Remote Physician Reviewer Medicare Utilization Management
Solving IT
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
- ...IntePros is seeking a Physician Reviewer to provide remote support for a healthcare organization. The role involves reviewing medical necessity... ...a collaborative environment with opportunities to leverage clinical expertise in utilization management. #J-18808-Ljbffr...Remote work
- ...Oak Street Health is seeking a Full-Time Utilization Management Physician Reviewer to ensure accurate coverage determinations for inpatient and outpatient... ...a license to practice in the US. This position offers remote work options and competitive compensation packages,...Remote workFull time
$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... ...Director, Utilization Management. Work Location: This is a remote position, open to candidates who reside in the...Remote workHourly payFull timePart timeLocal areaWork from homeHome officeWeekend 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- 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
- ...Role Overview Our Utilization Management Reviewers evaluate medical necessity for... ...escalate complex cases requiring physician review or additional... ...compliance with Medicaid and Medicare industry standards... ...Flexible work solutions include remote options, hybrid work...Remote workMonday to FridayFlexible hoursWeekend work
- ...Working remotely on a full-time basis, the State Licensed Utilization Reviewer will perform utilization reviews on workers' compensation treatment referrals, ensuring... ...necessity and contributing to effective claims management. Key responsibilities: Utilize clinical...Remote workFull time
$86k - $117.3k
...roles that are 100% remote or hybrid, you must... ...We offer integrated managed care products, pharmaceutical... ...a supervisor, the Utilization Management Reviewer evaluates medical... ...cases requiring physician review or additional... ...standards, including Medicare, Medicaid, and private...Remote workHourly payContract workMonday to FridayFlexible hoursWeekend work- ...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...
- ...Working part-time in a remote capacity, the Illinois Licensed Utilization Reviewer will manage utilization review calls for Behavioral Health Services, including precertification... ...appeals Collaborate with clinical staff and physicians to communicate patient status and advocate for...Remote workPart time
$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- ...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
- 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
- ...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
$65k - $88.6k
...of our caring community The Utilization Management Behavioral Health... ...technical difficulties in a remote environment. Ability to work... ...experience with utilization review process Experience with behavioral... ...quality of life for people with Medicare and Medicaid, families,...Remote workFull timeTemporary workApprenticeshipPrivate practiceWork at officeWork from homeHome office- ...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
$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- ...adolescents, and adults as well as outpatient services such as medication management, case management, and counseling. Job Summary Mental Health Resource Center is looking for a Utilization Management Reviewer to monitor the utilization of clinical services provided at Mental...Full timeMonday to FridayFlexible hours
- ...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
- ...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
$32 per hour
...an ongoing need for Document Reviewers. Document Reviewers will review... ...! Position Details Remote work-from-home opportunity... ...required. Proficiency in utilizing modern technology, especially... ...investigation and data recovery and management needs of our clients....Remote workHourly payTemporary workWork from homeHome officeMonday to ThursdayFlexible hours$87k - $115k
...Location TX US (Primary) Category Management Travel Minimal Compensation... ...infrastructure meets innovation-shaping roads, utilities, and communities for the future. At ORC,... ...documents within approved systems Review documents to prepare reports detailing...Daily paidFull timeWork experience placementWork from homeRelocationHome office- ...Medical Review Position Performs medical reviews using established criteria sets and/or performs utilization management of professional, inpatient or outpatient, facility benefits or services... ...Friday. This position will be remote after 6 months of onsite training....Remote workFull timeContract workWork at officeMonday to Friday
- ## 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
$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- ...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
- ..., 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 workFull timeRelocationRelocation packageFlexible hours
$7.5k
...LPN Utilization Management Reviewer This position is eligible for up to $15,000.00 Sign on Bonus for those that are eligible. ($7,500.00 for those... ...with Care Coordination, Guthrie Clinic offices, other physician offices, and the Robert Packer Hospital Business Office,...Full timeWork at officeRelocation package$120k - $150k
...Senior Design Manager/Document Controller Fleet Data Centers designs... ...and coordinate design reviews to ensure compliance with specifications... ...document control systems: utilize document management platforms... ..., TX. Will also consider remote candidates. Fleet Data Centers...Remote workWork at office
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