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
- ...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
- ...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 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
- ...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
- ...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
$219k - $286.9k
...Job Description Hi, we're Oscar. We're hiring a Physician Reviewer to join our Utilization Management team. Oscar is the first health insurance company... ...Utilization Management. Work Location: This is a remote position, open to candidates who reside in the United...Remote workFull timeLocal areaWork from homeHome officeWeekend 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
- ...Physician Reviewer Opportunity Dane Street, a nationally recognized Independent... ...Board Certification to conduct Utilization Reviews. This is a fully remote, non-clinical role offering supplemental... ...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. ,...Remote workHourly payFull timePart timeWork from homeHome office- ...Department Name: Utilization Mgmt Work Shift:... ...As an RN Utilization Management Care Reviewer, you will be an important... ...Team. This 100% remote role manages a typical... ...care and specialty physicians to provide the most... ...CPHQ). Experience with Medicare Advantage, ACOs,...Remote workFull timeMonday to FridayShift work
$248.5k - $373k
...internal medicine or family medicine physician to join our Utilization Management team. Optum is a clinician-led... ...processes Participates in case review and medical necessity determination... ...fluency *All employees working remotely will be required to adhere to...Remote workMinimum wageFull timeWork experience placementWork at officeLocal areaWork from home$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 processes Participates in case review and medical necessity...Remote workMinimum wageFull timeWork experience placementWork at officeLocal areaWork from home- ...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 jobFull timeContract workFor contractorsFlexible hours
$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 workFull timeRelocation- ...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
- ...Umpqua Health is seeking an Utilization Review Clinician to perform clinical reviews for mental... ...health and substance use services. This remote role may require on-site travel to... ...schedule. The URC collaborates with care management teams to ensure appropriate level of...Remote workFull time
- ...Role: Physician ED Claims Reviewer Duration: 12 months Required skills: Physician... ...coding (CPT/HCPCS) and managed care to conduct clinical review... ...: Experience/knowledge in utilization management is a plus.... ...a fast paced environment. This is a remote position....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
$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- ...Primary Care Physician OpportunityOur client is seeking... ...serving Medicaid and Medicare populations. If you are... ...working with high-utilization patients, this opportunity... ....Skilled in managing patients with multiple... ...multidisciplinary care team.No remote work – this is a fully...Remote workFull time
$204.76k - $292.52k
...primary care providers. We’re rapidly expanding and 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 include advising other physician reviewers and attending...Hourly payFull timeWork at officeLocal area- ...Job Description Job Description Physician Peer Reviewer – Multiple Specialties in Texas and/or... ...Review Organization (IRO) with Health Utilization Management (HUM) accreditation. For the past 30... ...years, if performing external reviews Job Type Contract Work Location Remote...Remote workContract workWork experience placementWork at office
- ...Job Description Job Description Vivo HealthStaff is recruiting for a Utilization Review Physician based in New York for a Managed Care Insurance Plan. This position requires 4 days per month on-site.The Utilization Review Physician is the lead clinician for the health...Remote work
$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 jobHourly payReliefLocal area- ...Description Job Description Remote but must be able to get to... ...1. Conducts on-site/virtual reviews at participating provider offices... ...environment, quality of physicians medical records, and compliance... ...quality improvement and health management. 4. Assists the Quality...Remote work
- ...Founded in 1983, Medical Review Institute of America (MRIoA... ...specializing in technology-driven utilization management and clinical medical review... ...seeking Board-Certified physicians in RADIOLOGY to conduct... .... This is a flexible remote opportunity requiring just...Remote workFull timeContract workFor contractorsFlexible hours
- ...Behavioral Health Utilization Management Coordinator This position is responsible... ...the Medical Director for review. Refer to and work closely... ...with the treating physician or other providers of care.... ...government program contracts (Medicare and Medicaid) and benefits,...Contract workWork at office
$28.29 per hour
...production or helping financial institutions manage high-volume print and digital... ...90 day probation - 3 days onsite 2 days remote The Team Lead position is responsible... ...complex software or hardware problems Utilize appropriate logs and/or tracking software...Remote workHourly payFull timeWork experience placementImmediate startTrial periodMonday to FridayShift workAfternoon shift- ...RN Reviewer (Workers' Compensation Utilization Review) iMPROve Health is seeking an RN Reviewer (Workers' Compensation... ...external medical reviews remotely on an ad hoc basis. As a peer reviewer... ..., utilization review, case management, or occupational health. Working...Remote jobContract workFor contractorsWork at officeHome office
- ...CVS Health is seeking a Registered Nurse for Utilization Management on a work-from-home schedule with weekend coverage. You will assess, plan, implement, coordinate, monitor, and evaluate options to facilitate healthcare services and member benefits. Responsibilities...Remote workWork from home
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