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
- ...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
- ...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
- ...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
$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
...care one person, one family and one community at a time. Company: Oak Street Health Title: Utilization Management Physician Reviewer Location: Fully Remote Hours: full time, Monday - Friday, 8am -5pm Salary: $230k per year Role Description:...Remote workHourly payFull timeLocal areaMonday to Friday- ...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
- ...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
$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$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- ...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
$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- ...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
- Cook Children's Health Plan in Fort Worth, TX seeks an experienced RN Reviewer for Utilization Management to coordinate care and ensure timely, quality services for plan members. The role focuses on behavioral health and ambulatory care, with cross-training across areas...Remote job
$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- ...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- ...leading healthcare organization is seeking a RCS-Physician Advisor to join their Denial Management team. This full-time remote position requires a medical degree and board... ...to help optimize hospital services and resource utilization. #J-18808-Ljbffr Indiana University HealthRemote jobFull time
$134.6k - $230.8k
...quality organization supporting utilization management operations across a large,... ...across utilization management, physician advisor functions, peer-to-peer review support, and appeals operations... ...enjoy the flexibility to work remotely * from anywhere within the U.S....Remote workMinimum wageFull timeWork experience placementWork at officeLocal area- ...Comagine Health is seeking a Clinical Reviewer with LCSW/LPC/LCPC licensure for a remote, Oregon-based role requiring travel to Salem and surrounding areas... ...diverse populations. The position emphasizes utilization review, documentation, and collaboration with stakeholders...Remote workWork from home
- ...the organization. Identifies opportunities to manage members' clinical situations with a view toward... ...management for members whose cases come for review, in partnership with case managers. Participates in the Physician Review Units' appeal process of service denials...Remote work
- ...Summary: We are seeking a highly experienced DRG Clinical Physician Reviewer to join our growing clinical review team. This is a fully remote opportunity for a physician with a strong background in utilization review and clinical validation who thrives in a fast-paced,...Remote work
- ...Comagine Health in Oregon seeks a Clinical Reviewer to evaluate medical necessity and... ...review clinical documentation, perform utilization reviews, and document determinations in... ...across children, youth, and adults. This remote, Oregon-based role requires active licensure...Remote work
- ...A leading Independent Review Organization is seeking a Board-Certified Physical... ...Rehabilitation provider to perform Utilization Reviews. This fully remote role offers flexible scheduling and... ...Certification. Apply to join our Physician Review Panel and start earning based...Remote workExtra incomeFlexible hours
- ...COMAGINE HEALTH is seeking a remote utilization review clinician based in Oregon to evaluate medical necessity for behavioral health services. The role involves reviewing clinical documentation, performing initial and continued stay assessments, and coordinating care across...Remote work
$213.1k - $308.3k
...communities we serve. The Job The Utilization Management (UM) Physician Medical Director provides physician-... ...organization's prior authorization, concurrent review, and appeals programs. This role... ...308,301 per year Work Mode - Mostly Remote: Employees who reside outside the...Remote workFor contractorsWork at officeLocal areaRelocation- ...Physician Peer Reviewer - Multiple Specialties in Texas and/or New Mexico Overview... ...Review Organization (IRO) with Health Utilization Management (HUM) accreditation. For the past 30... ...reviews Job Type Contract Work Location RemoteRemote workContract workWork experience placementWork at office
$155 - $165 per hour
...job poster from EPITEC As a Physician Reviewer, you'll play a critical role... ...experience Understanding of managed care and proficiency in PC (... ...Experience with managed care and utilization management Strong leadership... ...What We Offer Fully remote work arrangement (Weekends only...Remote workFull timeContract workWork at officeWeekend work$42.18 - $51.56 per hour
...colors to blue. The Role The Clinical Utilization Reviewer is responsible for facilitating care for... ...using clinical skills, principles of managed care, nationally recognized medical... ...Interact with treatment providers, PCPs, physicians, therapists, and facilities as needed...Flexible hoursShift work
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Remote Utilization Management Physician Reviewer. Be the first to apply!
- supervising physician Richmond, VA
- doctors office nurse Richmond, VA
- anesthesia physician Richmond, VA
- physician-geriatric medicine Richmond, VA
- lpn doctors office Richmond, VA
- internal medicine primary care physician Richmond, VA
- doctor work from home Richmond, VA
- physician neurology Richmond, VA
- remote physician reviewer Richmond, VA
- permanent doctor Richmond, VA



