Remote Utilization Management Physician Reviewer
$174.07k - $374.92kOak Street Health, part of CVS Health
Oak Street Health, part of CVS Health, is seeking a Full-Time Utilization Management Physician Reviewer to ensure accurate coverage determinations for inpatient and outpatient services. This role requires at least one year of Utilization Management experience in Medicare/Medicaid, a clinical license in the U.S., and effective communication skills. The position supports personalized primary care for older adults, emphasizing on quality care. The typical pay range for this role is between $174,070 and $374,920 annually and includes comprehensive benefits. #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
- ...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...Remote work
- ...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
$211.2k - $277.2k
...Physician Reviewer - Utilization Management You will determine the medical appropriateness of inpatient, outpatient, and pharmacy services by reviewing... ..., 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- ChenMed is looking for a Licensed Physician Reviewer - Ortho for a remote role based in Miami, FL. This position involves conducting Utilization Management reviews and advising other physician reviewers while participating in quality improvement efforts. The ideal candidate...Remote job
- A healthcare organization is seeking a Physician Clinical Reviewer specializing in Dermatology to join their utilization management team. This remote role involves reviewing medical service requests, collaborating with healthcare professionals, and ensuring compliance...Remote work
- ...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
- 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
- ...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
- ...Dane Street, a leading Independent Review Organization (IRO) and national provider of Utilization Review (UR) services, is currently expanding our physician panel. We are seeking Board-Certified... ...medical reviews on a flexible, remote (telework) basis. This is a non...Remote workExtra incomeContract workFor contractorsFlexible hours
- ...Specialty Health System (StarCare) is seeking a full time Utilization Management (UM) Reviewer to join its outstanding Utilization Management team... ...will work in a hybrid work environment (combination of remote and on-site) and must be able to work on-site when job duties...Remote workFull timeWork at officeMonday to Friday
- ...IDD Utilization Management Reviewer Competitive Compensation & Benefits Package! Position eligible for: ~ Annual incentive bonus plan... ...Forgiveness Qualifying Employer Office Location: Remote Option Available; Flexible for any of Partners' NC locations...Remote workWork at officeFlexible hours
$90.87 - $154.33 per hour
A leading healthcare management company is seeking a Physician Clinical Reviewer specialized in Dermatology. This remote position involves reviewing cases and collaborating with physicians to ensure compliance with medical necessity guidelines. Candidates should possess...Remote work$90.87 - $154.33 per hour
A healthcare management company is seeking a remote Physician Clinical Reviewer specializing in Dermatology. This role involves reviewing cases that require clinical expertise, interacting with physicians, and providing clinical rationale for appeals. Candidates must hold...Remote work- ...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
$105 - $115 per hour
...EPITEC is seeking a Physician Reviewer to evaluate clinical service requests and utilize medical expertise for decision-making.... ...involves supporting utilization management processes and participating in... ...offers flexible hours, fully remote work (excluding CA, NY, HI, or...Remote workHourly payFlexible hours$150 - $170 per hour
...CareCentrix is seeking a Part-Time Physician Reviewer to conduct utilization reviews, ensuring medical necessity across various services. This role involves... ...at least 3 years of clinical practice and utilization management experience. The position offers flexible hours, paying...Hourly payPart timeFlexible hoursWeekday work- ...certified “Great Place to Work” company is seeking a Physician to provide utilization review services for the Group Health Department. This role requires... ...background required Experience in Utilization Management with criteria review utilizing standard practice guidelines...
- About Dane Street Dane Street is a leading Independent Review Organization (IRO) and national provider of Utilization Review services. As we continue to expand our physician panel, we’re offering flexible, remote opportunities for board-certified physicians seeking supplemental...Remote workExtra incomeFor contractorsFlexible hours
- Position: Licensed Physician Reviewer - Ortho (remote) - ChenMed, Miami, FL The Physician Reviewer is the primary reviewer for Utilization Management/Clinical Appropriateness cases within our organization. The role requires advising other physician reviewers, attending...Remote jobWork at officeLocal area
- Overview Medical Review Institute of America (MRIoA) is a nationally... ...organization specializing in utilization management and clinical review services.... ...medical determinations. Position Physician Advisor (UM Medical Director) - Full‑time, remote (United States) Role Summary...Remote workFull timeFlexible hoursShift workWeekend work
$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- ...Dane Street, LLC is seeking a remote Physician Reviewer for full-time work from home. The role requires an MD or DO, board-certified in Internal or Family Medicine, to perform utilization reviews, including preauthorization and appeals. Ideal candidates will have prior...Remote workFull timeWork from home
- ...Dane Street is seeking a Physician Reviewer based in Bellevue, WA, allowing for customized scheduling and caseloads. This independent contractor... ...a WA license or be willing to obtain one. The position is remote with some in-person exams starting in Bellevue. Dane Street compensates...Remote workFor contractorsFlexible hours
- ...Overview Dane Street is an Independent Review Organization and a national provider of Utilization Review services. We are expanding our physician panel with opportunities for non-... ...physicians who are board certified in Pain Management with active California licenses and...Remote workExtra incomeContract work
- ...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 workFull time
$331.41k - $373.44k
...Providence Swedish Medical Center is seeking a Physician Advisor to provide leadership in Utilization Management. This fully remote role supports Washington ministries and... ...patient flow. Responsibilities include reviewing cases for medical necessity, leading denial...Remote work$331.41k - $373.44k
...Wapa is seeking a Physician Advisor to provide leadership within Utilization Management. This fully remote position supports Washington ministries, enhancing medical necessity practices and optimizing patient flow through data-driven strategies. Ideal candidates are...Remote work$110k - $203.51k
...scientists, digital innovators, program and construction managers and other professionals delivering projects that... ...**AECOM** is seeking an **Assistant Project Manager - Utility Design Reviewer** to work **remotely** . However, the client is located in Sacramento, CA and...Remote workFor contractorsFor subcontractorLocal areaWorldwideRelocationVisa sponsorshipFlexible hours
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