Remote Utilization Management Physician Reviewer
Oak Street Health, part of CVS Health
- Remote job
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 care. The position requires an MD/DO, 1+ year UM experience with Medicare/Medicaid, and knowledge of CMS/MCG guidelines. Benefits are competitive and focused on quality care. #J-18808-Ljbffr Oak Street Health, part of CVS 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
$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,... ...information and applying evidence-based guidelines. This remote role in the United States offers work from home with...Remote jobWork from home$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... ...Utilization Management. Work Location: This is a remote position, open to candidates who reside in the...Remote workFull timeLocal areaWork from homeHome officeWeekend 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 ensure...Remote jobFull 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 jobFull timeCasual workMonday 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
$230k
...health 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 CST Salary: $230k per year Role Description...Remote workHourly payFull timeLocal areaMonday to Friday- 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
- ...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
$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
- 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
- ...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
$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
$35 - $40 per hour
Sagility LLC, a leader in healthcare transformation, seeks an RN Utilization Management Reviewer for a fully remote role. You will perform timely clinical decision reviews for services requiring prior authorization across various clinical areas, applying criteria like...Remote jobHourly pay- 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
- 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
$35 - $40 per hour
...service offerings for clinical, case management, member engagement, provider... ...across 5 countries. Job title: RN Utilization Management Reviewer Job Description: We are currently hiring... ...May require weekends This is a fully remote work at home role. You must have a secure...Remote workHourly payTemporary workCurrently hiringMonday to FridayFlexible hoursWeekend work- ...and The Power of Every One. Job Title Utilization Management RN Reviewer Location Cleveland Facility Remote Location Department Utilization And... ...appeals process, clinical team interaction, Physician Adviser interaction and special projects....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- ...Medicine) looking for a full-time, remote job in a nonclinical setting? Then... ...! ExamWorks is seeking a physician board-certified in either Family Medicine... ...to join the team full-time as a Utilization Management Physician Reviewer. This position is 100% remote...Remote workFull timeMonday to FridayWeekend 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... ...processes Participates in case review and medical necessity determination...Remote workMinimum wageFull timeWork experience placementWork at officeLocal areaWork from home- Dane Street is expanding its physician panel and inviting independent contractors to participate in a telework model. Reviewers determine medical necessity for treatment requests and appeals, with control over schedule and caseload. You will work as an independent contractor...Remote jobFor contractors
- ...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
- 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
- ...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
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