Remote Clinical Review Supervisor - Utilization & Quality
Comagine Health
Comagine Health in Oregon is seeking a Supervisor, Clinical CM to provide operational supervision of clinical staff performing utilization reviews and specialty reviews using InterQual criteria. You will mentor reviewers, ensure medical necessity decisions are accurate, and maintain regulatory compliance while coordinating with internal and external stakeholders. This role supports a flexible remote work model with occasional on-site collaboration, based out of Oregon, serving diverse healthcare #J-18808-Ljbffr
- ...Health in Oregon is seeking a Clinical Review Supervisor to lead clinical reviewers and oversee utilization review activities, ensuring... ...You will coach staff, monitor quality, and collaborate with stakeholders... .... The role emphasizes remote management, staff development...Remote work
- ...Medical Director, Concurrent Review, to evaluate hospitalizations... ...nationwide. The role emphasizes using clinical expertise to determine... ...recommendations. This remote position offers a predictable... ...path to expand knowledge in Utilization Review. Ideal candidates hold...Remote work
- ...for overseeing and performing utilization reviews, prior authorizations, and... ...Director will serve as a key clinical expert, ensuring appropriate... ...peer discussions. This is a remote position requiring a "roll... ...protocols. Participate in quality improvement initiatives,...Remote workFull timeFlexible hours
- ...Description Job Description: Clinical Supervisor, UM Denial Compliance... ...Position Type: Hybrid (85% remote, 15% onsite in Burbank, CA)... ...essential in ensuring a high-quality, efficient, and compliant denial... ...managing daily tasks, performance reviews, and disciplinary actions....Remote workPermanent employmentTemporary work
- ...A peer review organization is seeking a full-time remote Utilization Management Physician Reviewer. Ideal candidates must hold... ...and providing guidance on clinical questions. This is a unique opportunity... ...home while contributing to quality medical reviews. #J-18808-...Remote workFull timeWork from home
- ...the underserved community, is currently seeking a driven Clinical Supervisor – Utilization Review to join our mission to provide compassionate services... ...both licensed and unlicensed clinicians, ensuring high-quality care for clients while supporting the professional growth...Local areaImmediate startShift work
- Spectrum Billing Solutions is seeking an ABA Utilization Review Specialist to review clinical information and obtain authorizations for ABA and related services. This role supports remote or office/home hybrid work and emphasizes attention to medical necessity and HIPAA...Remote jobWork at officeWork from home
$100.1k - $150.2k
...currently seeking an experienced Quality Manager - Utilties/Civil with... ...oversight for underground utility construction, including stormwater... ...documentation processes. Review and interpret project... ...for improvement. Serve as a remote-based quality resource with regular...Remote workContract workFor contractorsH1bWork at officeFlexible hours- ...Remote Drug Utilization Review Pharmacist Safe & Cost-Effective Medication Use Work from home analyze medication use patterns, apply clinical guidelines, and collaborate with providers all from home.... ...requirements, and contributing to quality-improvement initiatives and...Remote jobWork from home
$180 per hour
...REMOTE MEDICAL DIRECTOR – UTILIZATION MANAGEMENT & APPEALS $180/hour | W-2 Contract | Monday... ...for a physician who enjoys clinical decision-making, medical necessity review, and appeals oversight without... ...to ensure appropriate, high-quality, and medically necessary...Remote workContract workWork at officeMonday to Friday- Comagine Health is seeking a Clinical Reviewer with LCSW/LPC/LCPC licensure for a remote, Oregon-based role requiring travel... .... The position emphasizes utilization review, documentation, and collaboration... ...stakeholders while supporting quality initiatives. #J-18808-Ljbffr...Remote jobWork from home
- ...Holding Corporation is seeking a Medical Director to lead all utilization management reviews (Pre-service, Post-service, Concurrent Review and Appeals... ...ABMS board certification or eligibility, and 5+ years of clinical experience, with strong communication and team...Remote work
- ...is seeking a Medical Director, Utilization Management to lead clinical utilization reviews for inpatient and post-acute care... ...and evidence-based criteria. Remote opportunity in New Jersey for a... ...responsible for regulatory compliance, quality initiatives, and collaboration...Remote work
$223.8k - $313.1k
...on medical background and reviews health claims. The... ...dedicated to advancing the quality of inpatient care through clinical expertise and thoughtful... ...or those experienced in Utilization Review are encouraged to... ...Travel: While this is a remote position, occasional travel...Remote workFull timeTemporary workApprenticeshipWork at officeLocal areaWork from homeHome officeMonday to FridayWeekend work- ...LLC is seeking a Medical Director, Utilization Management to lead clinical utilization management activities for... ...on inpatient and post-acute reviews to ensure timely, medically necessary... ...to the Chief Medical Officer with remote work, a 6–9 month contract length,...Remote workContract workImmediate start
$248.5k - $373k
...yearJob Area: Medical & Clinical OperationsCompany:... ...physician to join our Utilization Management team. Optum... ...the flexibility to work remotely * from anywhere within... ...processesParticipates in case review and medical necessity... ...quality assurance and education...Remote workMinimum wageFull timeWork experience placementWork at officeLocal areaWork from home$240k - $250k
...Medical Director Utilization Management We are looking... ...medical and surgical clinical areas to deliver on Cohere... ...of services by reviewing clinical information and... ...perspectives. This is a remote-first role that may... ...care to improve the quality of patient outcomes...Remote workFlexible hours- The Bureau of Prisons/Federal Prison System in Grand Prairie, Texas, seeks a Health System Specialist (Medical Designator/Utilization Review Administrator) to oversee medical designation and inmate health management upon entry and during placement in FPS facilities. The...Work at office
- ...Refer a Friend Back Remote Work from Home Share This... ...8:00 AM - 5:00 PM As a Utilization Review Registered Nurse for Johns... ...the opportunity to use your clinical, managed care, utilization... ...partners to drive improved quality and better health outcomes for...Remote workFull timeLocal areaWork from homeMonday to FridayDay shift
- SCAN is seeking an Utilization Management Physician Medical Director to lead medical necessity determinations, prior authorizations, and reviews. This physician will influence policy, provide clinical mentorship, and ensure compliant, evidence-based decision-making while...Remote job
- ...experienced physician leader for a remote Medical Director, Utilization Management (Home Health,... ...serve as the primary clinical authority for home health... ...medical necessity reviews for Medicare Advantage populations... .... Policy & Quality Improvement Contribute...Remote workFull timeContract workPart timeLocal areaWork from home
$269.5k - $425.5k
...Overview Medical Director - Clinical Review / DRG - Remote. Optum is a global organization that delivers... ...Provide consistent high-quality DRG-based clinical reviews within the... ...success in collaboration with hospital utilization management and claims adjudication teams...Remote workMinimum wageFull timeWork experience placementLocal area- CAI is seeking a Medical Director to ensure utilization management is performed per current clinical standards. This full-time, remote role requires leadership in medical reviews, policy adherence, and collaboration with the CMDM team. Responsibilities include case determinations...Remote jobFull time
- ...Technician to support retail pharmacy operations remotely. This role involves processing prescriptions, performing prior authorization reviews, and coordinating care for patients.... ...pharmacy, ideally with experience in utilization review. A strong knowledge of insurance processes...Remote work
- Bickham Services Unlimited LLC is seeking a Medical Director, Utilization Management for a fully remote, 6-9 month contract with an immediate start. The role oversees inpatient and post-acute reviews for Commercial and Medicare Advantage members, ensuring medical necessity...Remote jobContract workImmediate start
- ...Northpoint Recovery Holdings, LLC is seeking a licensed Utilization Review Specialist to ensure clinically appropriate care, discharge planning, and cost-effective utilization across the treatment continuum. You will lead reviews of admissions, stays, discharges, and...Remote work
- ...seeking a Medical Director, Utilization Management for Home Health, Acute and Post-Acute, fully remote and part-time in the United States... ...will lead medical necessity reviews and mentor nursing teams... ...to complex cases, promoting quality outcomes and policy development...Remote jobPart timeLocal area
- ...Medical Director to oversee utilization management, ensuring adherence to current clinical standards in a fully remote, full-time capacity across... ...preferred). You will lead reviews, author clear rationales, and... ...CMDM team to enhance care quality and compliance. #J-18808-...Remote workFull time
- ...Centene Corp. is seeking an Utilization Review Clinician - Behavioral Health to conduct clinical reviews for mental health and substance use services, ensuring appropriate... ...level of care for Oregon Medicaid in a fully remote role. The position follows a Monday–Friday 8–...Remote workMonday to Friday
$200k - $250k
# Medical Director, Utilization ManagementManaged Care & Clinical ProgramsOrlando, FloridaOctober 5, 2026$230,000 -... ...across prior authorization, concurrent review, and appeals, and serves as a... ..., with a combination of onsite and remote days* Monday through Friday, standard...Remote workHourly payFull timeMonday to Friday
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Remote Clinical Review Supervisor - Utilization & Quality. Be the first to apply!
- healthcare facilities manager Brooklyn, NY
- clinical supervisor lmft lcsw Brooklyn, NY
- behavioral health supervisor Brooklyn, NY
- clinical program manager Brooklyn, NY
- lead clinical data manager Brooklyn, NY
- assistant clinical director Brooklyn, NY
- occupational health manager Brooklyn, NY
- director behavioral health Brooklyn, NY
- junior clinical data manager Brooklyn, NY
- clinical manager Brooklyn, NY






