Remote Utilization Management Physician Reviewer
Oak Street Health
- Remote job
Oak Street Health is seeking a Full-Time Utilization Management Physician Reviewer to provide accurate coverage determinations for inpatient and outpatient services, applying UM criteria, clinical judgment, and internal policies. You will coordinate with care teams to ensure medically appropriate care is delivered in the right setting, at the right time. The role requires an active US medical license, MD/DO degree, and 3–5 years of primary care experience, with a focus on managed care and care #J-18808-Ljbffr Oak Street Health
- ...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 workFull timeWork from home
- ...certified "Great Place to Work" company is seeking a Physician to provide utilization review services for the Group Health Department. This role... ...business background required Experience in Utilization Management with criteria review utilizing standard practice...Remote work
- ...Oak Street Health is seeking a Utilization Management Physician Reviewer for a fully remote, full-time role. You will apply UM criteria and clinical judgment to determine coverage for inpatient and outpatient services, coordinating with care teams to ensure appropriate...Remote workFull time
- ...A leading independent review organization is seeking a Utilization Management Physician Reviewer for a full-time remote role. Candidates must possess an active Nebraska medical license and have a minimum of 5 years clinical practice experience. Responsibilities include...Remote workFull timeCasual workMonday to Friday
- ...Oak Street Health is seeking a Full-Time Utilization Management Physician Reviewer to provide accurate coverage determinations for inpatient and outpatient services, applying UM criteria, clinical judgment, and internal policies. You will coordinate with care teams to...Remote workFull time
$219k - $286.9k
...Hi, we're Oscar. We're hiring a Physician Reviewer to join our Utilization Management team. Oscar is the first health insurance company built around a full stack... ...every 16 weeks Work Location: This is a remote position, open to candidates who reside in the United...Remote workFull timeLocal areaWork from homeHome officeWeekend work$230k
...Utilization Management Physician Reviewer We're building a world of health around every individual — shaping a more connected, convenient and compassionate... ...time. Company: Oak Street Health Location: Fully Remote Hours: Full-Time, Monday - Friday, 8am -5pm CST...Remote workFull timeMonday to Friday- Oscar Health seeks a Physician Reviewer to join the Utilization Management team in a remote US-based role. You will determine the medical appropriateness of services and document decisions using evidence-based guidelines and Oscar workflows. Responsibilities include timely...Remote job
- In this remote contract role, the physician reviews clinical service requests from members and providers, applying clinical judgment and managed care criteria to determine appropriate care. The work... .... Preferred Experience in utilization review, case review, or related...Remote workFull timeContract workWeekend workWeekday work
- ...Role Overview Our Utilization Management Reviewers evaluate medical necessity for inpatient and outpatient... ...escalate complex cases requiring physician review or additional intervention... ...Flexible work solutions include remote options, hybrid work schedules, competitive...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 workFor contractors
$204.76k - $292.52k
...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 timeWork at officeLocal area$86k - $117.3k
...For roles that are 100% remote or hybrid, you must have access... ...most. We offer integrated managed care products,... ...direction of a supervisor, the Utilization Management Reviewer evaluates medical necessity... ...escalate complex cases requiring physician review or additional...Remote workHourly payContract workMonday to FridayFlexible hoursWeekend work2 days per week- ...nationally recognized Independent Review Organization (IRO), is expanding its panel of Physician Reviewers. We are... ...Certification to conduct Utilization Reviews. This is a fully remote, non-clinical role... ...portal and streamlined case management Full onboarding and ongoing...Remote workPrice workExtra incomeFor contractorsFlexible hours
$130 - $145 per hour
...Hi, we're Oscar. We're hiring a Behavioral Health Physician Reviewer to join our Utilization Management team. Oscar is the first health insurance company built... ...Management. Work Location: This position is fully remote and open to candidates residing in the U. S. , excluding...Remote workHourly payFull timePart timeWork from homeHome office- 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 MMRO Managed Medical Review Organization (MMRO) is a nationally recognized... ...of experienced practicing physicians. MMRO is committed to... ...questions. Reviews are conducted remotely and do not require direct... ...turnaround times. Utilize MMRO review templates and ensure...Remote workFull timeTemporary workFor contractorsFlexible hours
- ...Independent Contractor (1099) Remote Opportunity Required State... ...Founded in 1983, Medical Review Institute of America (MRIoA... ...specializing in technology-driven utilization management and clinical medical review... ...seeking Board-Certified physicians in Dermatology to conduct...Remote jobFor contractorsFlexible hours
$35 - $40 per hour
...service offerings for clinical, case management, member engagement, provider... ...containment, and analytics. Job Title RN Utilization Management Reviewer Responsibilities Conduct timely clinical... ...require weekends. Location: Fully remote work at home role. Secure, private area...Remote workHourly payTemporary workMonday to FridayFlexible hoursWeekend work- Cook Children's Health Care System is seeking a Registered Nurse Utilization Management/Episodic Case Manager (UM/ECM - RN) Reviewer to coordinate the efficient utilization of health care resources for CCHP members and ensure timely, quality care throughout the continuum...Remote job
- ChenMed is seeking a Physician Reviewer to serve as the primary reviewer for Utilization Management (UM) cases across the assigned markets. You will advise other physician reviewers and participate in daily health plan calls to coordinate care for patients. This role supports...Local area
- ...System team, and The Power of Every One. Job Title Utilization Management RN Reviewer Location Cleveland Facility Remote Location Department Utilization And Quality... ...denials appeals process, clinical team interaction, Physician Adviser interaction and special projects. A...Remote workFull timeWork at officeShift workWeekend work
- Coastal Care Services, Inc. is seeking an LPN licensed Utilization Management Nurse Reviewer for a work-from-home opportunity serving the Miami, FL... ...Equipment, reviews medical necessity, collaborates with physicians, patients and families to assure cost-effective, high-quality...Remote jobWeekday work
$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- 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
- ...join our dynamic team of expert reviewers! In this role, you will have the opportunity to utilize your medical expertise to conduct... ...clients. We are looking for Physicians in the following area: ~ Internal Medicine/Pain Management Be a part of a team that values...Remote workFor contractors
$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- Oak Street Health is seeking a Utilization Management Physician Reviewer to determine inpatient and outpatient coverage using UM criteria and clinical judgment. You will coordinate with care teams to ensure appropriate care, while aligning with CMS guidelines and organizational...Remote job
- 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
- Elevance Health is seeking a Psychologist Reviewer - ABA to join our behavioral health team in a virtual, full‑time capacity. You will... ...clinical/counseling psychology, an active license, and experience in managed care. Travel is not required, training sessions are in-person...Remote jobFull time
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