Remote Physician Reviewer — Medicare Utilization Management. Be the first to apply!