Medical Policy & Reviews Director (Remote)
$191.5k - $355.6kHCSC
- Remote job
A leading health service corporation is seeking a Physician (M.D. or D.O) to handle medical policy responsibilities and perform medical reviews while interacting with provider communities. The ideal candidate must have an unrestricted physician license, board certification, and 5 years of clinical experience. The position is 100% remote, with a competitive compensation package ranging from $191,500 to $355,600 annually, depending on skills and experience. #J-18808-Ljbffr HCSC
$115k - $160k
GFT is seeking a Design Plan Review Lead to join our Construction Management Team in Chicago... ...Benefits: Hybrid (in-person and remote) work environment. Comprehensive benefits... ...leave, and pet insurance, in addition to medical, dental, vision, disability, and life insurance...Remote workMedicalFull timeContract workWork at officeLocal area- ...DOMA Technologies is seeking a Nurse Reviewer to support independent dispute resolutions at... ...State levels. This role involves analyzing medical records, providing quality assurance... ...direct patient care experience. This is a remote position that offers the flexibility of working...Remote workMedicalWork from home
- ...provider in Omaha, Nebraska is seeking a full-time Utilization Review Nurse to ensure effective management of injured workers' treatments... ...transition into a new area. Responsibilities include reviewing medical treatment requests, advocating for injured workers, and...Remote workMedicalFull timeWork at officeWork from home
- ...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 workMedicalFull timeWork from home
- ...Infectious Disease Physician to support the California Department of Managed Healthcare (DMHC) as an Independent Medical Reviewer . This is a flexible, fully remote opportunity ideal for physicians interested in case review work with no patient contact. About the Role...Remote workMedicalFor contractorsFlexible hours
- ...Job Description Maximus Federal is seeking REMOTE 1099 PROVIDERS **Supplemental Income** Maximus Federal is currently seeking medical providers to join our Medical Consultant panel to be an Expert Medical Reviewer. Highlights: ~ Maximus - REMOTE ~...Remote jobMedicalExtra incomeFlexible hours
- ...Job Description Become A 100% Remote Medical Expert Reviewer with Maximus Federal. Join Maximus as an Expert Medical Advisor Maximus is seeking MD/DO professionals to join our team providing expert medical opinions, peer reviews, and expert testimony cases...Remote jobMedical
- ...could negatively affect patient access. Review/analyze complex health policy proposals, including regulatory... ...Benefits) Retirement and Savings Plan; medical/dental/vision; life/disability;... ...shutdowns. Flexible work models (including remote where possible). Application...Remote workMedicalFlexible hours
- A leading healthcare company is seeking a Medical Director to perform clinical reviews and assess medical necessity for inpatient cases. This role offers the chance to collaborate with a team of physicians, making a significant impact on patient care. Requires an MD/DO...Remote workMedicalWork from home
- ...seeking physicians with a minimum of 5 years clinical experience, preferably in Family Medicine, for a peer review role. Responsibilities include reviewing medical records and making standard of care determinations while working from home with a flexible schedule....Remote workMedicalWork from homeFlexible hours
- ...IntePros is seeking a Physician Reviewer to provide remote support for a healthcare organization. The role involves reviewing medical necessity determinations and applying InterQual criteria. Candidates should have an MD or DO, active board certification, and a background...Remote workMedical
$170k - $275k
...accounting. About the Role The Director, Tax Planning plays a... ...diligence and execution, including review of deal structures and... ...seamlessly transitioning between remote work and in‑office operations... ...package that includes medical, dental, vision, retirement savings...Remote workMedicalWork at officeRelocation$78k - $92k
...TalentLNX LLC is seeking a Utilization Review Nurse for a remote position focusing on evaluating medical necessity of inpatient and outpatient services. Ideal for experienced RNs aiming to utilize their clinical expertise without direct patient care. The role involves...Remote workMedical- ...Avosys Technology is hiring a Remote Registered Nurse - Medical Review Specialist in Texas, responsible for performing clinical reviews and ensuring compliance with Medicare regulations. We offer a competitive benefits package along with no weekend and holiday requirements...Remote workMedicalShift work
$45 per hour
...seeking a Clinical Appeals Specialist to handle member-generated appeal processes remotely from California. The role involves reviewing medical records and ensuring compliance with clinical policies. Ideal candidates will have strong managed care and clinical nursing...Remote workMedicalHourly pay$145 per hour
...Maximus is currently seeking a BC Family Practice MD/DO as a Medical Expert Reviewer, supporting the California Department of Managed Health... ...and complete surveys in three phases: Pre-Onsite (Remote): Review plan documents Complete Technical Assistance...Remote workMedicalPart timeFlexible hours$190k - $275k
...portfolio also includes outpatient medical buildings, research centers... ...purposes.About the RoleThe Director, Tax Planning will play a... ...diligence and execution, including review of deal structures and... ...seamlessly transitioning between remote work and in-office...Remote workMedicalWork at officeLocal areaRelocation- ...group in Omaha seeks a full-time Utilization Review Nurse to oversee treatment requests and... ...care. The role involves reviewing medical requests, advocating for injured workers,... ...documentation. The position offers options for remote work, health insurance, and other...Remote workMedicalFull time
- ...Stryker Corporation is seeking a Clinical Claim Review Nurse to perform detailed reviews of claims against medical records. The position offers the flexibility to telecommute within the U.S. and demands strong clinical skills along with a comprehensive understanding of...Remote workMedical
- ...Hospital is seeking a clinical professional for a fully remote role focused on medical management. The position requires an active New York State... ...will coordinate with healthcare providers, conduct clinical reviews, and ensure that members receive the appropriate level of...Remote workMedicalFlexible hours
- A healthcare review company is seeking a Physician Reviewer to work telecommuting. This role utilizes clinical expertise to review insurance... ...evidence-based guidelines. Responsibilities include reviewing medical records, ensuring documentation quality, and maintaining...Remote workMedicalFor contractors
- ...services, is hiring a Physician, Medical Document Review. This pivotal role focuses on reviewing... ...Collaborate with the Medical Director to implement standard policies and procedures that uphold... ...5 days for 1st 6 mos. with 1 day remote post-probationary period. Hours...Remote workMedicalWork at officeFlexible hours
$75.77k - $113.66k
A healthcare company is looking for a Medical Management Nurse to review complex cases and utilize nursing judgment to determine medical necessity. This role offers maximum flexibility with virtual work options and involves collaborating with healthcare providers to ensure...Remote workMedical$33.12 - $56.77 per hour
...Elevance Health is seeking a Nurse Reviewer I who will perform medical necessity reviews for diagnostic imaging services from a virtual setting. Candidates are encouraged to apply remotely, ensuring a flexible work-life arrangement. The role requires a nursing degree and...Remote workMedicalHourly payFlexible hours- ...Centene Corp. is looking for a Clinical Review Nurse - Prior Authorization to work remotely. This position entails analyzing prior authorization requests to determine medical necessity, working with healthcare providers for timely reviews, and maintaining compliance with...Remote workMedicalMonday to Friday
- A leading medical review organization is looking for Board Certified Ophthalmologists to join their team as independent contractors. This telework position allows for flexible scheduling and involves evaluating medical records, providing clinical summaries, and participating...Remote workMedicalFor contractorsFlexible hours
- A leading Independent Review Organization is seeking a Board-Certified Physical Medicine... ...perform Utilization Reviews. This fully remote role offers flexible scheduling and supplemental... .... Responsibilities include reviewing medical records, submitting determinations, and...Remote workMedicalExtra incomeFlexible hours
- ...Registered Nurse (RN) Intern to conduct clinical reviews and support healthcare initiatives. This role is... ...military spouses, providing key training in a remote work setting. Key responsibilities include performing medical necessity reviews, documentation, and quality assurance...Remote workMedicalInternship
- A leading medical service provider is seeking a board-certified neurologist to join their remote physician panel. This role involves conducting independent medical record reviews with flexible hours and no direct patient interaction. Ideal candidates will have strong analytical...Remote workMedicalExtra incomeFlexible hours
$36.27 - $56.77 per hour
...Elevance Health is looking for a Nurse Reviewer I in Walnut Creek, CA, allowing for virtual work full-time with in-person training. Responsibilities include conducting reviews for diagnostic imaging services and collaborating with healthcare providers to ensure quality...Remote workMedicalFull time
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