Remote Healthcare Case Reviewer — Utilization & Medical Mgmt
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Integrated Management Strategies (IMS) LLC, a woman-owned small business in the Washington DC area, is seeking an experienced Case Reviewer to join our healthcare consulting practice. This fully remote role allows you to work from anywhere in the United States but requires Maryland residency and quarterly training visits to Columbia, MD. As a Case Reviewer in the Utilization Management department, you will perform utilization review and medical management of prior authorizations, ensuring #J-18808-Ljbffr Jobless
- ...area, is seeking an experienced Case Reviewer to join our healthcare consulting practice. This fully remote role allows you to work from... .... As a Case Reviewer in the Utilization Management department, you... ...perform utilization review and medical management of prior authorizations...Remote jobMedical
$77.25k - $128.75k
...Department Name: Utilization Mgmt Work Shift: Day... ...for. As a Remote RN Utilization Management Care Reviewer , you’ll play a critical... ...to review medical necessity, optimize... ...coordination, or case management—and experience... ...comprehensive healthcare solutions for Maricopa...Remote workMedicalFull timeWork experience placementMonday to FridayShift work$7.5k
...LPN Licensed Practical Nurse - Utilization Mgmt Reviewer - Case Management - Full Time Cortland, NY, United... .... Experience with CPT/ICD coding, medical record or chart auditing, and experience... ...relationships with members of the healthcare team. Proactively researches case...MedicalFull timeWork at officeRelocation packageShift work$174.07k - $374.92k
...Health Title: Full-Time Utilization Management Physician Reviewer Location: Remote/ Treehouse Role... ...responsible for ensuring medically appropriate care is recommended... ..., external UM and case management staff, internal... ...a mission to rebuild healthcare as it should be, providing...Remote workMedicalHourly payFull timeLocal area- A recognized healthcare provider is seeking a Board Certified Orthopaedic... ...Spine Surgeon to conduct utilization reviews. This telework position... ...Responsibilities include reviewing medical records, ensuring compliance... ...clear rationale for case decisions. Preferred candidates...Remote jobMedicalFor contractorsMonday to FridayFlexible hours
- ...recognized Independent Review Organization (IRO),... ...an active New York medical license and Workers... ...to conduct Utilization Reviews. This is a fully remote, non-clinical role... ...99) status Average case takes 15 minutes or... ...outcomes across the healthcare system. Apply today...Remote workMedicalPrice workExtra incomeFor contractorsFlexible hours
- ...integrating, and monitoring the utilization of behavioral health (BH... .... Refers appropriate cases to the Medical Director for review and works closely with... ...supporting the Lifetime Healthcare Companies' mission and... ...may be opportunity for remote work within all jobs posted...Remote workMedicalContract workWork at office
$219k - $286.9k
.... We're hiring a Physician Reviewer to join our Utilization Management team. Oscar... ...You will determine the medical appropriateness of inpatient... ...Work Location: This is a remote position, open to candidates... ...decisions during case review. Meet the appropriate...Remote workMedicalFull timeLocal areaWork from homeHome officeWeekend work- Oak Street Health is seeking a Full-Time Utilization Management Physician Reviewer to provision accurate and timely coverage determinations... .... You will coordinate with providers, UM and case management staff, and regional medical leaders to ensure the right care is delivered...Remote jobMedicalFull time
$65k - $75k
Piper Companies is seeking a Remote Utilization Management/Review Nurse to evaluate member cases, ensuring medical necessity and appropriate healthcare service utilization. The role requires clinical expertise and collaboration with providers to make high-quality care...Remote jobMedical$204.76k - $292.52k
...team. The Physician Reviewer is the primary physician reviewer for Utilization Management (UM) cases in our organization.... ...from accredited Medical School with a valid,... ...we’re transforming healthcare for seniors and changing... ...please see job aid HERE to apply #LI-RemoteRemote workMedicalHourly payFull timeWork at officeLocal area- ...Oak Street Health is seeking a Full-Time Utilization Management Physician Reviewer to determine coverage for inpatient and outpatient services using... ...collaboration with internal and external teams to ensure medically appropriate care is provided to patients. Ideal...Remote workMedicalFull time
- ...Oak Street Health is seeking a Full-Time Utilization Management Physician Reviewer to provision timely UM determinations for inpatient and outpatient services... ...with Transitional Care, PCP teams, and regional medical leaders to ensure medically appropriate care. This role...Remote workMedicalFull time
- ...Oak Street Health is seeking a Full-Time Utilization Management Physician Reviewer to determine coverage for inpatient and outpatient services using... ...judgment. You will coordinate with care teams to ensure medically appropriate care and maintain regulatory compliance across...Remote workMedicalFull time
- ...Street Health is hiring a Full-Time Utilization Management Physician Reviewer to determine coverage for inpatient... ...CMS and MCG guidelines to ensure medically appropriate recommendations. Requirements... ...care with UM experience. This remote role offers a comprehensive benefits...Remote workMedicalFull time
- ...Oak Street Health is seeking a full-time Utilization Management Physician Reviewer to provision accurate coverage determinations for inpatient and outpatient... ...role requires collaboration with care teams to ensure medically appropriate care is recommended and aligned with...Remote workMedicalFull time
- ...Oak Street Health seeks a Full-Time Utilization Management Physician Reviewer to determine inpatient and outpatient coverage using UM criteria and clinical... ...judgment, coordinating with care teams to ensure medically appropriate care. The role emphasizes staying current...Remote workMedicalFull time
- ...Oak Street Health is seeking a Full-Time Utilization Management Physician Reviewer to determine inpatient and outpatient coverage using UM criteria and... ...with Transitional Care and PCP teams to ensure medically appropriate care, aligning with CMS guidelines and internal...Remote workMedicalFull time
$68.64k - $72.8k
...Overview: The RN Reviewer position is a... ...to determine the medical appropriateness of... ...simplifying the way healthcare is delivered and contributes... ...and retrospective cases to ensure... ...collaboration skills across remote teams... ...understanding of utilization and case management...Remote workMedicalHourly payFull timeFlexible hoursShift workWeekend work$23 - $27 per hour
...Solutions is looking for a Case Reviewer to join our team of professionals... ...the position is performed remotely Monday through Friday,... ...responsible for performing utilization reviews to authorize services... ...program policies, verifying medical, technical, and financial eligibility...Remote workMedicalWork at officeWork from homeMonday to FridayShift work$85k - $90k
...clinical excellence to healthcare. We are a leading... ..., and Readmission Reviews. Under the... ...while identifying cases requiring clinical... ...This is a fully remote position. Candidates... ...productivity daily utilizing department productivity... ...level courses in medical terminology,...Remote workMedicalFull time- ...area, specializing in healthcare, technology, and... ...seeking an experienced Case Reviewer to join our healthcare... ...practice. The role is fully remote within the US,... ...critical role in our Utilization Management department... ...utilization review and medical management of prior...Remote workMedicalLocal areaWork from home
- ...features. Location: Remote (Must reside in IL,... ...their Medicare Utilization Management team as Physician Reviewers. In this remote role... ...direct patient care or medical diagnosis. Key... ...and anticipate future healthcare needs. Partner with case managers on...Remote workMedicalFull timeWeekend work
$86.92k - $153k
...surveillance of observation cases and works with PA discussing... ...8. Completes and documents utilization reviews, physician advisor referrals... ...Atlantic Health Morristown Medical Center, Morristown, NJ... ...Atlantic Health CentraState Healthcare System, Freehold, NJ Atlantic...MedicalHourly payFull timeTemporary workPart timeFor contractorsFor subcontractorFlexible hours- ...Clinical Physician Reviewer to join our... .... This is a fully remote opportunity for a... ...strong background in utilization review and clinical... ...complex hospital cases to ensure accurate... ...that directly impact healthcare quality and... ...compliant Evaluate medical records, diagnostic...Remote workMedical
$219k - $286.9k
Oscar Health is hiring a Physician Reviewer to join our Utilization Management team. You will determine the medical appropriateness of inpatient, outpatient, and pharmacy... ...and applying evidence-based guidelines. This remote role in the United States offers work from home...Remote jobMedicalWork from home- ...Street Health is seeking a Full-Time Utilization Management Physician Reviewer to provide timely coverage... ...coordinate with care teams, and ensure medically appropriate recommendations for patients... ...UM experience are required. Remote work option, standard full-time hours...Remote jobMedicalFull time
- ...Street Health is seeking a Full-Time Utilization Management Physician Reviewer to provide timely coverage... ...criteria and clinical judgment. This remote role collaborates with Transitional... ...Medicaid, MD or DO from an accredited medical school, an unrestricted US medical...Remote jobMedicalFull time
- Oak Street Health is seeking a Full-Time Utilization Management Physician Reviewer to provide accurate coverage determinations for inpatient and outpatient... ...emphasizes coordination with care teams to ensure medically appropriate care is delivered at the right time and...Remote jobMedicalFull time
- ...Street Health is seeking a Full-Time Utilization Management Physician Reviewer to ensure accurate coverage... ...clinical judgment. Candidates must have a medical degree, at least one year of... ...practice in the US. This position offers remote work options and competitive compensation...Remote jobMedicalFull time
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