Remote Clinical Reviewer (PT/OT) | Utilization Review
Comagine Health
- Remote job
Comagine Health is seeking remote Clinical Reviewers (Licensed Physical Therapist or Occupational Therapist) to support workers’ compensation therapy reviews, with one full-time opening and one PRN/part-time opening. Reviewers work from an electronic review queue analyzing medical records for medical necessity and apply workers’ compensation guidelines to approve or refer cases. The role requires strong clinical criteria knowledge, documentation of decisions, collaboration with physicians and #J-18808-Ljbffr Comagine Health
$91k - $119k
...an alternative application process. Clinical Reviewer (PT or OT-Licensed) US 4 days ago Requisition... ...of care? Comagine Health is seeking remote Clinical Reviewers (Licensed Physical... ...(Desired Qualifications) 1 year of utilization review, other medical management experience...Remote workPTS cardFull timeContract workPart timeReliefWork from homeShift work- Comagine Health is seeking remote Clinical Reviewers licensed as Physical Therapists or Occupational Therapists in Washington state to support workers' compensation therapy reviews. This full-time role involves evaluating medical records, applying clinical criteria, and...Remote jobPTS cardFull time
- Comagine Health is seeking remote Clinical Reviewers (Licensed Physical Therapist or Occupational Therapist) to support workers' compensation therapy reviews. This is a full-time opening with an additional PRN/part-time role requiring two 4-hour shifts weekly. Reviewers...Remote jobPTS cardFull timePart timeReliefShift work
$88k - $93k
Profile Remote work opportunities are available in the following states: AK, AR, AZ, CO, FL, HI, IA, ID, IL, KS, LA, MD... ...family members are encouraged to apply. Job Summary The Utilization Management Clinical Review nurse reviews and makes decisions about the...Remote workContract workTemporary workInterim roleWork at officeLocal areaShift work- Comagine Health is seeking Clinical Utilization Review Nurses (RN) based in Alabama to assess medical necessity and quality of care through prospective... ...utilization management reviews. This full-time, remote position supports compliant, cost-effective care in line with...Remote jobFull time
$45 - $50 per hour
Greenlife Healthcare Staffing is looking for a dedicated Registered Nurse Clinical Reviewer for a fully remote position in New York. This role involves conducting utilization and quality reviews and contributing to clinical studies. With a competitive pay of $45 - $50...Remote jobHourly pay- Northwestern Medicine is seeking a remote RN Case Manager (PT) to support Utilization Review at Catherine Gratz Griffin Lake Forest Hospital. This role provides staffing coverage with no set schedule and requires availability on weekdays and weekends; shifts are 6a-6p or...Remote jobPTS cardShift workWeekend workWeekday work
- ...Carolina subsidiary, seeks a Medical Reviewer II (RN) to perform medical... ...decisions and supports utilization review across multiple services. The position is remote, full-time, with standard hours... ...associate degree, and 2+ years of clinical RN experience required. #J-18...Remote jobFull time
$26.41 - $51.49 per hour
...support for member services review assessment activities for... ..., align with established clinical guidelines, insurance policies... .... Adheres to applicable utilization management policies and... ...Occupational Therapist (OT), Physical Therapist (PT), Speech-Language Pathologist...Remote jobPTS cardHourly payWork experience placementWork at office- ...related experience. Clinical knowledge and ability to... ...preferred. Knowledge of utilization management processes preferred... ...medical necessity and clinical reviews of authorization requests to... .... Examples include Nursing, PT and OT." "Performs medical...Remote workPTS card
- ...LOCATION: Remote - This is a home based, virtual position that... ...payment audits of DRG coding and clinical documentation. The ideal... ...quality recoverable claims by reviewing medical records and other documentation... ...-10 PCS codes and MS-DRGs. Utilizing evidence-based criteria...Remote workLive inWork from homeMonday to Friday
- ...passionate about using your clinical expertise to support quality... ...services? Do you enjoy critically reviewing clinical documentation,... ...are recruiting for 5 full-time remote/hybrid Clinical Reviewer positions... ...Reviewer position supports utilization management activities by...Remote workFull timeWork from homeMonday to Friday
- ...Behavioral Health Services Reviewer Are you passionate about improving... ...? Do you enjoy using your clinical expertise to evaluate needs,... ...evidence-based criteria to utilization management reviews; document... ...success on this team. This is a remote position based in Oregon and...Remote workFull timeContract workWork from home
- ...Clinical Reviewer Our client, a leading provider of healthcare delivery systems and solutions... ...looking for a Clinical Reviewer for their remote/CA location. Responsibilities: The purpose of this position is to utilize clinical expertise to review medical records...Remote workContract workFlexible hours
$28.37 - $35 per hour
...outcomes through technology, services, and clinical expertise. Our mission is to innovate health... ...Acentra seeks a Clinical Reviewer to join our growing team. Job Summary: The Clinical Reviewer utilizes clinical expertise during beneficiary interaction...Remote workContract workWork at officeLocal areaMonday to FridayFlexible hoursShift workWeekend work- ..., our scalable solutions and clinical expertise help solve programmatic... ...Member. This position is REMOTE within US Only - Equipment... ...West Coast) The Clinical Reviewer supports the WISeR Prior Authorization... ...judgment within regulated utilization management or prior...Remote workWork at officeImmediate startMonday to FridayFlexible hoursAfternoon shift
- ...Clinical Quality Reviewer Ensures compliance with the contract, and program requirements for Clinical Quality Management (CQM) within West... ...records retrospectively for potential quality, safety, and utilization issues by using organizational, national, and URAC standards...Remote workContract workInterim role
- ...Summary Our client is seeking a Clinical Reviewer for the CO SUD project starting in August... ...2026. The role involves conducting a utilization management overread of a percentage of... ...The position is 100% remote and offers flexible hours within a standard...Remote workMinimum wageTemporary workLocal areaMonday to FridayFlexible hours
- ...RN - Utilization Review Excel is seeking highly skilled healthcare professionals for travel assignments across the United States. As a Travel... ...state licensure in [specify relevant states] (e.g., RN, LPN, PT, OT). Minimum [number] years of experience in [specialty]....PTS cardHourly pay
$2,272 per month
...Nursing Profession RN Specialty Utilization Review Job ID 37905527 Job Title RN - Utilization... ...state licensure in [specify relevant states] (e.g., RN, LPN, PT, OT). Minimum [number] years of experience in [specialty]....PTS cardHourly payWeekly payShift work$32 - $33 per hour
...career opportunity is for you. We have an opening for a Clinical Field Reviewer - Remote in Eastern MT We are a team of Registered Nurses... ..., practice cultural humility with each client, and utilize evidence-based practice as a foundation for our interventions...Remote workHourly payPart timeLocal areaWork from homeHome officeFlexible hours$122.91k - $188.02k
...Healthfirst is seeking a Medical Peer Reviewer in the Town of Florida, NY, to consult on medical necessity within utilization management. This vital role involves reviewing authorization requests and ensuring compliance with Healthfirst's regulations. The ideal candidate...$120k - $135k
...medical appropriateness of services by reviewing clinical information and applying evidence-based... ...supervision will be provided. This is a remote-first role that may require travel to... ...based on evidence-based criteria while utilizing clinical acumen Clearly and accurately...Remote workFlexible hours- ...community resources, family and member; coordinating care across the health care continuum while monitoring and managing benefit utilization; and, collaborating with multi-disciplinary health care team members in identifying the educational and discharge needs of members...
- ...Clinical Utilization Review Nurses (RN) Based In Alabama Comagine Health is a national, mission-driven, nonprofit organization that has engaged... ...improve care delivery and patient outcomes. Our talented remote workforce spans the country and plays a vital role in our...Remote workFull timeContract work
$70k - $80k
...Piper Companies is seeking a Remote Clinical Appeals Analyst to provide clinical expertise in reviewing and resolving complex member and provider appeals. Candidates... ...active North Carolina licensure as an RN, LPN, PT, or OT and have significant clinical experience. The...Remote workPTS cardFull timeContract workMonday to Friday$62.7k - $100.4k
...Job Summary: Clinical Care Reviewer II is responsible for processing medical necessity reviews for appropriateness of authorization for... ...clinical care or home health experience preferred Utilization Management/Utilization Review experience preferred Medicaid...Remote workHourly payWork at office$122.91k - $188.02k
Healthfirst is seeking a Medical Peer Reviewer based in Pennsylvania to evaluate medical necessity as part of utilization management. The role requires collaboration with various medical departments and demands flexibility in workload. The hiring range is $122,907 to $1...$122.91k - $188.02k
Healthfirst is seeking a Medical Peer Reviewer to consult on medical necessity in utilization management and ensure compliance with internal and external regulations... ...collaborating with various departments to manage clinical judgements efficiently. The position requires a...- ...Rehabilitation Educator to lead onboarding and training for PTs, OTs, Activities Coordinators, and PCAs at PACE Centers. The role... ...Practice Operations, ensuring consistent onboarding, competency reviews, and workflow optimization. You will collaborate with Practice Operations...Remote jobPTS card
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