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 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
...Physician Reviewer - Utilization Management Hi, we're Oscar. We're hiring a Physician Reviewer to join our Utilization Management team. Oscar is... ..., 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$174.07k - $374.92k
...Full-Time Utilization Management Physician Reviewer We're building a world of health around every individual... ...Company: Oak Street Health Location: Remote/ Treehouse Role Description:... ...Utilization Management services to a Medicare and/or Medicaid line of business...Remote workHourly payFull time- 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 jobFull timeWork from home
$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- ChenMed LLC seeks a physician with strong clinical and UM background to cover delegated utilization management across multiple territories. The role requires residency in Internal... ...in hospital medicine, with utilization review experience preferred. You will coordinate with...Remote job
- 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
- ChenMed LLC is seeking a Physician Reviewer to lead delegated utilization management (UM) reviews across multiple markets. You will establish daily case counts, attend essential calls with health plans, advise other reviewers, and participate in ongoing process and quality...Remote job
- ...Dual Occupational Medicine/Pain Management, Dual Internal Medicine/Pain... ...turnaround times. Our reviewers are compensated on a per-case... ...contractor. JOB SUMMARY As a Physician Reviewer/Advisor for Disability Peer Review, you will utilize clinical expertise to review...Remote workFor contractorsMonday to Friday
$204.76k - $292.52k
...Physician Reviewer We're unique. You should be, too. We're changing lives every day. For both our patients and our team members... ...Physician Reviewer is the primary physician reviewer for Utilization Management (UM) cases in our organization. Other duties include advising...Remote workHourly payFull timeWork at officeLocal area- ...Beyond Blue Job Posting Title: Utilization Management Reviewer Requisition Number: R-000002878 Department Name: Supervisor... ...certifications and authorizations. • Coordinates with physicians, care teams, and ancillary staff to support effective...Remote workFull timePart timeReliefInternshipShift work
- ...Orthopedic Spine Surgeon Reviewer Dane Street, a... ...expanding its panel of Physician Reviewers. We are currently... ...Certification to conduct Utilization Reviews. This is a fully remote, non-clinical role offering... ...portal and streamlined case management Full onboarding and...Remote workPrice workExtra incomeFor contractorsFlexible hours
- ...Role Overview Our Utilization Management Reviewers evaluate medical necessity for... ...escalate complex cases requiring physician review or additional... ...compliance with Medicaid and Medicare industry standards... ...Flexible work solutions include remote options, hybrid work...Remote workMonday to FridayFlexible hoursWeekend work
$86k - $117.3k
...roles that are 100% remote or hybrid, you must... ...We offer integrated managed care products, pharmaceutical... ...a supervisor, the Utilization Management Reviewer evaluates medical... ...cases requiring physician review or additional... ...standards, including Medicare, Medicaid, and private...Remote workHourly payContract workMonday to FridayFlexible hoursWeekend work- 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
- ...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
- ChenMed is seeking a Physician Reviewer to lead Utilization Management review across multiple markets. The role requires medical training, IM/FP residency, and pain management certification, with experience in hospital medicine and utilization review preferred. The position...
- ChenMed LLC is seeking a Physician Reviewer to lead Utilization Management (UM) cases across multiple markets. The role includes coordinating with health plans and local teams, attending daily calls, and guiding other physician reviewers in a growing delegated UM program...Local area
- ChenMed is hiring a Physician Reviewer for Utilization Management to oversee delegated UM cases across multiple markets, supporting health plan calls and local teams. You will participate in care coordination and contribute to ongoing quality initiatives within our expanding...Local area
- ChenMed is seeking a Physician Reviewer to lead Utilization Management cases across multiple markets. The role covers delegated UM duties, coordination with health plans, and collaboration with local teams to ensure optimal patient care. A medical degree, active unrestricted...Local area
- ChenMed is seeking a Physician Reviewer to lead Utilization Management reviews for seniors in a rapidly expanding, physician-led organization. Based in Florida, you will support delegated UM cases, participate in health-plan and local calls, and contribute to process and...Local area
- ...and monitoring the utilization of behavioral... ...Medical Director for review. Refer to and... ...closely with Case Management to address member... ...with the treating physician or other providers... ...contracts (Medicare and Medicaid) and... ...opportunity for remote work within all jobs...Remote workContract workWork at office
$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$240k
...Utilization Management Physician (UMP) Remote | Full-Time | Florida Compensation: $240,000 base + bonus Schedule: 40 hours/week Work Model:... ...Utilization Management Physician to perform medical necessity reviews, peer-to-peer discussions, and clinical...Remote workFull timeRelocation$248.5k - $373k
...Medical Director For Utilization ManagementWellMed, part of... ...medicine or family medicine physician to join our Utilization Management team. Optum is a... ...the flexibility to work remotely from anywhere within the... ...processesParticipates in case review and medical necessity...Remote workMinimum wageFull timeWork experience placementWork at officeLocal areaWork from home$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 payPart timeWork from homeHome office- 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
- ChenMed is seeking a Physician Reviewer to lead Utilization Management (UM) reviews across assigned markets and coordinate care for our patients. You will cover delegated UM, attend health plan and local calls, and participate in quality improvement within our growing UM...Local area
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Remote Physician Reviewer Medicare Utilization Management. Be the first to apply!
- doctor work from home United States
- ent physician United States
- physician-med-peds United States
- smile doctors United States
- sound physicians United States
- physician medical doctor United States
- resident doctor United States
- physician-geriatric medicine United States
- doctor of optometry United States
- drug safety physician United States


